Psychiatry and the South Asia Disaster

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Psychiatry and the South Asia Disaster

Postby Corpsman-Up » Thu Jan 06, 2005 4:04 pm

I have a question that has been nagging my brain for a week now...

Obviously, the destruction from the tsunami disaster in South Asia is staggering. I have found myself wishing that I was already done with medical school so I could go help out somehow.

Is there anything that a psychiatrist could do to help in that type of an overseas situation, or is the language barrier an insurmountable one? (Certainly, if a doc is dually-trained, then the skills in IM or FM would be of obvious worth, but what about the psychiatric side of things?) The trauma for the people there has to be overwhelming, but how do you treat people with whom you cannot readily communicate?

Is there any precedent for treating people (in a psych setting) with the aid of an interpreter? With the Marines we used to do it for regular medical stuff all the time, but it seems that psych would be different somehow.

Just wondering.
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Re: Psychiatry and the South Asia Disaster

Postby Marie » Sun Jan 09, 2005 6:27 am

I am a first year combined internal medicine-psychiatry resident currently doing inpatient psychiatry. We (myself and other interns) have had patients who speak anything from Spanish to Vietnamese to Polish as well as other languages. Although it is ideal to have a physician who can speak the patient's primary language that is often not the case and interpretors are used. It potentially can be a bit more awkward or difficult discussing mental health issues through an interpretor, however, patients are often so relieved that someone is addressing the issue that they don't seem to care. I also think that most of the awkwardness is something that we feel (if you were a patient, what is the difference between telling one versus two people about your depression and thoughs of suicide or voices you hear- as long as both people are acting professionally?). What is said through an interpretor remains confidential and patients need to be informed and reminded of that. In my experience, patients seem more comfortable speaking their primary language and having an interpretor present than the alternatives. The interpretor can also clue you in to certain cultural differences.

As for going to other countries when disaster strikes. I do think that there is a role for mental health care workers, including psychiatrists. One thing to keep in mind, however, is that most people immediately after an event are in shock or denial and are dealing with the bottom of Maslov's hierarchy of needs (food, water, shelter, etc.). There are often normal grief reactions that may need counseling (often better provided by crisis counselors or mental health social workers). Much of the psychiatric stuff doesn't come until later.

You sound like someone who might be interested in Doctors without Borders (Medicins sans Frontiers).

Hope this helps!
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