title: Psychiatric and medical disorders in the after math of the uttarakhand disaster: assessment, approach, and future challenges.
abstract: OBJECTIVE
  To present the descriptive data on the frequency of medical and psychiatric morbidity and also to discuss various pertinent issues relevant to the disaster management, the future challenges and psychosocial needs of the 2013 floods in Uttarakhand, India.
  
  
  METHODS
  Observation was undertaken by the disaster management team of National Institute of Mental Health and Neurosciences in the worst affected four districts of Uttarakhand. Qualified psychiatrists diagnosed the patients using the International Classification of Diseases-10 criteria. Data were collected by direct observation, interview of the survivors, group sessions, individual key-informant interview, individual session, and group interventions.
  
  
  RESULTS
  Patients with physical health problems formed the majority of treatment seekers (39.6%) in this report. Only about 2% had disaster induced psychiatric diagnoses. As was expected, minor mental disorders in the form of depressive disorders and anxiety disorders formed majority of the psychiatric morbidity. Substance use disorders appear to be very highly prevalent in the community; however, we were not able to assess the morbidity systematically.
  
  
  CONCLUSIONS
  The mental health infrastructure and manpower is abysmally inadequate. There is an urgent need to implement the National Mental Health Program to increase the mental health infrastructure and services in the four major disaster-affected districts.
authors.affiliation: Department of Psychiatry, Hosur Raod, Bengaluru, Karnataka, India.
authors.forename: Naveen Kumar
authors.initials: NK
authors.lastname: Channaveerachari
authors.affiliation: Department of Psychiatry, Hosur Raod, Bengaluru, Karnataka, India.
authors.forename: Aneel
authors.initials: A
authors.lastname: Raj
authors.affiliation: Department of Psychiatry, Hosur Raod, Bengaluru, Karnataka, India.
authors.forename: Suvarna
authors.initials: S
authors.lastname: Joshi
authors.affiliation: Department of Psychiatry, Hosur Raod, Bengaluru, Karnataka, India.
authors.forename: Prajna
authors.initials: P
authors.lastname: Paramita
authors.affiliation: Department of Psychiatry, Hosur Raod, Bengaluru, Karnataka, India.
authors.forename: Revathi
authors.initials: R
authors.lastname: Somanathan
authors.affiliation: Department of Psychiatry, Hosur Raod, Bengaluru, Karnataka, India.
authors.forename: Dhanya
authors.initials: D
authors.lastname: Chandran
authors.affiliation: Department of Psychiatry, Hosur Raod, Bengaluru, Karnataka, India.
authors.forename: Sekar
authors.initials: S
authors.lastname: Kasi
authors.affiliation: Department of Psychiatry, Hosur Raod, Bengaluru, Karnataka, India.
authors.forename: N Roopesh
authors.initials: NR
authors.lastname: Bangalore
authors.affiliation: National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Raod, Bengaluru, Karnataka, India.
authors.forename: Suresh Bada
authors.initials: SB
authors.lastname: Math
keywords: Disaster; Uttarakhand; psychiatric morbidity