title: Epidemiological surveillance linked to an outreach psychological support program after the Xynthia storm in Charente-Maritime, France, 2010.
abstract: BACKGROUND
  Following the Xynthia storm of February 2010 in France, an outreach program was initiated by the regional health authorities during the post-emergency phase to improve access to mental health care for the population exposed to the floods. The program was designed to complement routine health and social care services. It relied on a special telephone service and outreach consultations located in the town halls of the five most affected cities. The objective of this outreach service was to provide initial psychological counseling free of charge and without appointment. Another objective was to refer persons for appropriate treatment and follow-up by routine health care services. A surveillance program was developed to monitor the use of mental health services by first-time users, describe outreach service users with psychological manifestations, and provide timely information to decision makers.
  
  
  METHODS
  Health providers working in affected towns were asked to complete an individual record sheet for each person who displayed psychological manifestations directly or indirectly linked with the storm on their first visit, and to send it to the regional health office. Participation was voluntary. Data analysis was performed monthly during the six-month surveillance period.
  
  
  RESULTS
  Only mental health providers participated in the surveillance. A total of 227 individual files were sent from April 7 through September 19, 2010. New cases were mainly female adults, and one fifth had a past history of psychiatric illness. Depressive signs and anxiety were the most commonly reported symptoms, followed by signs of post-traumatic stress disorder. A total of five feedback reports were produced for surveillance participants (informants) and authorities.
  
  
  CONCLUSIONS
  With initiation in the post-emergency phase of a disaster and timely regular feedback, the surveillance program enabled the authors to describe the occurrence of psychological distress, monitor mental health service use by first-time users, and provide guidance to health authorities. This research showed the advantages of integrating epidemiology in the development of strategy for mental health and psychosocial support in the aftermath of natural catastrophes.
authors.affiliation: French Institute for Public Health Surveillance (InVS), Poitiers Regional Office, Poitiers, France. marie-eve.raguenaud@ars.sante.fr
authors.forename: Marie-Eve
authors.initials: ME
authors.lastname: Raguenaud
authors.forename: Philippe
authors.initials: P
authors.lastname: Germonneau
authors.forename: Jackie
authors.initials: J
authors.lastname: Leseigneur
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Chavagnat
authors.forename: Yvon
authors.initials: Y
authors.lastname: Motreff
authors.forename: Martine
authors.initials: M
authors.lastname: Vivier-Darrigol
authors.forename: Philippe
authors.initials: P
authors.lastname: Pirard
mesh_terms: D000328:Adult; D003156:Community Mental Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data / Q000639:trends; D003159:Community-Institutional Relations; D004190:Disasters; D005260:Female; D055868:Floods; D005602:France; D006801:Humans; D008297:Male; D062486:Public Health Surveillance / Q000379:methods; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000628:therapy*