Practical Assessment and Evaluation of Mental Health Problems Following a Mass Disaster

Almost all individuals who experience a severe trauma will develop symptoms of posttraumaticstress disorder (PTSD) shortly after the traumatic event. Although the natural history of PTSD variesaccording to the type of trauma, most people do not develop enduring PTSD, and, in many of thosewho do, it resolves within 1 year without treatment. To the extent that is possible, maintenance of normaldaily activities is believed to help patients cope more successfully in the aftermath of majortrauma. In the case of a disaster such as the Asian tsunami, the whole community is involved, and it isimpossible to continue with normal daily activities. To improve overall outcome after trauma, itwould be optimal to identify individuals at increased risk for developing PTSD. This article describesscreening and assessment tools for posttrauma mental health problems, particularly PTSD, and examinesin more detail instruments that can be used in rapid field assessment of individuals who may beaffected or who have already been identified and require monitoring. Self-rated instruments are mostappropriate, but the choice of instrument will depend on the local situation and availability of appropriatelyvalidated questionnaires. The article also addresses important aspects of training nonmedicalpersonnel in screening and assessment.