Abstract
Given the frequency of natural hazards in Haiti, disaster risk reduction is crucial. However, evidence suggests that many people exposed to prior disasters do not engage in disaster preparedness, even when they receive training and have adequate resources. This may be partially explained by a link between mental health symptoms and preparedness; however, these components are typically not integrated in intervention. The current study assesses effectiveness of an integrated mental health and disaster preparedness intervention. This group-based model was tested in three earthquake-exposed and flood-prone communities (N = 480), across three time points, using a randomized controlled trial design. The 3-day community-based intervention was culturally-adapted, facilitated by trained Haitian lay mental health workers, and focused on enhancing disaster preparedness, reducing mental health symptoms, and fostering community cohesion. Consistent with hypotheses, the intervention increased disaster preparedness, reduced symptoms associated with depression, post-traumatic stress disorder, anxiety, and functional impairment, and increased peer-based help-giving and help-seeking. Mediation models indicated support for the underlying theoretical model, such that the effect of the intervention on preparedness was mediated by mental health, and that effects on mental health were likewise mediated by preparedness. The community-based mental health-integrated disaster preparedness intervention is effective in improving mental health and preparedness among community members in Haiti vulnerable to natural hazards. This brief intervention has the potential to be scaled up for use with other communities vulnerable to earthquakes, seasonal flooding, and other natural hazards.
Highlights
In recent years, the UN’s head of disaster planning has warned that a global failure to plan for future natural disasters will have ‘inconceivably bad’ consequences, especially as climate change leads to increase in chronically-occurring natural disasters and the humanitarian crises that often result (Jones, 2016)
As hypothesized (11), the effect of the intervention on disaster preparedness was partially mediated by changes in depression, posttraumatic stress disorder (PTSD) and anxiety, such that the intervention decreased mental health symptoms (a), and this reduction in symptoms partially explained the increase in preparedness (b)
These results suggest that chronically disaster exposed individuals may be especially vulnerable to mental health symptoms and related impairment, which may in turn result in low-levels of preparedness
Summary
The UN’s head of disaster planning has warned that a global failure to plan for future natural disasters will have ‘inconceivably bad’ consequences, especially as climate change leads to increase in chronically-occurring natural disasters and the humanitarian crises that often result (Jones, 2016). We hypothesize that a brief intervention that integrates disaster preparedness content with mental health psychoeducation and coping skills, as well as a framework that encourages social cohesion and peer support, is likely to be especially effective in such settings. To this end, we developed a 3-day mental health integrated disaster preparedness group intervention for vulnerable communities in metropolitan Port-au-Prince, Haiti and evaluated it using a randomized controlled trial (RCT) design. We predict (13) a change in social cohesion will explain the impact of the intervention on preparedness and on mental health
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