McFarlane A C, Williams Richard
Department of Psychiatry, Centre for Traumatic Stress Studies, The University of Adelaide, Adelaide SA 5000, Australia.
Depress Res Treat. 2012;2012:970194. doi: 10.1155/2012/970194. Epub 2012 Jul 1.
Disasters test civil administrations' and health services' capacity to act in a flexible but well-coordinated manner because each disaster is unique and poses unusual challenges. The health services required differ markedly according to the nature of the disaster and the geographical spread of those affected. Epidemiology has shown that services need to be equipped to deal with major depressive disorder and grief, not just posttraumatic stress disorder, and not only for victims of the disaster itself but also the emergency service workers. The challenge is for specialist advisers to respect and understand the existing health care and support networks of those affected while also recognizing their limitations. In the initial aftermath of these events, a great deal of effort goes into the development of early support systems but the longer term needs of these populations are often underestimated. These services need to be structured, taking into account the pre-existing psychiatric morbidity within the community. Disasters are an opportunity for improving services for patients with posttraumatic psychopathology in general but can later be utilized for improving services for victims of more common traumas in modern society, such as accidents and interpersonal violence.
灾难考验着民政部门和卫生服务部门以灵活但协调良好的方式采取行动的能力，因为每场灾难都是独特的，会带来不同寻常的挑战。根据灾难的性质和受灾人群的地理分布，所需的卫生服务差异显著。流行病学表明，卫生服务不仅要配备应对创伤后应激障碍的能力，还要应对重度抑郁症和悲伤情绪，不仅要为灾难的受害者提供服务，还要为应急服务人员提供服务。挑战在于，专业顾问既要尊重和理解受灾人群现有的医疗保健和支持网络，又要认识到其局限性。在这些事件刚发生后的初期，大量精力投入到早期支持系统的建立中，但这些人群的长期需求往往被低估。这些服务的构建需要考虑到社区内已有的精神疾病发病率。灾难总体上是改善创伤后精神病理学患者服务的契机，之后还可用于改善现代社会中更常见创伤受害者的服务，如事故和人际暴力的受害者。
