Via The Conversation, an article by Yuval Neria, Director of Trauma and PTSD Program at Columbia University: Treating Ebola has focused on the physical – but there will be mental scars too. Excerpt:
Since its re-emergence in the summer of 2014, the Ebola outbreak in West Africa has ravaged communities, killed thousands, created fear, anxiety and distrust and, in some instances, violence. The Ebola outbreak has now been largely contained and a number of major advances achieved in prevention, treatment and vaccine development. However, the consequences of this sustained period on the mental health of the populations has been largely overlooked.
To date, only few, and largely uncoordinated, efforts have been made to address the mental health needs of victims, their families, and treatment teams, and none have resulted in systematic or coordinated projects. Consequently, efforts to devise and to test scientifically sound interventions and prevention programmes and, if effective, to use them to help the general public, are yet to materialise.
Addressing mental health needs
Exposure to extreme traumatic events such as mass mortality, orphaning of children, loss of healthcare workers and inadequate supplies of medicine, food and resources, as well as discrimination against affected families due to stigma, are highly potent risk factors for mental health problems. These include anxiety, depression, complicated grief and post-traumatic stress disorder (PTSD). A lack of mental health systems and poverty further exacerbate these risks.
The WHO has made recommendations for mental health counselling in Ebola-stricken areas, but a more proactive, research-informed, mental health response is desperately needed to mitigate the magnitude of the mental health consequences.
The Ebola outbreak has affected large populations who are at high risk of developing mental health problems, including those who have survived the outbreak but have been stigmatised, bereaved family members, and ostracised orphans. Healthcare and burial workers, who have consistently witnessed the horror unfold, are also among them.
Programmes should now include evidence-based measures to assess mental health needs and the delivery of trauma-focused therapies such as prolonged exposure – which lowers distress through careful, repeated exposure to trauma-related thoughts, feelings and situations they have been avoiding – interpersonal treatment, or appropriate medication with or without psychotherapy. In cases of prolonged and clinically significant grief, existing evidence-based treatments are recommended.