Is there a link between natural disasters and mental health? Experts decode

“Natural disasters are traumatic life events, and hence, extremely overwhelming,” said Tanushri Baikar Talekar, clinical psychologist, Masina Hospital. “These are on a large-scale, and often unexpected,” she added.

Exploring this nature of such disasters, a June 2022 study by the University of California, Irvine focused on indirect, direct, and media-based exposure to hurricanes Irma and Michael, which hit the United States in 2017 and 2018 respectively. It found that symptoms of post-traumatic stress (PTSD), depression, and anxiety were identified, along with general ongoing fear and worry in the study population. It further indicated a link between natural disasters and adverse psychological issues, raising concerns about the impact of climatic events on mental health.

“Most people will recover and display resilience over time. However, as climate-related catastrophic hurricanes and other natural disasters such as wildfires and heat waves escalate, this natural healing process may be disrupted by repeated threat exposure,” noted Dana Rose Garfin of the University of California, Irvine, and the first author of the study.

As such, in the wake of the recent natural disasters like floods (in Assam, more than 45 lakh people affected), earthquakes (in Afghanistan, more than 1,000 people dead), cyclones (in Sunderbans and surrounding areas), heatwaves in Iran, Spain and parts of the United States, experts elucidate the link between natural calamities and mental health, and what must be done.

Heatwaves have been prevailing across regions (Express Photo by Praveen Khanna)

According to National Center for Biotechnology Information (NCBI)’s 2011 review titled Disasters and their consequences for public health, “disasters directly impact the health of the population resulting in physical trauma, acute disease, and emotional trauma. In addition, disasters may increase the morbidity and mortality associated with chronic disease and infectious disease through the impact on the health care system”.

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Notably, National Disaster Management Authority (NDMA) states that since “disasters do not affect uniformly” with their effect differing from person-to-person and region-to-region, even under normal circumstances, vulnerable groups due to their physical, emotional, and social limitations do not get adequate help and support and are “prone to both physical and psychological difficulties”.

The loss of resources, loss of daily routine, lack of control over one’s own possessions and loss of social support were associated with elevated levels of acute psychological distress, a 2019-review of literature from NCBI noted.

Why are natural disasters a matter of concern?

Research from NCBI also indicates mental health issues, in general, have been considered as a neglected subject especially in India in view of the stigma attached. Mental health issues caused by disasters are even more neglected, it states. Thus, in order to fill this gap, there is a need to understand more about disasters and mental health. Agreed Dr Dipti Reddy Nallu MD, psychiatry, Citizens Specialty Hospital and said, “Loss of social and economic resources are acknowledged by the disaster survivors and the community but recognising psychological suffering is usually stigmatised or neglected by most.”

In psychological terms, such calamities can affect people in the short-term and the long-term (representative) (Source: Pixabay)

According to a 2020 book Public Health and Disasters: Health Emergency and Disaster Risk Management in Asia, the 1999 Odisha super cyclone, which impacted more than 10,000 people, triggered several studies on mental health vulnerability (Kar et al., 2004) and PTSD (Sharan et al., 1996, Kar et al., 2007). The Indian Ocean Tsunami (2004) that killed 10,000 people in India and rendered several homeless brought forth further research on mental health and psychosocial care for adults (Becker, 2007, Sharan et al., 1996) and women (Becker, 2009) survivors of the disaster.

The magnitude of psychological trauma and subsequent experiences due to disasters like earthquakes and tsunamis may be severe for a majority of the people, mentions National Disaster Management Guidelines’ Psycho-Social Support and Mental Health Services in Disasters. “The greater the trauma, the more severe is the psychological distress and social disability,” it states.

Not just that, NCBI also notes how various studies have explained, for instance, the physical and psychological health effects of a flood. During and after floods, people suffering from physical health effects like cold, cough, flu, sore throat, or throat infections and headaches, skin rashes, gastrointestinal illness, chest illness, high blood pressure, asthma also experience psychological stress, it notes.

In situations where support systems get compromised as well, the impact can be more long-lasting and devastating, said psychologist Kamna Chhibber. “People are known to develop mental health-related illnesses such as anxiety, depression, PTSD, insomnia, to name a few on account of exposure to such events,” Chhibber told indianexpress.com.

In psychological terms, such calamities can affect people in the short-term and the long-term. Agreeing with Chhibber, Talekar explained that the psychological toll can “linger on for years”. “The survivors go through intense emotions such as shock, pain, confusion, and disbelief,” added Talekar.

A file photo from Mizoram (Express Archives)

It can also precipitate as substance dependency, and adjustment problems which affects the proper functioning of the individual as well as the community resulting in family conflicts, as per NCBI.

What can be done?

First would always be medical aid at the earliest and providing realistic solutions to cope. “These would be practical things which relate to where people need to go, access to medical services, food, shelter, etc. The availability of information is crucial to ensuring that panic does not set in and people feel they are being led in a calm, collected manner that would ensure their safety and security,” explained Chhibber.

According to NDMA, India’s mental health response during disasters has “evolved from identifying and treating individual psychiatric cases to strengthening the coping abilities of survivors in a community (Kishore Kumar et al., 2000)“. The National Mental Health Programme (NMHP) includes strategies for Psychosocial Care and Mental Health Services in disasters (PSMHS). Acceptance of psychological impact of a natural disaster is the first step towards coping strategies, asserted Dr Reddy Nallu.

NDMA’s guidelines also aim at improved coping capacities of disaster struck communities by offering appropriate support to rebuild their lives. The service networks consists of psychiatric units of tertiary healthcare facilities, and educational institutions, clinical psychologists, social workers, NGOs, paramedical professionals, community level workers, and volunteers.

Chhibber said providing “real-time practical solutions to the problems being faced can help build hopefulness and resilience and support coping”.

“Reassurance through the presence of supportive others can go a long way in helping individuals. Continuing to encourage individuals to discuss their experiences is an imperative that allows them to be able share, express and gain perspective as well,” she said.

Psychiatrist Dr Samir Parekh concurred. He said rather than bottling up feelings, it can help when one tries to share experiences with people whom may have the same or similar experience. “Individual, group counselling, or/and medications along with gradual social interactions can help deal with traumatic events,” he explained.

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