Tasdik Hasan M, Adhikary Gourab, Mahmood Sultan, Papri Nowshin, Shihab Hasan M, Kasujja Rosco, Ahmed Helal Uddin, Azad Abul Kalam, Nasreen Mahbuba
1Department of Psychological Sciences, University of Liverpool, Liverpool, UK.
2Institute of Disaster Management & Vulnerability Studies, University of Dhaka, Dhaka, Bangladesh.
Int J Ment Health Syst. 2020 Mar 5;14:12. doi: 10.1186/s13033-020-00351-0. eCollection 2020.
Bangladesh, one of the most densely populated countries in the world has been ranked 9th on the Climate Risk Index for 2017: the 10 most affected countries & 7th on the Long-Term Climate Risk Index: the 10 countries most affected from 1998 to 2017. Every year it is afflicted with various climatic disasters including floods, hurricanes and cyclones. Apart from the obvious devastation of lives and property, there is a huge increase in clinical diseases when these disasters occur. Mental health of affected persons after these disasters is a topic that is often neglected by local and national level.
A qualitative case study was conducted on perceived need on mental health support & availability of such services in a cyclone affected area in rural Bangladesh. Ten (10) key informant interviews (KIIs) with different stakeholders and ten (10) in-depth interviews (IDIs) with affected people were taken.
We found that cyclones had numerous psychosocial impacts on the population including acute stress disorder, sleep disorder, post-traumatic stress disorders (PTSDs), generalized anxiety disorders, suicidal ideation and depression. The survivors had specific needs for receiving support. Children, elderly and women were perceived to be more vulnerable. The government and NGOs had no specific action plans and initiatives to address these issues and support the mental health of affected population. There was a visible gap in finding effective ways to provide affected people with the required mental health & psycho-social services (MHPSS).
Resilient, responsive and self-sustaining health systems for this vulnerable population are required. Implementation of effective mental health programs and strong mental health policies remain a challenge in Bangladesh where there is a cultural fatalistic acceptance of mental health issues.
孟加拉国是世界上人口最密集的国家之一，在2017年气候风险指数排名中位列第9（受影响最严重的10个国家），在长期气候风险指数排名中位列第7（1998年至2017年受影响最严重的10个国家）。该国每年都遭受各种气候灾害，包括洪水、飓风和旋风。除了对生命和财产造成明显破坏外，这些灾害发生时临床疾病也大幅增加。灾害后受影响人群的心理健康是地方和国家层面经常忽视的一个话题。
在孟加拉国农村一个受旋风影响的地区，针对心理健康支持的感知需求及此类服务的可获得性进行了一项定性案例研究。对不同利益相关者进行了10次关键 informant 访谈（KIIs），并对受影响人群进行了10次深入访谈（IDIs）。
我们发现旋风对民众产生了众多心理社会影响，包括急性应激障碍、睡眠障碍、创伤后应激障碍（PTSD）、广泛性焦虑障碍、自杀意念和抑郁症。幸存者有接受支持的特定需求。儿童、老年人和妇女被认为更易受伤害。政府和非政府组织没有具体的行动计划和举措来解决这些问题并支持受影响人群的心理健康。在找到为受影响人群提供所需心理健康和心理社会服务（MHPSS）的有效方法方面存在明显差距。
需要为这一弱势群体建立有韧性、有响应能力且自我维持的卫生系统。在孟加拉国，实施有效的心理健康项目和强有力的心理健康政策仍然是一项挑战，因为该国在文化上对心理健康问题持宿命论态度。
