據8月7日發表在《美國醫學會雜誌》上的一則研究披露，一項對有關災難及緊急精神衛生反應幹預和服務方面的文章的回顧顯示，在災難後的環境中，一個包括案例確定、分揀和精神衛生幹預的系統性框架結構應該被整合到急診醫學和創傷治療反應之中；這是一期關於暴力/人權的專刊。
「重大災難所造成的精神及身體上的後果需要得到有效的社區響應，這已經得到了越來越多的關注。據估計，美國人口中的大多數會在他們的一生中接觸到一種...自然災難；如果在這一估計值之上再加上諸如飛機墜毀等技術性事件及諸如恐怖主義等蓄意的人為事件，那麼就會估算出更高的數字。接觸災難帶來的精神衛生影響與為所有創傷形式的倖存者提供治療是相關的。」
達拉斯市北德克薩斯健康護理系統VA及德克薩斯大學西南醫學中心的Carol S. North, M.D., M.P.E.及俄克拉荷馬城的俄克拉荷馬大學健康科學中心的Betty Pfefferbaum, M.D., J.D.對證據進行了回顧和總結，旨在提供一個框架，以給予那些剛剛經歷了災難的個人以合適的精神健康幹預。在對經過了同行評審的有關災難精神衛生反應的英語文獻進行了搜索後，得到了222篇符合納入該綜述標準的文章。
文章的作者寫道，「與身體損傷不同，災難造成的不良精神健康轉歸可能並不明顯，因此，需要一種系統性的方法來確認案例並將其分揀以進行恰當的幹預。在災難後環境中的具有症狀的個人可能會經歷新近起病的與災難相關的精神疾病、已經存在的精神病理及/或心理困擾的加劇。描述性的災難心理健康研究發現，許多（11-38%）來到庇護場所及家庭援助中心進行評估的痛苦的人具有應激相關性及調適障礙、喪親之痛、嚴重憂鬱症，而物質使用障礙也可被觀察到；有多達40%的痛苦的個人具有預先存在的各種障礙。」
總體與創傷有關的，且特別是與災難有關的精神疾病的標準治療包括藥物療法及心理療法。創傷相關疾病及症狀管理的常見的臨床實踐一般是恰當的。
文章的作者寫道：「有著活動性精神疾病的患者可對其進行循證治療，但對痛苦個體進行諸如心理急救、心理匯報、危機輔導及心理教育等心理社會幹預還沒有被充分地評估以確認它們在災難情況中的裨益或害處。」
「案例確認、分揀及幹預的3個組分與既定的對大規模傷亡事件做出緊急和醫療反應的方法是一致的，並因此可促使精神衛生服務被整合到醫療災難反應之中。」（生物谷 Bioon.com）
原文標題：研究檢查了在社區災難發生之後確定有提供心理衛生服務需要的重要性
生物谷推薦的英文摘要
JAMA doi:10.1001/jama.2013.107799
Mental Health Response to Community Disasters: A Systematic Review
Carol S. North, MD, MPE1,2; Betty Pfefferbaum
Importance Exposure to a disaster is common, and one-third or more of individuals severely exposed may develop posttraumatic stress disorder or other disorders. A systematic approach to the delivery of timely and appropriate disaster mental health services may facilitate their integration into the emergency medical response.
Objective To review and summarize the evidence for how best to identify individuals in need of disaster mental health services and triage them to appropriate care.
Evidence Review Search of the peer-reviewed English-language literature on disaster mental health response in PsycINFO, PubMed, Cochrane Database of Systematic Reviews, Academic Search Complete, and Google Scholar (inception to September 2012) and PILOTS (inception to February 2013), using a combination of subject headings and text words (Disasters, Natural Disasters, Mental Health, Mental Health Programs, Public Health Services, Mental Disorders, Mental Health Services, Community Mental Health Services, Emergency Services Psychiatric, Emotional Trauma, Triage, and Response).
Findings Unlike physical injuries, adverse mental health outcomes of disasters may not be apparent, and therefore a systematic approach to case identification and triage to appropriate interventions is required. Symptomatic individuals in postdisaster settings may experience new-onset disaster-related psychiatric disorders, exacerbations of preexisting psychopathology, and/or psychological distress. Descriptive disaster mental health studies have found that many (11%-38%) distressed individuals presenting for evaluation at shelters and family assistance centers have stress-related and adjustment disorders; bereavement, major depression, and substance use disorders were also observed, and up to 40% of distressed individuals had preexisting disorders. Individuals with more intense reactions to disaster stress were more likely to accept referral to mental health services than those with less intense reactions. Evidence-based treatments are available for patients with active psychiatric disorders, but psychosocial interventions such as psychological first aid, psychological debriefing, crisis counseling, and psychoeducation for individuals with distress have not been sufficiently evaluated to establish their benefit or harm in disaster settings.
Conclusion and Relevance In postdisaster settings, a systematic framework of case identification, triage, and mental health interventions should be integrated into emergency medicine and trauma care responses.