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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.



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3. Williams R, Bisson J, Ajdukovic D, et al; NATO Joint Medical Committee. Guidance for Responding to the Psychosocial and Mental Health Needs of People Affected by Disasters or Major Incidents. September 2008. www.healthplanning.co.uk/principles/Principles_for_Disaster_and_Major_Incident_Psychosocial_Care_Final.pdf (PDF). Accessed October 24, 2013.
4. Neria Y, Gross R, Olfson M, et al. Posttraumatic stress disorder in primary care one year after the 9/11 attacks. Gen Hosp Psychiatry. 2006;28(3):213-222.
5. Neria Y, Schultz JM. Mental health effects of Hurricane Sandy: characteristics, potential aftermath and response. JAMA. 2012;308(24):2571-2572.
6. Norris FH, Friedman MJ, Watson PJ, Byrne CM, Diaz E, Kaniasty K. 60,000 disaster victims speak: Part I. An empirical review of the empirical literature, 1981-2001. Psychiatry. 2002;65(3):207-239.
7. Norris FH, Friedman MJ, Watson PJ. 60,000 disaster victims speak: Part II. Summary and implications of the disaster mental health research. Psychiatry. 2002;65(3):240-260.
8. Yehuda R. Post-traumatic stress disorder. N Engl J Med. 2002;346(2):108-114.
9. World Health Organization. Mental health assistance to the populations affected by the tsunami in Asia. www.who.int/mental_health/resources/tsunami/en/index1.html. Accessed October 24, 2013.
10. Galea S, Ahern J, Resnick H, et al. Psychological sequelae of the September 11 terrorist attacks in New York City. N Engl J Med. 2002;346(13):982-987.
11. DiGrande L, Perrin MA, Thorpe LE, et al. Posttraumatic stress symptoms, PTSD, and risk factors among lower Manhattan residents 2-3 years after the September 11, 2001 terrorist attacks. J Trauma Stress. 2008;21(3):264-273.
12. US Department of Veterans Affairs, National Center for PTSD. PTSD Screening and Referral. Common reactions after trauma. www.ptsd.va.gov/public/pages/common-reactions-after-trauma.asp. Accessed October 24, 2013.
13. Davidson JR. Recognition and treatment of posttraumatic stress disorder. JAMA. 2001;286(5):584-588.
14. US Department of Veterans Affairs, National Center for PTSD. PTSD Screening and Referral: For Health Care Providers. Primary Care PTSD Screen (PC-PTSD). www.ptsd.va.gov/professional/pages/assessments/pc-ptsd.asp. Accessed October 24, 2013.
15. Marshall RD, Olfson M, Hellman F, Blanco C, Guardino M, Struening E. Comorbidity, impairment and suicidality in subthreshold PTSD. Am J Psychiatry. 2001;158(9):1467-1473.
16. Stein MB, McQuaid JR, Perdelli P, Lenox R, McCahill ME. Posttraumatic stress disorder in the primary care medical setting. Gen Hosp Psychiatry. 2000;22(4):261-269.
17. Grieger TA, Fullerton CS, Ursano RJ. Posttraumatic stress disorder, depression, and perceived safety 13 months after September 11. Psychiatr Serv. 2004;55(9):1061-1063.
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21. National Institute of Mental Health. Depression. www.nimh.nih.gov/health/publications/depression/complete-index.shtml. Accessed October 24, 2013.
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25. American Psychiatric Association. Practice guideline for the treatment of patients with major depressive disorder. 3rd ed. 2010. www.guidelines.gov/content.aspx?id=24158. Accessed October 24, 2013.
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27. Gliatto MF. Generalized anxiety disorder. Am Fam Physician. 2000;62(7):1591-1600,1602.
28. Stein MB. Attending to anxiety disorders in primary care. J Clin Psychiatry. 2003;64(suppl 15):35-39.
29. Spitzer RL, Kroenke K, Williams JBW, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092-1097.
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31. National Institute on Alcohol Abuse and Alcoholism. Alcohol use disorders. www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders. Accessed October 25, 2013.
32. US Department of Defense Deployment Health Clinical Center. Guidelines: Substance Use Disorders. 2009. www.pdhealth.mil/clinicians/substanceusedisorder.asp. Accessed October 24, 2013.
33. National Institute on Drug Abuse. Stress and substance abuse: a special report after the 9/11 terrorist attacks. www.drugabuse.gov/stressanddrugabuse.html. Accessed October 24, 2013.
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39. Smith PC, Schmidt SM, Allensworth-Davies D, Saitz R. A single-question screening test for drug use in primary care. Arch Intern Med. 2010;170(13):1155-1160.
40. Bernstein J, Bernstein E, Tassiopoulos K, Heeren T, Levenson S, Hingson R. Brief motivational intervention at a clinic visit reduces cocaine and heroin use. Drug Alcohol Depend. 2005;77(1):49-59.
41. Humeniuk R, Dennington V, Ali R, on behalf of the WHO ASSIST Phase III Study Group. The Effectiveness of a Brief Intervention for Illicit Drugs Linked to the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) in Primary Health Care Settings: A Technical Report of Phase III Findings of the WHO ASSIST Randomized Control Trial. www.who.int/substance_abuse/activities/assist_technicalreport_phase3_final.pdf (PDF). Accessed October 24, 2013.
42. Madras BK, Compton WM, Avula D, Stegbauer T, Stein JB, Clark HW. Screening, brief interventions, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple healthcare sites: comparison at intake and 6 months later. Drug Alcohol Depend. 2009;99(1-3):280-295.
43. Amato L, Minozzi S, Davoli M, Vecchi S. Psychosocial and pharmacological treatments versus pharmacological treatments for opioid detoxification. Cochrane Database Syst Rev. 2011;(9):CD005031.

Parachute NYC is a new Health Department program that offers adults experiencing psychosis-related symptoms free home-based treatment and short-term residential alternatives to hospitalization for up to 1 year. For more information, go to www.nyc.gov and search for "parachute." You or any health care provider can call 1-800-LIFENET to refer an individual to Parachute NYC.

Falls are the leading cause of hospitalization and injury death among older New Yorkers. NYC REACH and the New York City Health Department are offering a free 20-minute recorded webinar on falls prevention. Click here to access the program.