Prevention of the Consequences of Man-Made or Natural Disaster at the (Inter)National, the Community, the Family and the Individual Level

Abstract

It is possible by definition to prevent a posttraumatic stress syndrome by eliminating the traumatic event or by reducing its consequences. However, the psychotraumatic sequelae of a man-made or natural disaster often affect so many people that they cannot be addressed with current models of clinical psychology and psychiatry. These models are often based on dyadic curative care such as crisis intervention or brief psychotherapy, sometimes complemented with a systemic approach. Instead it is necessary to resort to a public mental health approach based on community action in order to deal with the enormous size of the problems in a number of war and postwar situations, or after natural disasters. The mere figures make this public mental health approach necessary. In the Nineties the number of refugees and displaced persons alone is estimated at 18 million refugees covered by the 1951 UN Convention relating to the status of refugees and there are twice that number of internally displaced persons (De Jong et al. 1994). Most mental health professionals have limited training or experience working at the broader community, national, or international levels, although war, political repression, human rights violations and natural disasters have direct mental health consequences that can eventually come to the attention of mental health professionals (Punamäki, 1989; Westennyer, 1987; Williams & Berry, 1991).