Search

Emily Goldmann is an Assistant Research Professor at NYU in the College of Global Public Health. Her research primarily focuses on the social and environmental factors affecting mental health. She has written several articles on the mental health conditions in soldiers, which can sometimes be extended to emergency responders in disaster zones. 

Sandro Galea is a professor and dean at Bostom University and former Chair of Epidemiology at Columbia University. He formerly was an emergency physician and served with MSF. His research primarily focuses on the causes of mood and anxiety disorders in realtion to urban populations. He also talks on inequality in health care and the consequences of traumatic events on specific populations.

THe bibilography is made up mostly of other research articles and studies, suggesting this paper is more technical in nature than discussive. There is little to no opinion given, rather hard facts and statistics.

“More than 20 years ago, social scientists Harry Otway and Brian Wayne cautioned that accident prevention (safer designs, better operator training, etc. , but even more so emergency planning, faced significant economic and managerial hurdles.”(p199)

“Nuclear accidents have tended to trigger organizational reform with regard to nuclear emergency response, but not on an international level. In considering this problematic ground, where might we start to develop a global approach to nuclear disaster mitigation?”(p200)

“The specific kinds of highly specialized knowledge involved with operation nuclear reactors however may not be accessible to broad public debate to the same degree as, for example, evacuation policies. But in the interest of sustainable, socially legitimate solutions, arguably decisions about even the technical responses to disasters should not be left to scientists and engineers alone, whether they are based within the nuclear industry, a regulatory bod, or a nongovernmental organization.”(p196)

“For all its undeniable flaws, the nuclear industry worked for several decades- in Japan and elsewhere. That is also the truly frightening realization after Fukushima: this disaster was not ‘waiting to happen’, but occurred in a system that had been functioning reasonable well for quite some time.”(p198)

“…The Way Forward is embedded in a technocratic rationality that seeks an effective ‘technical fix’ for reducing the risk of a nuclear disaster to manageable proportions. That misses the less tangible social expertise and improvisational skills inevitable involved in any successful disaster response.” (p206)

This article presents some statistics on common psychological issues post- disaster. PTSD and Major Depression are the two most commonly studied issues in realtion to post-disaster. A realtively new term "resilience" has been brought to the table, defining the ability of people to "bounce-back" after disasters. Substance abuse is another studied issue, with some reporting an increase in substance use following disasters. However, it is noted that the post-disaster abuse of substances is highest in those already using or abusing these ubstances. Other conditions such as generalized anxiety disorder, phobias, and other stress disorders are studied and have links to disaster experience.

The article also discusses some risk factors for post-disaster psychological disorders. Prior to disasters, women tend to be less resilient, and more suscpetible to disorders, excepting substance abuse. Children are especially vulnerable to issues. Socioeconomic status, ethnicity, and community support are also factors in the outcome of a person's mental state post-disaster. During a disaster, the degree of exposure to the incident is the greatest factor in outcome. After a disaster, support network and ongoing life stressors play a large rold in the outcome. The biggests steps to preventing poor outcome post-disaster are prepartion and anticipation of the disaster, and recognition/prevention of mental illness. 

Generally, only a small percentage of victims seek help from services provided for mental health disorders. This makes it difficult to accurately research the affects and prevalence of mental health disorders. 

The article is largely a review/update on the state of the research being done into disaster-related mental health conditions. Thus all the support for the arguments is research based rather than example based. The author backs up their definition of disasters in three categories: natural, human-made nonintentional, and human-made intentional. These criteria affect the outcomes for the psyches of the victims, with the human-made disasters carrying more weight, particularily the intentional ones. 

PTSD has been continually supported in literature, and the author simply recites sources of research dating back to the Vietnam War. The WHO has since devleoped more detailed planning tools and treatment tools for victims of trauma. 

The authors also cite multiple levels of research into the risk factors for multiple mental health issues, regardless of and related to specific disasters. 

The shift in thought from prevention to response is well supported as a necessary move. This can obviously be seen by the occurrence of these accidents despite adequate regulation. Nuclear energy is a promising, but dangerous thing, and can quickly become disastrous despite efforts to maintain control. This was seen in the accident at Fukushima, following the earthquake and resulting tsunami in the region. Despite preparation for such an event and the existence of backup generators and batteries, responders were rendered useless in the efforts as they could not access the area. This is where the need for a prepared system of nuclear response is needed. Historically, such emergency response groups have been poorly resourced and short-lived, such as the Soviet Spetsatom developed after the Chernobyl disaster in 1986. This group, which focused on preserving lessons learned and developing response systems, was absorbed by a larger ministry with the goal of integrated disaster response.

Additionally, the author cites a number of factors that played a role in creating the Fukushima-Daiichi disaster, such as “environmental, social, and technical systems” that, due to their complexity and separate protocol, resulted in lack or preparedness for the disaster. Following the disaster, the response efforts were delayed by this lack of preparation, and the media called out TEPCO and the Japanese government for this. STS analysis is important in this aftermath as much as in the creation of the initial plan. By utilizing an interdisciplinary approach, the media (and the people) can be heard and used to reform existing policies, or create new ones. This establishes a continuously evolving system of response that can adapt and take into account many different view of disaster relief. 

I did an initial google search of “international emergency response team” and found an article from IAEA about the establishment of RANET. This network was made operational by Finland, Mexico, Sri Lanka, and the US in 2008. I found this interesting as, aside from the US, none of these countries were what I thought of in terms of nuclear energy production. Upon further research, I learned that Mexico has two reactors supporting 4% of their electricity and Finland has four reactors providing 30% of the total electricity. At the time of the article, Sri Lanka had no future in nuclear power, but in 2015 signed a deal with India to jointly create a new power plant. 

"Third, additional studies are needed of interventions that aim to prevent or reduce symptoms of mental illness among disaster victims (42, 49). Although some interventions have been deemed efficacious in randomized controlled studies, effectiveness studies are needed to evaluate how well interventions work in the general population with practicing clinicians (38) and how well they prevent or reduce comorbid depression and substance use disorders..."

"The disaster context introduces additional methodological challenges, over and above the challenges that affect all studies of mental health, in four key areas: defining the target population, obtaining a representative sample of affected persons from this population, implementing an appropriate study design, and measuring key constructs"

"Psychological first aid (PFA) has become the preferred post-disaster intervention, with three goals: Secure survivors’ safety and basic necessities (e.g., food, medical supplies, shelter), which promotes adaptive coping and problem solving; reduce acute stress by addressing post-disaster stressors and providing strategies that may limit stress reactions; and help victims obtain additional resources that may help them cope and regain feelings of control."

The main arguments brought up in this article are the shift in thought from nuclear disaster prevention to disaster response and the importance of the STS community in providing input for policy. From these arguments, another is proposed in the form of the need for an international nuclear disaster response team. 

The author likely read through the referenced articles to find where they could be appropriately cited, and then conducted first hand interviews with select people (as mentioned in the notes) to put the information into context. Together, the multiple forms of media allow for a well-rounded point of view in writing the article, with various angles being well-represented throughout.