Center for the Study of Traumatic Stress
CSTS | Department of Psychiatry | Uniformed Services University | 4301 Jones Bridge Road, Bethesda, MD 20814-4799 | www.CSTSonline.org

Psychosocial Concerns after Natural
Disaster: Tips for Health Care Providers
Health care providers assume
should be mindful of the losses
Healthcareproviders
assumemanyroles
many roles in the midst of naturalexperienced by the population
disasters: caregiver, leader, comforter,
they will assist. Interviewing within the midst of natural disasters: caregiver,and information source. Natural
sensitivity is essential, and is theleader,
comforter,
andinformation
source.
disasters displace thousands,ﬁrst step in assessing speciﬁc needs.
destroy homes and property, andThis fact sheet provides information
claim numerous lives. Even after afor health care providers after
disaster’s strength has dissipated, its aftermath is felt for adisasters and pays special attention to some of the issues forconsiderable time.
individuals providing support in the aftermath of a natural
As health care providers mobilize to help, theydisaster.
Services and basic needs, such as water, food, power,and sanitation, have been disrupted. Depending on theextent of damage and access to damaged areas, it may
be some time before these are restored. The potential for
spread of disease and infections underscores the need forsurveillance and institution of public health measures.
Providers play an integral role in advocating for therestoration of basic services as public health necessities.
Those who have otherwise well-controlled medical
conditions may not have access to their regular
medications. Evacuation and relocation may disrupt
medication availability and may exacerbate ongoing mental
health and other medical conditions. In addition, persons
who routinely use alcohol, tobacco, or illicit drugs may
experience additional difﬁculties when these are not readily
available.
Psychological First Aid, an evidenced-informed
approach for helping populations cope in the aftermathof a disaster, aims to reduce the emotional and physicalresponses in the immediate aftermath of a disaster.
Principles include:■ Promotion of safety: help people meet the basic needs
for shelter and food, provide a ‘recovery environment’,
which includes limited exposure to news and othermedia related to the disaster, and encourage those
who are relocated to return only when their areas aredeemed safe.
■ Promote calm: offer accurate information about thedisaster and the efforts underway to help the situation.

■ Promote connectedness: help to reunite families andfriends, establish a sense of normalcy for children by
reinforcing parent-child bond, reunite children withplaymates, and re-establish, if possible, school and othersafe environments.
■ Promote self-efﬁcacy: give practical suggestions andreferrals that move people to help themselves.
■ Promote hope: direct people to services that areavailable, remind people (if you know) that moreassistance will be arriving.
Many people who have experienced a natural disasterﬁrst-hand have lost loved ones, pets, jobs, and property.
After such losses, it is not uncommon to experience distressin the form of difﬁculty sleeping, disbelief, nightmares,
feeling sad, and anxiety. In most individuals, these
symptoms remit over time and require no formal treatment.
A small subset will continue to have difﬁculties and may
present with depression, anxiety, increased arguments withsigniﬁcant others, unexplained medical symptoms, andincreased use of cigarettes and alcohol. Should health careproviders identify such problems, this may indicate a needfor more formalized assessment and intervention.
Providers must be aware of the impact of the disaster onthemselves and their professional colleagues. Times of highdemand and the desire to “do more” put providers at risk
for burn out, fatigue, and reduced effectiveness.
Providers are not immune, and should attend to theirown needs as well as those around them.