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More focus needed on mental health triage in disaster preparedness, Johns Hopkins bioethicists urge
Date:5/23/2011

Johns Hopkins University bioethicists say disaster-response planning has generally overlooked the special needs of people who suffer from pre-existing and serious mental conditions. Survivors already diagnosed with schizophrenia, dementia, addictions and bipolar disorder are vulnerable long before a disaster strikes, they point out.

In a commentary appearing in the June issue of the journal Biosecurity and Bioterrorism, faculty from the Johns Hopkins Berman Institute of Bioethics say that more attention should be devoted to triaging and managing those already identified as having mental disorders. This group must be given just as much consideration during the planning stage as is given those who will have physical injuries and more obvious anxiety-related reactions, such as post-traumatic stress disorder (PTSD).

"Disasters limit the availability of resources, and these groups are especially vulnerable because they cannot advocate for themselves," says Peter Rabins, M.D., M.P.H., a core faculty member at the Berman Institute. "But little attention has been given to the ethical challenges that arise when resources are limited, to the importance of identifying these ethical issues ahead of time, and for establishing mechanisms to address these moral dilemmas."

In the article, Rabins and Nancy Kass, Sc.D., the Berman Institute's deputy director for public health, say that many of the mentally ill are dependent on caretakers and aren't fully capable of making sound decisions on their own. Emergency planners are ethically obligated to ensure that immediate and adequate mental health services are provided alongside more traditional triage, the bioethicists state.

"Disaster-response managers and those on the front line are well aware that survivors may succumb to PTSD and other mental disorders," says Rabins, the Richman Family Professor for Alzheimer's and Related Diseases at the Johns Hopkins University School of Medicine.
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Contact: Michael Pena
mpena@jhu.edu
410-614-5381
Johns Hopkins Medical Institutions
Source:Eurekalert

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