City Health Information
Volume 33 (2014) New York City Department of Health and Mental Hygiene No. 1; 1-8



Diagnosing and Managing the Mental Health
Needs of Adults Exposed to Disaster
  • Educate patients about physical and emotional symptoms of normal stress reactions.
  • Ask patients about their exposure and reactions to disaster.
  • Identify patients who may have posttraumatic stress disorder, depression, generalized anxiety disorder, or a substance use disorder and use standard screening tools for further evaluation.
  • Encourage patients to take advantage of psychotherapy, pharmacotherapy, or both.

Survivors of a disaster, whether natural or man-made, will often experience significant event-related distress, fear, and anxiety; with some developing longer-term disorders such as posttraumatic stress disorder (PTSD), depression, generalized anxiety disorder, and substance use disorder (1-8). After a severe disaster, overall population rates of mental health disorders, such as depression, anxiety disorders, and PTSD, can be expected to increase (2,9,10). Among people directly exposed to a disaster, about 75% will experience mild and transient psychological distress, 20% to 40% will experience more sustained distress that may become more severe after the events have subsided, and 0.5% to 5% will develop one or more long-term mental health disorders (3). Following the anniversary of Hurricane Sandy, the New York City Health Department reminds providers that exposure to a disaster may have long-term mental health effects, so it is important to remain alert and screen for trauma-related disorders, not only days and months—but even years—after the event (2).

Primary care providers (PCPs) are often the first point of care for patients with disaster-related mental health disorders and have a unique opportunity to identify these patients and manage their care. In the wake of a disaster, clinicians should educate patients about normal stress reactions and their physical and emotional symptoms, diagnose and manage mental health conditions according to accepted guidelines, and make referrals when appropriate (10).

An online interactive CME/CNE course on recognizing and managing trauma-related mental health disorders is available at no cost for health care providers in New York City (Resources—At-Risk in Primary Care).