A Brief Report of Surveillance of Traumatic Experiences and Exposures After the Earthquake-Tsunami in American Samoa, 2009

Context: Rapid mental health surveillance during the acute phase of a disaster response can inform the allocation of limited clinical resources and provide essential household-level risk estimates for recovery planning. Objective: To describe the use of the PsySTART Rapid Mental Health Triage and Incident Management System for individual-level clinical triage and traumatic exposure assessment in the aftermath of a large-scale disaster. Methods: We conducted a cross-sectional, comparative review of mental health triage data collected with the PsySTART system from survivors of the September 2009 earthquake-tsunami in American Samoa. Data were obtained from two sources-secondary triage of patients and a standardized community assessment survey-and analyzed descriptively. The main outcome measures were survivor-reported traumatic experiences and exposures-called triage factors-associated with risk for developing severe distress and new mental health disorders following disasters. Results: The most common triage factors reported by survivors referred for mental health services were "felt extreme panic/fear" (93%) and "felt direct threat to life" (93%). The most common factor reported by persons in tsunami-affected communities was "felt extreme panic or fear" (75%). Proportions of severe triage factors reported by persons living in the community were consistently lower than those reported by patients referred for mental health services. Conclusions: The combination of evidence-based mental health triage and community assessment gave hospital-based providers, local public health officials, and federal response teams a strategy to match limited clinical resources with survivors at greatest risk. Also, it produced a common operating picture of acute and chronic mental health needs among disaster systems of care operating in American Samoa. Language: en