Mental Health in the Recovery Phase

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Hospital Damage in Joplin










During and after emergencies, people are more likely to suffer from a range of mental health problems. Some people develop new mental disorders after an emergency, while others experience psychological distress. Those with pre-existing mental disorders often need more help than before. Psychological First Aid is an excellent resource for all those who routinely care for victims of emergencies, regardless of the size or scope of the incident, and could also be an effective tool for family members, friends or neighbors who may find themselves rseponding to an emergency involving those they care for. 


Article posted from CDC's Public Health Matters Blog

By: Dennis Cooley, MD, FAAP

Joplin, Missouri was devastated by an F5 tornado in 2011. Heart to Heart International set up a clinic in a Walgreens parking lot near the hardest hit area to care for injured volunteers.  The clinic provided medical care on a walk-in basis. Dr. Dennis Cooley worked in the clinic three weeks after the storm hit the town.

Many of the patients who came to the clinic were volunteers injured during cleanup efforts. The clinic’s staff also provided follow up care of wounds from victims of the tornado, as well as other patients with chronic illnesses who needed refills for medications that had run out or been lost in the chaos of the storm.

Managing patient care was a challenge. Clinic staff was unable to access primary care physicians, medical records, or prescription information. Post-storm, many patients were homeless and living in tents in the Joplin area with no money. “Trying to manage these patients without medical records, without homes, and without money was extremely difficult as you can imagine,” said Dr. Cooley.

Home damaged in JoplinAmidst all the chaos, Dr. Cooley recalls one patient experience that stands out most clearly.. A woman walked into the reception area minutes before the clinic closed for the day. She didn’t have an injury or illness.  Across the street from the clinic parking-lot was a residential district that had suffered significant damage. A close friend of the woman had died in a home within view of the clinic. When she had driven by her friend’s destroyed house she was overwhelmed by emotions and became distraught. She didn’t know what to do or where to go. When she saw the clinic, she pulled in and stopped.  One of nurses took her inside, gave her a cup of coffee and just listened. For forty five minutes, she listened. Eventually, after the woman calmed down, she was able to drive home.

“Did we help this woman? Yes, I think so. Did we do all we could have done? Yes and no. Just by listening and letting her verbalize her feelings, we were able to help her.  However, I can’t help but think that we could have done more for this woman, if we had the training and been prepared for the psychological first aid Adobe PDF fileExternal Web Site Icon for the survivors,” Cooley reflects.

Being well versed in the psychological effects of a disaster is critical for first responders and caregivers.  Rarely will someone walk into a clinic looking for help like the woman in Joplin. Instead, health professionals must watch for the signs of post-traumatic stress in adults and children, just as they look for the physical injuries.

Dr. Cooley’s experience reminds us that disaster management is more than taking care of children and families during the first 48 hours, or even the first week after the event. “Patient care extends after the news cameras have left”, says Cooley. “It is performing follow up services, it is providing care to volunteers who have come to the area to work on clean up, and it is taking care of the psychological aftermath of the disaster.” Although these are not glamorous roles, they are definitely just as important.

Read more about psychological first aid and coping with disaster.

This blog post was provided courtesy of the American Academy of PediatricsExternal Web Site Icon and Dr. Dennis Cooley. Dennis M. Cooley MD is a general pediatrician who has been in private practice in Topeka, Kansas for over 30 years. He is on staff at Stormant Vail Regional Health Center and is a volunteer Clinical Instructor with the University of Kansas School of Medicine. Dr. Cooley is active in the American Academy of Pediatrics (AAP) and is the Disaster Preparedness Coordinator for the AAP’s Kansas Chapter.

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