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

"But sudden devastation also puts people with both lifelong and acquired intellectual disabilities in grave danger as well."

Whether a disaster is natural, as in an earthquake, or is caused by man, as in war, the ethical obligation to treat those with mental disabilities in the aftermath is just as important as aiding those with flesh wounds, Rabins says.

One study the authors cite found that 22 percent of Hurricane Katrina survivors who had pre-existing mental disorders faced limited or terminated treatment after the disaster.

Beyond patients with dementia and others who are mentally impaired, the authors say that this vulnerable group includes those who suffer from chronic pain and may be dependent on opiates, as well as substance abusers who receive treatment in the form of powerful sedatives classified as benzodiazepines. Withdrawal can be life threatening, the authors note.

The authors acknowledge that drug and alcohol addicts are often seen as unworthy of focused attention during a state of emergencyand scarce resourcesbecause their condition is widely perceived as "self-inflicted." But distinguishing between conditions that individuals have or don't have control over "is neither practical nor ethically justifiable, and in emergencies becomes wholly impractical," the authors assert.

Recommendations

As a first step, the authors recommend that disaster-response planners proactively identify and anticipate what needs might arise by meeting with clinicians and public health officials. Those discussions would then guide comprehensive advance planning.

Because licensed practitioners will likely be scarce immediately after a disaster, planners should consider training emergency medical technicians (EMTs) and other first-responders to identify those with pre-existing mental conditions and recognize those in need of prompt attention.

Acknowledging that first-responders may also be spread th
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Contact: Michael Pena
mpena@jhu.edu
410-614-5381
Johns Hopkins Medical Institutions
Source:Eurekalert

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