Trauma in sub-Saharan Africa: review of cost, estimation methods, and interventions.

Trauma is a widely acknowledged problem facing individuals and communities in developing countries. In sub-Saharan Africa-a region that is home to some of the world's worst human rights violations, ethnic and civil conflicts, disease epidemics, and conditions of poverty-trauma is an all-too-common experience in citizens' daily lives. In order to address these conditions effectively, the impact of trauma must be understood. The authors reviewed recent literature on the cost and consequences of psychological trauma in sub-Saharan Africa to provide a substantive perspective on how trauma affects individuals, communities, and organizations and to inform the effort to determine a method for measuring the impact of trauma in sub-Saharan Africa and the efficacy of trauma interventions in the region. Several recommendations are offered to help broaden and deepen the current approaches to conceptualizing trauma, evaluating its cost, and intervening on behalf of those impacted by trauma in sub-Saharan Africa.

Church attendee help seeking priorities after Hurricane Katrina in Mississippi and Louisiana: a brief report.

After a disaster, survivors find themselves seeking many types of help from others in their communities. The purpose of this exploratory study was to assist in mental health service planning by determining the type and priority of support services sought by church attendees after Hurricane Katrina. Surveys were given to church attendees from two Mississippi coast and four New Orleans area churches that were directly affected by Hurricane Katrina participants were asked to review a list of 12 potential sources of help and were asked to rank the items chronologically from whom they had sought help first after Hurricane Katrina. Overall, participants sought out assistance from informal social networks such as family and friends first, followed by governmental and clergy support. This study also showed there may be differences in help-seeking behaviors between church attendees in more urban areas versus church attendees in more rural areas. Moreover, findings highlighted that very few church attendees seek out mental health services during the initial impact phase of a disaster. Since timely engagement with mental health services is important for resolving trauma, strategies that link professional mental health services with clergy and government resources following a disaster could improve the engagement with mental health professionals and improve mental health outcomes. Disaster mental health clinical implications and recommendations are offered for psychologists based on these findings.

Developing standards of care: a tale of two panels.

OBJECTIVE: How will a group of experts convened to develop standards of care communicate in meaningfully different ways when interacting online in contrast to traditional face-to-face meetings. Furthermore, does online interaction facilitate discussion among participants from diverse cultural backgrounds and at what cost? DESIGN: A project to develop standards of care for deaf and hard of hearing adults used two panels of experts operating in two different formats: online and face-to-face. One panel interacted via an online system while the other met in a day-long face-to-face conference. As one component of the project, we tracked the interactions of these two groups in order to describe and contrast their group processes. STUDY PARTICIPANTS: The subjects were volunteer experts in hearing impairment and health care, from organizations across the United States. They were a geographically diverse group with widely varying communication needs. We applied two different systems for facilitating communication among culturally diverse participants, and assessed interaction and satisfaction. MAIN OUTCOME MEASURES: Data were collected on the two groups on the pattern of interactions, satisfaction with the process, and satisfaction with outcomes. RESULTS: The results showed a high level of user satisfaction with both process and outcomes, and provide data for a description of the source of user satisfaction and the management of the groups. CONCLUSION: Online interaction offers unique advantages but poses unique management requirements for success.