Newsflash: disasters are bad for mental health (but not how you think)

Some highlights from WADEM 2025 in Tokyo

It was mental health week last week in Canada. It made me think, “you know what’s bad for mental health? Disasters.” But possibly in ways that aren’t obvious.

A number of presentations at WADEM 2205 in Tokyo highlighted the effects of disasters on mental health and their subsequent manifestations. I’ll highlight a few from one session that overturned a few assumptions I held. Here are some of the questions addressed:

-Does the size and impact of a disaster correlate with the impact on mental health?

-Is mental distress greatest immediately after a significant crisis and decline steadily thereafter?

-Does getting “back to work”, and being immersed in the tasks of daily life and recovery indicate resilience and good coping?

-Do restrictions and mitigative measures, such as during COVID lockdowns, with resulting decreases in morbidity and mortality, justify the mental health effects caused by such measures?

-Are youth less impacted by disasters?

-Is interference with school, being the main source of social interactions for youth, a big factor?

Here are some of the answers presented.

-mental distress is not strongly temporally related to disasters

-nor is it related to the size (number of deaths) of disasters

-youth are particularly vulnerable to the mental stress of disasters but not going to school was far less important than not playing sports

-PTSD may look like resilience

-Restrictive measures (lockdowns) have longstanding effects (burnout) that have to be weighed against decreasing morbidity/mortality of pandemics (I probably don’t need to belabour this one, we’re all still reeling from COVID).

Not really Dr. Newnham

Dr. Elizabeth Newnham, School of Population Health, Curtin University, Australia presented on Longitudinal Patterns of Healthcare Workers’ Mental Health during Western Australia’s Unique Policy Response to COVID-19.  During the pandemic, people with lower “depression or anxiety symptoms at baseline reported a larger increase in symptoms over time, and those with higher symptoms at baseline had a smaller decline over time, indicating a ‘catch up’ effect.” Effects of mitigation measures have to be considered. And not just their effects on morbidity and mortality, but also on lasting effects on mental health as a result.

Another presenter, Marjolijn Verweij from the ARQ National Psychotrauma Centre in the Netherlands (1), summarized her research paper exploring risk factors—sociodemographics (such as social support, health problems, and others), and factors related to exposure (among these loss of loved ones or property, time from exposure, etc.). Research and clinical care tend to focus on immediate and short-term effects of disasters. It’s clear that mental health care begins well before an event (again, no surprise, similar to the all-important social determinants of health), but also well after.

Not really the Netherlands

By measuring contact with primary care provider for mental health concerns, Dr. Marc Bosmans, from the Netherlands Institute for Health Services Research, and his team estimated the impact of infection control measures, specifically lockdowns, during the COVID pandemic. Not surprisingly, GP visits for depression were more frequent during lockdowns. Cancellation of sports, but not school, was also associated with more GP visits for mental health concerns. Given the importance of social contact, the majority of in-person contact with peers being during school, the researchers expected to see an effect of school closures. Of course this doesn’t reflect causality, but gives food for thought (and further research).  In older age groups, the equivalent to school closures, work-from-home mandates, saw increased contacts for fatigue and irritability, especially among 45-74 year-olds. In other research, Dr. Newnham has shown that “…depression and anxiety remained elevated for years following disasters and pandemics.” This effect is significantly higher in children than adults (2).

Considering the idea that bigger disasters might have bigger effects on mental health (negatively, of course), Dr. Michel Dückers presented research showing that it is not so simple. In an extensive review of the literature, he and colleagues examined different disaster types, numbers of fatalities, mental health outcomes and other factors. They saw that the mental health effects from disasters are “profound and long-lasting” but not related to numbers of fatalities. Dr. Dückers has done a ton of research in this area. I’ll point you towards some fascinating stuff about the “vulnerability paradox…lower vulnerability at the country level is accompanied by a higher prevalence in a variety of mental health problems in national populations” (4) and disaster risk reduction specific to mental health (5).

Disasters affect health care providers. We know that, but the stigma is still there. Dr. Robin Jacoowitz, director of the Institute for Disaster Mental Health at SUNY New Paltz (https://www.newpaltz.edu/idmh/) talked about barriers to seeking mental health care. Studying EMS providers, we see ongoing hesitancy to seek help from lack of resources to fear of negative impacts on career.

It might be such stigma that pushes mental distress deeper down to manifest later, in subtle forms. Dr. Arinobu Hori, a psychiatrist from Japan, reported on cases of PTSD resulting from the Fukushima disaster (2011 earthquake/tsunami/nuclear power plant explosion - see reference 6 for an overview - a categorization of deaths resulting from this event. Dr. Hori is one of the authors). Initially, patients seemed to be very resilient, over-adapting, actually. Vigorous involvement in recovery efforts, community service, and personal projects may be a response to disaster. In these cases, depressive symptoms developed much later, as well as the connection between their experienced trauma and mental health symptoms.

Disasters shape our lives and our hearts. Understanding how and why might help the shaping be constructive and creative rather than diminishing and destructive.

References and further reading

1. ARQ National Psychodrama Centre, Netherlands. https://arq.org/en further information, research, and an informative video in the melodic dutch language (with English subtitles).

2. Newnham EA, Mergelsberg ELP, Chen Y, Kim Y, Gibbs L, Dzidic PL, et al. Long term mental health trajectories after disasters and pandemics: A multilingual systematic review of prevalence, risk and protective factors. Clinical Psychology Review [Internet]. 2022 Nov [cited 2025 May 12];97:N.PAG.

3. Bosmans M, Marra E, Baliatsas C, de Vetten-Mc Mahon M, Dückers M. The consequences of the COVID-19 pandemic on the health and wellbeing of the youth: a systematic review. European Journal of Public Health. 2022 Oct 1;32(Supplement_3):ckac129-480.

4. Dückers ML, Reifels L, De Beurs DP, Brewin CR. The vulnerability paradox in global mental health and its applicability to suicide. The British Journal of Psychiatry. 2019 Oct;215(4):588-93

5. Reifels L, Dückers ML. Disaster mental health risk reduction: appraising disaster mental health research as if risk mattered. International journal of environmental research and public health. 2023 May 23;20(11):5923

6. 6. Yoshimura H, Sawano T, Murakami M, Uchi Y, Kawashima M, Kitazawa K, et al. Categorization of disaster-related deaths in Minamisoma city after the Fukushima nuclear disaster using clustering analysis. Scientific Reports [Internet]. 2024 Feb 8 [cited 2025 May 15];14(1):1–15.