Mental health problems in the aftermath of earthquakes in Nepal

Abstract

Introduction Mental health problems may increase in populations affected by humanitarian emergencies, such as the 2015 earthquakes in Nepal. Objectives We assessed mental health and psychosocial problems (depression, anxiety, post-traumatic stress disorder, alcohol use disorder, suicidal ideation), and available mental health resources to deal with these problems 4 months after the earthquakes. Methods The study was conducted in three affected districts: Kathmandu, Gorkha, and Sindhupalchowk. The study used a mixed methods design with both qualitative and quantitative approaches. The outcome measures used in the study were locally validated Hopkins Symptoms Checklists (HSCL), PTSD Checklist-Civilian version (PCL-C), Alcohol Use Disorder Identification Test (AUDIT), and a functioning impairment scale. We used a stratified multi-stage cluster sampling method to select 513 adults (171 from each districts). Results 32.4% (26.7-38.7; 95% CI) of participants met threshold criteria for depression, 30.8% (24.5-37.9) for anxiety, 5.2 (3.9-6.8) for PTSD, and 20.4% (17.1 - 24.3) for alcohol use disorder. Prevalence of suicidal ideation was 11%. Despite high rates of mental health problems, few participants reported impaired daily functioning. Conclusion We found elevated prevalence estimates of mental health problems but overall daily functioning was good. The need for trauma-specific treatments for PTSD do not appear to be widespread. However, support services to address anxiety, depression, and substance abuse could benefit large numbers of earthquake-affected communities.