Disaster Care for Persons With Psychiatric Disabilities: Recommendations for Policy Change

There is growing concern that the management of persons with psychiatric disabilities after disaster has been inadequate. Unfortunately, the literature is extremely limited, and empirical evidence on the best practices for addressing the needs of persons with psychiatric disabilities after disasters is sparse. A literature search of articles published in 3 widely used databases revealed only 12 articles on the topic. The 12 reviewed articles included persons with psychiatric disabilities after both natural disasters and acts of terrorism, both in close proximity to the disaster site and far away and in 3 different treatment modalities. All of the studies used clinically based samples. The available literature indicated that many persons with psychiatric disabilities demonstrate an ability to handle the stress of a disaster without decompensation from their primary illness. However, the literature also revealed that persons with severe mental illness (SMI) can experience posttraumatic stress disorder (PTSD), depression, anxiety, and illness exacerbation after disaster. There is evidence that persons with SMI can be resilient in the short term when they are enrolled in an assertive community treatment program prior to the disaster however, the outcomes for people with severe mental illness in other treatment modalities are unclear. Well-designed studies with clinical and population-based samples on disaster reactions of persons with psychiatric disabilities are needed for disaster psychiatrists and emergency planners to develop empirically based treatment guidelines for this population.