Particular circumstances may add to a person’s risk for developing serious behavioral and mental health problems following a chemical incident, such as: surviving/witnessing mass destruction or death, unresolved bereavement, loss of home or community, displacement and separation from trusted support systems (for example, due to sheltering or evacuation), history of prior trauma, and experiencing major life stressors (e.g., divorce, job loss, financial losses). Some population segments, such as children, the elderly, and those with existing mental health or substance use problems, are at higher risk of experiencing severe adverse stress reactions and suffering serious mental or emotional distress.68,74
Leveraging the community’s resources and services for these high-risk groups is essential in both the short and long term. Health professionals should routinely screen individuals who are at greater risk for short- and long-term adverse stress reactions, and behavioral and mental health interventions should be offered by specialists or by trained and supervised community workers in the health and social sector.68 The Health & Social Services Recovery Support Function (RSF) of the National Disaster Recovery Framework (NDRF) may need to convene specific groups of relevant personnel to help communities address the health, behavioral health, and social services needs of those in high-risk groups, and those who support and care for them.
Response and cleanup workers exposed during their jobs are also at risk for developing mental health effects. For example, following the Deepwater Horizon oil spill, workers exposed to oil, dispersants, or other cleaning chemicals (e.g., benzene, toluene, ethylbenzene, xylene, 2-butoxyethanol, and propylene glycol) were at increased risk for depression and post-traumatic stress, as well as deficits in attention, memory, and executive function.78 Similar results were seen for workers at the Exxon Valdez and other oil spills.73,79 A specific and coordinated risk communication effort targeting responders/workers and their families to address their fears regarding chemical exposure is critical. Responders should be provided clear guidance about potential harmful effects of exposure to themselves, their children, and to other family members, and when to report symptoms or seek medical care. Responders are also susceptible to stress resulting from their incident response roles. They demonstrate mental and emotional resilience during an operation but have intense emotional reactions afterwards. Care provision plans should include mental health assistance programs for responders during and after their deployment.
Footnotes
68. Dembert, M., & Mark, L., (1991). Occupational Chemical Exposures and Psychiatric Disorders. Jefferson Journal of Psychiatry, 9(1). Print.; Attademo, L., Bernardini, F., Garinella, R., & Compton, M. T. (2017). Environmental pollution and risk of psychotic disorders: A review of the science to date. Schizophrenia research, 181, 55–59.
73. Young, B.H., Ford, J.D., Ruzek, J.I., Friedman, M.J., Gusman, F.D. (1998). Disaster Mental Health Services: A Guidebook for Clinicians and Administrators. Department of Veteran Affairs, The National Center for Post-Traumatic Stress Disorder.
74. Ginsberg, J. P., Holbrook, J. R., Chanda, D., Bao, H., & Svendsen, E. R. (2012). Posttraumatic stress and tendency to panic in the aftermath of the chlorine gas disaster in Graniteville, South Carolina. Social Psychiatry and Psychiatric Epidemiology, 47(9), 1441–1448.
78. Palinkas, L. A., Petterson, J. S., Russell, J., & Downs, M. A. (1993). Community patterns of psychiatric disorders after the Exxon Valdez oil spill. The American journal of psychiatry, 150(10), 1517–1523. ;
79. Federal Emergency Management Agency. (2020, August 3). Programs to Support Disaster Survivors.