Enhancing Community Resilience in the Acute Aftermath of Disaster: Evaluation of a Disaster Mental Health Intervention

Purpose

This study aimed to evaluate a culturally-adapted community-based disaster mental health intervention. The intervention was designed to mitigate the impacts of an acute natural disaster among disaster-prone communities in Haiti (hurricanes, floods, earthquakes) and Nepal (floods, landslides). The study aimed to use a longitudinal randomised controlled trial design to determine if the intervention was effective in achieving its goal of enhancing community resilience. This would be achieved by improving mental health and increasing engagement in disaster preparedness and response, including enabling community members to care for themselves and provide assistance to others when a disaster strikes.

Programmes and Outcomes Achieved

This was a rapid response grant in which baseline data collection was undertaken with 480 people in each of the two settings (flood-prone areas in Haiti and Nepal) prior to the occurrence of a particular natural disaster. Participants in the intervention groups were then invited to a 3-day disaster resource building training – Enhancing Community Resilience in the Acute Aftermath of Disaster – which was conducted by local partner clinicians. Subsequently both settings suffered significant flooding events during 2014 (Haiti) and 2015 (Nepal), enabling the full research to be triggered. In the immediate aftermath of the flooding all groups were re-interviewed, and again 3 months subsequently.

Key findings:

• In Haiti, there were significant reductions in PTSD, depression and anxiety amongst intervention groups compared to control groups
• In Nepal, there were some indications of reduced PTSD but not depression, and anxiety was not measured
• Measures showed increased social cohesion and endorsement of disaster preparedness behaviours in both countries

 Key outputs:

• Community-based Disaster Mental Health Intervention: Curriculum manuals produced in English, Nepali and Haitian Kreyol
• Dissemination workshops held in Nepal and Haiti for key national stakeholders
• Community workshops for dissemination of research findings held in Nepal and Haiti
• Service provider training undertaken
• At least three peer-reviewed articles planned, focusing on the pilot studies and RCTs in both settings

Next steps:
Further work was planned by the study team to undertake additional statistical analysis and preparation of data sets for the public repository.  Manuals were made publicly available for use in further settings.