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Disaster and Crisis Psychiatry

Psychiatric response to natural and human-made disasters and acute crises

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Psikiyatri department. Book Appointment →

What is Disaster and Crisis Psychiatry?

Disaster psychiatry encompasses preparation, immediate response, intermediate intervention, and long-term recovery from earthquakes, floods, fires, terrorism, war, displacement, pandemics, and mass casualty events. Mental health consequences include acute stress reaction, posttraumatic stress disorder (PTSD), depression, anxiety disorders, complicated grief, substance use disorders, and exacerbation of pre-existing mental illness.

Psychological first aid (PFA) is the immediate evidence-based intervention emphasizing safety, contact, comfort, stabilization, information gathering, practical assistance, social connection, coping support, and linkage to services. PFA replaces older debriefing models that may worsen outcomes. Triage prioritizes individuals with severe acute stress, suicide risk, psychosis, dependence on medications, or pre-existing severe mental illness.

Intermediate-phase interventions include trauma-focused cognitive behavioral therapy (TF-CBT), prolonged exposure (PE), eye movement desensitization and reprocessing (EMDR), and pharmacotherapy with SSRIs/SNRIs for established PTSD. Community-level interventions support resilience, restore social cohesion, and address structural determinants. Special populations include first responders, children, elderly, refugees, and pre-existing mental illness.

Symptoms

Acute stress reaction (intrusive memories, hyperarousal, avoidance) within hours-days
Dissociative symptoms (depersonalization, derealization, amnesia)
Sleep disturbance, nightmares
Hypervigilance, exaggerated startle
Irritability, anger outbursts
Concentration difficulty
Avoidance of trauma reminders
Numbing, emotional detachment
Survivor guilt
Depression, hopelessness
Suicidal ideation
Anxiety, panic attacks
Substance use escalation
Somatic complaints
Functional impairment
Children: regression, separation anxiety, traumatic play
Elderly: confusion, exacerbation of cognitive disorders
First responders: vicarious trauma, burnout
Refugees: complicated trauma, displacement stress
Mass psychogenic illness in some events

Risk Factors

Direct exposure to disaster
Loss of family member or friend
Severe property loss or displacement
Pre-existing mental illness
Pre-existing trauma history
Lack of social support
Children separated from caregivers
Elderly with limited mobility or cognitive impairment
First responders, healthcare workers
Refugees and internally displaced persons
Female sex (some risk higher)
Lower socioeconomic status
Substance use disorders
Multiple disaster exposures
Limited access to healthcare
Cultural and language barriers
Stigma against mental health care
Loss of social roles or employment
Disability or chronic illness
Indigenous and minority status with historical trauma

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Severe acute stress symptoms after disaster
  • Suicidal ideation or behavior
  • Severe sleep disturbance
  • Inability to function in daily activities
  • Symptoms persisting beyond 1 month
  • Pre-existing mental illness destabilization
  • Substance use escalation
  • Children with regression or behavioral changes
  • Elderly with confusion or worsening cognition
  • Family violence emergence
  • Healthcare worker or first responder burnout
  • Refugee or displaced person mental health concerns

Treatment Methods

01
Psychological first aid (PFA) with safety, contact, comfort, stabilization, information, practical assistance, social connection, coping, linkage
02
Avoidance of single-session debriefing (potentially harmful)
03
Triage for severe acute stress, suicide risk, psychosis, medication dependence
04
Mental Health and Psychosocial Support (MHPSS) framework integration
05
Community-level interventions to restore social cohesion
06
Skills for Psychological Recovery (SPR) for intermediate phase
07
Trauma-focused cognitive behavioral therapy (TF-CBT)
08
Prolonged exposure (PE) therapy
09
Eye movement desensitization and reprocessing (EMDR)
10
Cognitive processing therapy (CPT)
11
SSRIs (sertraline, paroxetine) or SNRI (venlafaxine) for PTSD
12
Prazosin for trauma-related nightmares
13
Sleep hygiene and brief sleep interventions
14
Mindfulness-based stress reduction
15
Group therapy and peer support
16
Family therapy
17
Interventions adapted for children (TF-CBT for children, play therapy)
18
Crisis hotlines and community-based services
19
Continuity of care for pre-existing mental illness with medication continuation
20
Coordination with emergency medical services and primary care
21
Integration with humanitarian organizations
22
Cultural adaptation and trauma-informed care
23
First responder and healthcare worker support programs
24
Long-term follow-up for delayed-onset PTSD and chronic mental health needs
25
Public health surveillance and population-based interventions

Which Department to Visit?

You can visit our Psikiyatri department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.