Dorji Chencho
Department of Psychiatry, JDW National Referral Hospital, Thimphu, Bhutan.
Int Rev Psychiatry. 2006 Dec;18(6):537-46. doi: 10.1080/09540260601037979.
Bhutan has taken the initiative in developing a comprehensive guideline on disaster risk preparedness and management in response to several minor disasters, namely earthquakes and flash floods in the country during the last couple of years. It is now widely accepted that the psychological symptoms of trauma resulting from devastation to lives and livelihood of affected people remain much longer and sometimes throughout their entire life span unless taken care of. Therefore, it is important to include psychosocial components of mental health protection and treatment of the affected persons in disaster risk preparedness and management to make it a comprehensive package. A four-tier system of mental health intervention and counselling has been proposed in line with the existing healthcare system and resources available in the country to make it sustainable. At the core of this programme is the mobilizing and training of volunteers from the community on psychosocial intervention, counselling and rehabilitation, backed up by three layers of trained health workers and mental health professionals.
不丹在应对过去几年国内发生的几次小灾害(即地震和山洪暴发)时,率先制定了关于灾害风险防范与管理的全面指南。现在人们普遍认识到,除非得到妥善处理,否则受灾民众生命和生计遭受破坏所导致的创伤心理症状会持续更长时间,有时甚至贯穿其整个生命周期。因此,在灾害风险防范与管理中纳入受影响人群心理健康保护和治疗的社会心理组成部分,使其成为一个全面的方案非常重要。为使其具有可持续性,已根据该国现有的医疗保健系统和可用资源,提出了一个四级心理健康干预和咨询系统。该方案的核心是动员和培训社区志愿者进行社会心理干预、咨询和康复工作,并有三层经过培训的卫生工作者和心理健康专业人员提供支持。