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Complementary Mental Health Interventions for Disaster Recovery: A
Review and Critical Appraisal of the Literature
Adrienne Connick

Introduction

Discussion

Post-disaster mental health outcomes manifest as distress reactions,
health risk behaviours, and psychiatric disorders (Morganstein &
Ursano, 2020) and the majority of people impacted by emergencies
will experiences some form of psychological distress (WHO, 2022). An
important aspect of disaster recovery planning is to respond to the
mental health needs of communities impacted by disasters. The
purpose of this study was to determine the potential impact of using
Complementary Mental Health Interventions (CMHIs) for disaster
recovery planning and answer the following questions: Are CMHIs
effective in reducing post-disaster mental health symptoms? What are
the advantages and disadvantages of these types of interventions?
And what are the considerations for integrating CMHI into community
disaster recovery planning?

The findings showed overall participant reductions in self-reported
mental health symptoms as a result of a CMHI conducted postdisaster. More research is needed to validate these results and better
understand the impact of CMHI’s on disaster impacted participants
and communities.

Background

Integration of CMHIs into community disaster recovery planning
require some considerations for success including: addressing cultural
context, utilizing multi-agency collaborations, and planning across all
phases of emergency management.

Natural disasters present several challenges for community mental
health recovery. The number of people impacted far exceeds the
resources available, clinical or psychological mental health resources
are limited and do not have the capacity to treat the large numbers of
people who will be impacted. Damage to infrastructure can make
treatment difficult in a healthcare setting and mental health
treatments are stigmatized so many people do not seek help.
Morganstein & Ursano (2020) describe complementary and
alternative interventions as having “an increasing body of knowledge
support in their use in the treatment of traumatic stress” and found
that “many individuals will prefer social and community support over
formal intervention” (p.9). CMHIs include those applications such as
mind-body and mindfulness practices, yoga, breathing techniques,
meditation, arts-based, and other non-clinical interventions which can
assist in reducing mental health symptoms in participants who have
experienced disaster and thus may offer an alternative or
complementary strategy for disaster mental health recovery.

Methods

The advantages of CMHIs are their practicality in the community
where local community leaders have the potential to be trained and
lead these interventions, they can be scalable to meet the needs of
different group sizes, and they do not need to be location-specific
adding to their value in a disaster context. The use of CMHIs also
removes the mental health or psychiatric label that can be a limiting
factor when people are seeking care (Math et al., 2015).

Conclusions or Recommendations
The findings have positive implications for the use of CMHIs in
disaster recovery planning. While more research is needed, there is
potential for CMHIs to be an effective tool within the scope of
community post-disaster recovery. Future research should consider
investigating the relationship between cultural context, demographic
characteristics, intervention type, and should also consider
standardizing tools for measuring mental health outcomes.

References
Baumann, S. E., Merante, M. M., Sylvain-Holmgren, M., & Burke, J. G.
(2021). Exploring community art and its role in promoting health,
social cohesion, and community resilience in the aftermath of the
2015 Nepal earthquake. Health Promotion Practice, 22, 111S-121S.
doi:10.1177/1524839921996083

The research involved conducting a literature search and review of
academic studies, through the JIBC and Google Scholar databases,
that investigated the use of CMHIs for natural disaster impacted
communities. A critical appraisal of the studies was done to
determine the validity and reliability of the research. The findings
were then used to answer the proposed research questions.

Math, S.B., Nirmala, M.C., Moirangthem, S., Kmart, N.C. (2015).
Disaster management: Mental health perspective. Indian Journal
of Psychological Medicine, 37(3), 261-271. https://10.4103/02537176.162915

Results/Findings

Morganstein, J. C., & Ursano, R. J. (2020). Ecological disasters and
mental health: Causes, consequences, and interventions. Frontiers
in Psychiatry, 11. https://10.3389/fpsyt.2020.00001

Overall the data indicated that participants who received CMHIs
reported reductions to the mental health symptoms that they were
experiencing as a result of a natural disaster. One study also found
positive physiological changes in the form of lowered cortisol levels.
Other common themes that emerged from the literature review
included: the need for collaborations, the challenges in conducting
research in a disaster zone, and the flexibility of CMHIs. The critical
appraisal also highlighted limitations of the data where methods and
design varied across the research.

World Health Organization (WHO). (2022). Mental Health in
Emergencies. https://www.who.int/news-room/factsheets/detail/mental-health-in-emergencies
Figure 2
Kiran Maharjan Paints an Urban Street Mural in the Aftermath of the Earthquake

Figure 1
Psychological and Behavioural Responses to Disasters

Note. From “Ecological Disasters and Mental Health: Causes, Consequences, and
Interventions”, by J. C. Morganstein and R. J. Ursano, 2020, Frontiers in Psychiatry,
11(1), 4 (doi: 10.3389/fpsyt.2020.00001). 2020 by Frontiers Media S.A.

Bachelor of Emergency and Security Management Studies

Note. From “Exploring Community Art and its Role in Promoting Health, Social
Cohesion, and Community Resilience in the Aftermath of the 2015 Nepal
Earthquake”, by S. E. Baumann et al., 2022, Health Promotion Practice, 22(1), 114
(doi:https://doi.org/10.1177/1524839921996083). 2021 by Society for Public
Health Education.

Justice Institute of British Columbia