(A14) Psychosocial Support Services in Disasters - Indian Experiences

Abstract

India with 1.08 billion populations is vulnerable to earthquake (56%), floods (8%), cyclones (12%) and droughts (28%) every year. It is further compounded with refugees, riots, epidemic and endemic situations. Disaster psychosocial support and mental health services has consistently grown and standardized over the past three decades in India. The initial experiments' started in 1981 with a circus tragedy and documentation of prolonged grief reaction. In the Bhopal gas tragedy (1984) mental health services were integrated through primary care doctors. The Marathwada earthquake (1991) involved primary health care personnel in provision of mental health care to the survivors. The Orissa super cyclone (1999) saw the emergence of psychosocial support to the community using local resources like community level workers who were survivors by themselves. The feasibility study involving 40 such workers was expanded to a pilot model with 400 workers in the Gujarat earthquake (2001) and later to the level of a District model in the Gujarat riots (2002). These developments paved way for the State model when Tsunami struck the eastern coast of India affecting three States and two Union Territories in India. The experiences and experiments led to the development of standardized capacity building tools and intervention kits with level and limits of care being addressed. The Indian experiences has seen a striding change from psychiatry paradigm to public health model, to the development of a standardized psychosocial support models involving community at large. The lesson learnt has been helpful in developing the National Guidelines on Psychosocial Support and Mental Health Services by the National Disaster Management Authority of India. These service models could be adapted to the developing South East Asian countries where there is a paucity of trained professionals to attend the needs of the survivors.