(A15) Trauma Signature Analysis: Evidence-Based Guidance for Disaster Mental Health Response

Introduction The first decade of the 2000s has advanced the field of mental health and psychosocial support (MHPSS) in disasters by providing expert consensus guidance. Nevertheless, MHPSS response to major disasters is frequently uncoordinated and rarely based on scientific evidence. Moreover, MHPSS response is not customized to the unique constellation of stressors and psychological risk factors that distinguish each disaster event. To address this lack of science and specificity, we have developed trauma signature (TSIG) analysis. Methods TSIG analysis consists of the following steps. Risk factors for disaster-related psychological distress and psychopathology (e.g., PTSD, depression) are continuously documented, updated, and refined. When disaster strikes, situation reports (sitreps) are issued in the early aftermath. We examine initial sitreps to determine the presence and intensity of evidence-based risk factors, subsumed under the headings of exposure to hazards, loss, and change. We estimate the size of the affected population. We rapidly create an initial TSIG and translate findings into actionable guidance regarding probable MHPSS needs for services and personnel. Results We have constructed TSIGs for prominent 2010 disasters: Haiti earthquake, Deepwater Horizon oil spill, and Pakistan monsoonal flooding. Psychological risk factor profiles contrast sharply across these three salient events. Regarding exposure to hazards, numbers of persons experiencing physical injury and perceiving threat to life are highly divergent. Losses differ dramatically when quantified in terms of deaths, numbers bereaved, homes and livelihoods lost, and economic toll. The degree of lifestyle and societal change, including displacement, lack of survival needs, lack of security, and interpersonal violence, also differentiates the psychological impact of these disparate events. Conclusion TSIG analysis can be used to provide rapid post-impact/pre-deployment MHPSS response guidance based on risk factor assessment. Using TSIG analysis, MHPSS response can be tailored and timed to the defining features of the disaster event.