Below is an interesting disaster mental health article from an Australia newsgroup called The ( The article shows what type of mental health issues are arising, as we might have expected from this type of disaster.



Indonesia tackles mental health crisis


By Andrew Quinn


January 13, 2005


Indonesia is launching its biggest mental health drive in an attempt to help traumatised tsunami survivors, many of whom have never heard of psychological counselling.


While the physical toll of the catastrophe is clear in the devastated towns of Aceh province, the invisible costs are more difficult to define in a country where people shun treatment for mental health problems such as anxiety and depression.


"We have 650,000 refugees who are in a very unstable emotional condition,"

said Yulizar Darwis, who heads the mental health division of Indonesia's Health Ministry. "We should reach all of them - if not, we estimate that between 20 and 50 per cent could have serious mental problems."


More than 100,000 people died in the province on the northern tip of Sumatra island in the earthquake and tsunami. The ministry has launched a 1.3 billion-rupiah ($A184,000) program, funded by the United Nations World Health Organisation, to establish guidelines for treating survivors and to send counsellors to affected areas.




In co-operation with the Indonesian Psychiatric Association and other groups, the program will draw on the experiences of Indonesian counsellors who have responded to earlier social crises.


Indonesian psychologists said the unprecedented scale of the tsunami tragedy, which has left coastal swathes of Aceh almost wiped clean of human habitation, meant a huge challenge for mental health experts.


Many of the worst-hit areas are remote, and traditional community support structures for mental health - ranging from extended family to religious institutions - have been badly damaged.


Aid workers in Aceh report rising numbers of survivors showing what Western psychologists would call post-traumatic stress disorder, with symptoms ranging from sleeplessness to depression, rage and despair.


"Severe stress and grief are commonplace and people are too terrified to return to their seaside homes for fear of tsunamis in the future,"

international relief group Medecins Sans Frontieres, which has four psychologists in the area, said in a statement.


Even those who show no immediate effects may be at risk.


"When a tragedy like this happens, sometimes the problems don't emerge immediately - it can take years," said Seto Mulyadi, a child psychologist and the head of Indonesia's National Commission for Child Protection.


Children will be a particular focus of the counselling program, which will develop "play-centred" programs aimed at easing shocked children back into normal social routines despite the devastation around them.


"We need to stimulate their spirit," said Lita Sarana, head of health at the Indonesian Red Cross Society.


Acknowledging the stigma surrounding mental problems, the Health Ministry's Mr Darwis said counsellors would use simple communication rather than complex psychological analysis. "We will approach them in the refugee camps, try to talk to them and see what their problems are," he said.


- Reuters



Paul A. Tabor, M.Miss.

State CISM Director

Community Preparedness Section

Dept. of State Health Services

1100 W. 49th St.; Austin, TX 78756-3199 Office 512.458.7128;  Fax 512.458.7211

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