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Research-based Principles May Help Improve Mental Health Recovery Following Mass Trauma

Science Update

Experts on trauma-related research and medical practices from around the world recently identified five principles to guide mental health care efforts immediately or shortly after a mass trauma, such as a natural disaster or terrorist attack. In a related commentary, NIMH scientist Farris Tuma, Sc.D., MHS, discusses how these principles may help determine effective mental health care for large numbers of people following an emergency, and how best to deliver it. The article and commentary were published in the Winter 2007 issue of Psychiatry: Interpersonal and Biological Processes.

Treatments for mass trauma survivors are difficult to study using traditional research methods, such as randomized clinical trials. As a result, there has been a general lack of research-based evidence to help communities and agencies plan for mental health care following a disastrous event. In fact, recent studies show that some current treatments that are commonly used after mass traumas, such as psychological debriefing, may not be helpful in reducing distress or the risk for post-traumatic stress disorder (PTSD) and other long-term, trauma-related illnesses. In some cases, these treatments may actually increase distress and risk.

To help address these issues, Stevan E. Hobfoll, Ph.D., of Kent State University and Summa Health System, and colleagues called together researchers and clinicians from around the world with expertise in a broad range of areas, including trends and practices in response to disaster, terrorism, or war, the study and treatment of trauma survivors, and other related fields. The panel reviewed existing research, and then determined five key principles of effective mass trauma mental health care, which involve promoting

  • a sense of safety
  • calm
  • a sense of being able to solve problems for oneself or as part of a group (such as family or any school, religious or community group that the person can identify with)
  • connectedness to social support, and
  • hope.

The article defines these five aspects, describes how they are disrupted after a mass trauma, examines types of existing mental health interventions that may be useful, and also provides examples of actions by individuals, the community, and the media that may help or hinder recovery and resilience among survivors. In addition, the authors discuss how different types of trauma, location, and culture may require different mass trauma responses. Nevertheless, the five principles and associated methods of intervention and helpful personal, community, and media actions may be useful to those who set emergency policies and design intervention strategies to develop plans that are sensitive and responsive to mental health outcomes following a mass trauma.

Hobfoll SE, Watson P, Bell CC, Bryant RA, Brymer MJ, Friedman MH, Friedman M, Gersons BPR, de Jong JTVM, Layne CM, Maguen S, Neria, Y, Norwood AE, Pynoos RS, Reissman D, Ruzek JI, Shalev AY, Solomon Z, Steinberg AM, Ursano RJ. Five Essential Elements of Immediate and Mid-Term Mass Trauma Interventions: Empirical Evidence . Psychiatry: Interpers Biol Processes. 2007 Winter;70(4):283-315.