Abstract
Disasters, whether they are natural or man-made, add considerably to the burden of physical and mental disease. It is only recently that disaster psychiatry has become a sub-specialty of psychiatry. As clinicians, what role can we play in this, and do we really need yet another specialty? The skills needed to manage individuals and families who have been affected by disorders are necessary to manage the immediate and long-term aftermath of disasters. Cultural and social context and responses need to be taken into account when managing disasters. The Committee on Disasters and Terrorism and the Group on the Advancement of Psychiatry of the American Psychiatric Association have come together to produce this multi-authored edited volume. The volume has 21 chapters and two appendices, with chapters broadly divided into four sections: Readiness, Evaluation, Intervention and Emerging and other topics. The appendices provide a key reading list and answers to the questions that are asked at the end of each chapter to review the learning. Each chapter is also provided with teaching points, which readers may find helpful. Part I on Readiness consists of four chapters, including preparation, communicating risk and needs assessment. It is inevitable that the context is largely American, as are the authors. Integrating response is critical. Involved in the post-Asian tsunami disaster, we found that the response from Thailand was the best organized, as there already existed a trained cadre of volunteers who were brought in rapidly with a clear ratcheting up of services according to needs. Planning and preparedness are key to managing disasters. The second part of the book covers evaluation – psychiatric, special populations and psychiatric conditions of serious mental illness, substance abuse and personality issues along with medical complaints and grief and resilience. Resilience needs better understanding at a number of levels – whether cultures and communities are able to manage in spite of loss and trauma, and what individuals do to manage. Cultures that are collectivist may fare better under these circumstances. The third part of the book covers interventions, such as psychological first aid, group and family interventions, psychotherapies and psychopharmacology and interventions for children and older adults. It would have been helpful to include something on gender and vulnerable groups in the volume as well. The last section covers telepsychiatry, ethics and the role of psychiatrists as ambassadors. This book provides a useful addition to the field, and clinicians will find both the theoretical background and practical advice helpful.