Not forgetting severe mental disorders in humanitarian emergencies: a descriptive study from the Philippines.
Severe mental disorders are often neglected following a disaster. Based on Médecins Sans Frontières' (MSF) experience of providing mental health (MH) care after the 2013 typhoon in the Philippines, we describe the monthly volume of MH activities and beneficiaries; characteristics of people seeking MH care; profile and outcomes of people with severe mental disorders; prescription of psychotropic medication; and factors facilitating the identification and management of individuals with severe mental disorders.



A retrospective review of programme data was carried out.



In total, 172 persons sought MH care. Numbers peaked three months into MSF's intervention and decreased thereafter. Of 134 (78%) people with complete data, 37 (28%) had a severe mental disorder, often characterised by psychotic symptoms (n=24, 64%) and usually unrelated to the typhoon (n=32, 86%). Four people (11%) were discharged after successful treatment, two (5%) moved out of the area, 20 (54%) were referred for follow-up on cessation of MSF activities and 10 (27%) were lost-to-follow-up. Psychotropic treatment was prescribed for 33 (75%) people with mental disorders and for 11 with non-severe mental disorders.



This study illustrates how actors can play an important role in providing MH care for people with severe mental disorders in the aftermath of a disaster.
Operational Centre Brussels, Médecins Sans Frontières, Brussels, Belgium Universidade de Sao Paulo, Psychology, Av Prof Mello Moraes, 1721 São Paulo, SP 05508-030, Brazil cicimoraes@yahoo.com.br.
Ana Cecilia Andrade de Moraes
AC
Weintraub
Operational Centre Brussels, Médecins Sans Frontières, Brussels, Belgium.
Mariana Gaspar
MG
Garcia
Operational Centre Brussels, Médecins Sans Frontières, Brussels, Belgium.
Elisa
E
Birri
Operational Centre Brussels, Médecins Sans Frontières, Brussels, Belgium.
Nathalie
N
Severy
Operational Centre Brussels, Médecins Sans Frontières, Brussels, Belgium.
Marie-Christine
MC
Ferir
Medical department, Operational Research Unit, Médecins Sans Frontières, Operational Centre Brussels, MSF-Luxembourg, Luxembourg.
Engy
E
Ali
Medical department, Operational Research Unit, Médecins Sans Frontières, Operational Centre Brussels, MSF-Luxembourg, Luxembourg.
Katie
K
Tayler-Smith
Office of the WHO Representative in the Philippines, Manilla, Philippines.
Dinah Palmera
DP
Nadera
Department of Mental Health, World Health Organization, Geneva, Switzerland.
Mark
M
Van Ommeren
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000533:Altruism; D002648:Child; D002675:Child, Preschool; D055867:Cyclonic Storms; D004190:Disasters; D004632:Emergency Medical Services / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000628:therapy*; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D009937:Organizational Objectives; D010679:Philippines; D012189:Retrospective Studies; D055815:Young Adult
Crisis intervention; Disasters; Mental disorders; Mental health services; Philippines; Psychotic disorders