Very often, the mental health needs of people are grossly underestimated or misunderstood. This challenge is even worse for those caught in catastrophes or emergencies. At a time when populations and countries are facing multiple disasters and emergencies many brought about by climate change and conflict, experts raise the need to prioritise access to mental health services in emergency responses.
This year’s World Mental Health Day theme: “Access to Services: Mental Health in Catastrophes and Emergencies” – highlights this urgency. The World Health Organization (WHO) points out: “Crises such as natural disasters, conflicts, and public health emergencies cause emotional distress, with one in five individuals experiencing a mental health condition. One in five people (22%) who have experienced war or conflict in the previous 10 years has depression, anxiety, post-traumatic stress disorder, bipolar disorder or schizophrenia, the WHO said.
The Indian scenario
Lakshmi Vijayakumar, psychiatrist and founder of the SNEHA suicide prevention centre in Chennai, said there has been some progress in public mental health after crisis situations. “It was after the 2004 tsunami that people realised that once the physical needs of survivors were met, there is mental trauma, post-traumatic stress disorder, loss and grief that needs to be addressed. Mental health services were ramped up after this, and integrated into the relief mechanism. A psychological first-aid protocol was developed,” she said.
Mental health is an important component of any disaster, she pointed out. The COVID-19 pandemic brought this to the fore, affecting everyone in some way or the other – infected or not. “Isolation, fear, uncertainty and lack of communication affected people deeply and psychologically. It was after COVID-19 that the task force for mental health was formed,” she noted.
Better understandings
Dr. Lakshmi emphasised that mental health, once equated with mental illness, is now better understood. It has a greater role in emergencies and crisis situations such as wars and manmade disasters.
She also stressed the importance of addressing children’s mental health as many may have been exposed to violence and trauma. “Nearly 80% of refugees live in low-and-middle income countries. Relief should include not only physical, but also mental and psychological support. Mental health components should be a part of the initial planning. It should be a package, and not a reactive process or after thought,” she insisted.
Government response
P. Poorna Chandrika, professor of psychiatry, Institute of Mental Health (IMH), Chennai, recalled how IMH responded during the Gaja cyclone that hit T.N. in 2018. “A team from IMH that included psychiatrists and psychologists went to Pudukottai, one of the most affected districts, and identified people in distress and grief. We stayed there for two to three days and followed up with those needing mental health care,” she said.
Physical needs such as shelter are met after a disaster, but mental health needs are most often neglected, she said, adding:. “People could be in a state of shock, not knowing what to do. They could look for a support system during crisis situations. Along with a general medical team, a mental health support system should be put in place to work in coordination. They should be able to assess and identify persons with acute stress reactions, those requiring grief counselling, and other support,” she said.
More efforts needed
Sivabalan Elangovan, consultant psychiatrist in Chennai, said that in crisis situations such as wars or disasters, efforts are first taken to restore all facilities. “Economy, health and stabilisation, in the case of war, are among the focus areas but the mental health of people in these zones is not looked into. The impact of crisis and emergencies on children and adolescents is long-term, and so, mental health services are crucial. Access to mental health services must be created on a priority basis in emergencies and catastrophes,” he pointed out.
In a country like India, decentralising mental health services must be the goal, to ensure availability and easy accessibility, he stressed. “Mental health services are assumed to be a luxury, but they are essential.” Dr. Sivabalan added.
Addressing accessibility
Being mentally healthy is essential for coping with any catastrophic situation, he said, adding: “We must ensure that mental health services are accessible during any emergency or catastrophe. With rising rates of unhealthy behaviours, substance abuse, violence, and non-communicable diseases, maintaining mental health is crucial. We need to actively promote discussions about mental health across all sectors to help remove stigma.”
Dr. Lakshmi also referred to the WHO and Inter-Agency Standing Committee guidelines for mental health and psychosocial support in emergency settings. “This outlines how to offer psychological help to people during disasters, and it is important to practice them actively,” she emphasised.
Published – October 10, 2025 06:00 am IST
