Crisis intervention following disasters : are we doing enough? (A second look).

Includes bibliographical references

Reprinted from American journal of emergency medicine; 1991; v. 9, no. 6; p. 598-602

During mass casualty events the consequences of psychological trauma are an important cause of morbidity among survivors and rescue personnel. Data available from military and civilian disasters over the past 70 years has shown a fairly predictable ratio of acute and severe emotional trauma associated with mass casualty events. Long-term morbidity from psychological trauma can rival or exceed that of the physical injuries of survivors. Psychological intervention reduces this morbidity, and early psychological intervention is more effective before adverse psychological symptoms have fully developed. However, the widely accepted value of early psychological intervention is not universal, with controversy over the degree of emotional trauma expected after a large-scale catastrophic mass casualty event, as well as the number of victims and the effectiveness of immediate psychological intervention. Some research even suggests that there is only a minor risk of acute emotional trauma among survivors of a major disaster. The United States faces the possibility of mass casualties from national disasters - particularly earthquakes - and conventional warfare. It has been predicted that 100,000 major injuries requiring hospitalization and 20,000 deaths would result from the maximum plausible natural disaster incident in the United States