Tsao Jennie C I, Dobalian Aram, Wiens Brenda A, Gylys Julius A, Evans Garret D
Pediatric Pain Program, Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA.
J Rural Health. 2006 Winter;22(1):78-82. doi: 10.1111/j.1748-0361.2006.00006.x.
Recent bioterrorism attacks have highlighted the critical need for health care organizations to prepare for future threats. Yet, relatively little attention has been paid to the mental health needs of rural communities in the wake of such events. A critical aspect of bioterrorism is emphasis on generating fear and uncertainty, thereby contributing to increased needs for mental health care, particularly for posttraumatic stress disorder, which has been estimated to occur in 28% of terrorism survivors.
Prior experience with natural disasters suggests that first responders typically focus on immediate medical trauma or injury, leaving rural communities to struggle with the burden of unmet mental health needs both in the immediate aftermath and over the longer term. The purpose of the present article is to draw attention to the greater need to educate rural primary care providers who will be the frontline providers of mental health services following bioterrorism, given the limited availability of tertiary mental health care in rural communities.
We reviewed the literature related to bioterrorism events and mental health with an emphasis on rural communities.
Public health agencies should work with rural primary care providers and mental health professionals to develop educational interventions focused on posttraumatic stress disorder and other mental disorders, as well as algorithms for assessment, referral, and treatment of post-event psychological disorders and somatic complaints to ensure the availability, continuity, and delivery of quality mental health care for rural residents following bioterrorism and other public health emergencies.
近期的生物恐怖袭击凸显了医疗保健机构为应对未来威胁做好准备的迫切需求。然而，此类事件发生后，农村社区的心理健康需求相对较少受到关注。生物恐怖主义的一个关键方面是强调制造恐惧和不确定性，从而导致心理健康护理需求增加，尤其是创伤后应激障碍，据估计，28%的恐怖主义幸存者会出现这种情况。
以往应对自然灾害的经验表明，急救人员通常专注于即时的医疗创伤或伤害，使得农村社区在事件刚发生后以及长期内都要应对未得到满足的心理健康需求的负担。鉴于农村社区三级心理健康护理的可及性有限，本文的目的是提请人们更加关注对农村初级保健提供者进行教育的必要性，这些提供者将是生物恐怖主义事件后心理健康服务的一线提供者。
我们回顾了与生物恐怖主义事件和心理健康相关的文献，重点关注农村社区。
公共卫生机构应与农村初级保健提供者和心理健康专业人员合作，制定侧重于创伤后应激障碍和其他精神障碍的教育干预措施，以及针对事件后心理障碍和躯体不适的评估、转诊和治疗算法，以确保生物恐怖主义和其他公共卫生紧急事件后农村居民能够获得、持续接受并得到高质量的心理健康护理。
