Emergency Response isn't directly addressed in the article. However there is one mention of emergency responders and the debriefing typically held after a traumatic event/call. But, the article also says that this method is not actually effective in preventing psychopathology, and can actually hinder the healing process by promoting exposure to traumatic memories.
The article was mainly backed by statistical evidence and cited other reesearch articles and studies. The authors, I assume, used their own extensive backgrounds in the field to support their arguments and views.
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.
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.
"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."