DISASTER PSYCHIATRIC SERVICE AT A GENERAL HOSPITAL FOLLOWING THE GREAT HANSHIN EARTHQUAKE

Abstract

This report is a kind of empirical study on disaster psychiatric services following the Great Hanshin Earthquake. Our work was performed at a general hospital (the Higashi-Kobe Hospital) located in the middle of the disaster area. Before the quake there were no psychiatric facilities at that hospital ; nevertheless many patients with mental problems visited there. And our team; consisting of several volunteer psychiatrists from all over Japan and some nurses of that hospital, immediately set up psychiatric emergency service at the hospital, and started to work on Jan. 19, 1995. We report our experience and some findings through it. We consulted 289 patients from Jan. 19, 1995 to Jan. 31, 1996. However in this report, we refor only to 204 outpatients that we saw during that period, with special reference to "disaster-related" cases. There were 145"disaster-related" cases and these "disaster-related" cases have still been appearing for a year after the disaster. The numbers of female patients was larger than that of males, and most of them were between 40 and 80 years old. Concerning psychopath- ological states, depressive and anxiety states were most often observed, and then PTSD (post-traumatic stress disorder) or PTSR (post-traumatic stress reaction) and acute psychotic state followed. "Relatively severe psychiatric cases" were observed during the rather earlier period following the quake. On the other hand the number of "relatively mild cases" increased since the second month after the quake. From our experience when a large city is hit by a catastrophic disaster, it is effective to set up psychiatric emergency services not only at public health centers or mental hospitals but also at general hospitals. Additionally, cooperation between psychiatric services and other medical services, such as internal medicine, surgery and so on, is very important and necessary in catastrophic conditions.