Mental health
In the immediate aftermath of a disaster, anxiety, neurosis and depression are not a major public health issue, and can generally be handled temporarily by other members of rural or traditional communities without external support. Confounding expectations, it is relief workers who may comprise a high-risk group. Whenever possible, all efforts must be made to preserve the social structure of families and communities. Likewise, the indiscriminate use of sedatives or tranquilizers during the relief stage of the disaster must be vigorously discouraged. In the industrialized or urbanized areas of developing countries, a significant increase in mental health problems often accompanies the long-term rehabilitation and reconstruction phase. Treatment must be provided. Special reference must be made to the traumas that are the result of contact with the horrors of armed confrontation and other forms of extreme violence. The violent death, disappearance, or injury of relatives and friends aggravates the trauma, which generally calls for protracted therapy.