Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-10T07:05:46.281Z Has data issue: false hasContentIssue false

Rapid Triage of Mental Health Risk in Emergency Medical Workers: Findings From Typhoon Haiyan

Published online by Cambridge University Press:  14 September 2017

Lauren Sylwanowicz
Affiliation:
Department of Emergency Medicine, University of California Irvine Health, Orange, California
Merritt Schreiber*
Affiliation:
Department of Pediatrics, LA BioMedical Research Institute, David Geffen School of Medicine at UCLA, Harbor-UCLA Medical Center, Los Angeles, California
Craig Anderson
Affiliation:
Department of Emergency Medicine, University of California Irvine Health, Orange, California
Carlos Primero D. Gundran
Affiliation:
National Institutes of Health, University of Philippines, Manila, Philippines
Emelie Santamaria
Affiliation:
National Institutes of Health, University of Philippines, Manila, Philippines
Jaifred Christian F. Lopez
Affiliation:
National Institutes of Health, University of Philippines, Manila, Philippines
*
Correspondence and reprint requests to Merritt D. Schreiber, PhD, Professor of Clinical Pediatrics, LA BioMedical Research Institute, Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA (e-mail: m.schreiber@ucla.edu).

Abstract

Objective

To determine the ability of a novel responder mental health self-triage system to predict post-traumatic stress disorder (PTSD) in emergency medical responders after a disaster.

Methods

Participants in this study responded to Typhoon Haiyan, which struck the Philippines in November 2013. They completed the Psychological Simple Triage and Rapid Treatment (PsySTART) responder triage tool, the PTSD Checklist (PCL-5) and the Patient Health Questionnaire-8 (PHQ-8) shortly after responding to this disaster. The relationships between these 3 tools were compared to determine the association between different risk exposures while providing disaster medical care and subsequent levels of PTSD or depression.

Results

The total number of PsySTART responder risk factors was closely related to PCL-5 scores ≥38, the threshold for clinical PTSD. Several of the PsySTART risk factors were predictive of clinical levels of PTSD as measured by the PCL-5 in this sample of deployed emergency medical responders.

Conclusions

The presence of a critical number and type of PsySTART responder self-triage risk factors predicted clinical levels of PTSD and subclinical depression in this sample of emergency medical workers. The ability to identify these disorders early can help categorize an at-risk subset for further timely “stepped care” interventions with the goals of both mitigating the long-term consequences and maximizing the return to resilience. (Disaster Med Public Health Preparedness. 2018;12:19–22)

Type
Brief Reports
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Goldmann, E, Galea, S. Mental health consequences of disasters. Annu Rev Public Health. 2014;35:169-183.CrossRefGoogle ScholarPubMed
2. Berninger, A, Webber, MP, Cohen, HW, et al. Trends of elevated PTSD risk in firefighters exposed to the World Trade Center disaster: 2001-2005. Public Health Rep. 2010;125(4):556-566.CrossRefGoogle Scholar
3. Guo, YJ, Chen, CH, Lu, ML, et al. Posttraumatic stress disorder among professional and non-professional rescuers involved in an earthquake in Taiwan. Psychiatry Res. 2004;127:35-41.Google Scholar
4. Schreiber, M, Pithia, N, Kusel, E, et al. Integrating responder behavioral health self triage into the urban shield 2013 full scale disaster exercise and learning program. Disaster Med Public Health Preparedness. 2014;8:579.Google Scholar
5. Shalev, AY, Ankri, Y, Israeli-Shalev, Y, et al. Prevention of posttraumatic stress disorder by early treatment: results from the Jerusalem Trauma Outreach And Prevention study. Arch Gen Psychiatry. 2012;69(2):166-176.Google Scholar
6. Brolin, K, Hawajri, O, von Schreeb, J. Foreign medical teams in the Philippines after Typhoon Haiyan 2013 – who were they, when did they arrive and what did they do. PLoS Curr. 2015;7.Google Scholar
7. Weathers, F, Litz, B, Keane, T, Palmieri, P, Marx, B, Schnurr, P. The National Center for PTSD Checklist for DSM-5 (PCL-5) website. http://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp. Published 2013. Accessed March 3, 2016.Google Scholar
8. Kroenke, K, Strine, T, Spitzer, R, et al. The PHQ-8 as a measure of current depression in the general population. J Affect Disord. 2009;114(1):163-173.Google Scholar
9. Alexander, D, Klein, S. First responders after disasters: a review of stress reactions, at-risk, vulnerability and resilence factors. Prehosp Disaster Med. 2009;24(2):87-94.Google Scholar
10. Castillo, DT, Chee, CL, Nason, E, et al. Group-delivered cognitive/exposure therapy for PTSD in women veterans: a randomized controlled trial. Psychol Trauma. 2016;8(3):404-412.Google Scholar
11. Roberts, N, Kitchiner, N, Kenardy, J, Bisson, J. Early psychological interventions to treat acute traumatic stress symptoms. Cochrane Database Syst Rev. 2010;3:1-50.Google Scholar