RESUMEN
Emergency and disaster situations such as war or terrorism can leave a devastating impact on the mental well-being of victimized populations. In Israel, the civilian aspects of trauma-related mental distress were first extensively tackled during the 1980s, and mainly within the terror-stricken Jerusalem and the localities along the northern border. Since then, a systematic process of trial and error has led to the evolution of emergency mental health services in the country. Over the course of about forty years, it has grown to be an exemplary one. It is a system deeply rooted in the ground, resulting from both a change of discourse and a naturalistic process of lesson learning, that is, drawing conclusions from actual fieldwork. This process and its implications on the mental well-being of Israelis are thoroughly discussed in this research.
RESUMEN
INTRODUCTION: The treatment of anxiety and acute stress reaction (ASR) in civilian casualties exposed to continuous missile attacks during Lebanon War II is described in this study. Casualties were treated in community stress centers (CSC) erected ad-hoc, as a result of cooperation between the Mental Health Section of the Home Front Command of the Israel Defense Forces (IDF), the Mental Health Services of the Ministry of Health (MOH) and the Emergency and Disaster Management Division of the MOH. RESULTS: A total of 536 casualties were admitted to the centers. Eighteen were evacuated to the zone hospitals due to physical problems. The remaining casualties were released within 2-4 hours of intensive intervention according to the protocol. Symptoms of casualties ranged from anxiety (and ASR)--90%; fear (mainly agoraphobia)--7%; adaptation--2%; sleep disturbances--1%. Mental health intervention included counseling talk--80%; ventilation--9%; relaxation--3%; non-verbaL intervention--3%; fulfillment of basic needs--1% and evacuation to hospitals--3%. We discovered that anxiety and ASR were the most prevalent syndromes among those casualties as a result of the missile attacks on the civil population. RECOMMENDATIONS: The CSCs succeeded in providing adequate response and treatment for the majority of the casualties, thus putting off the need to evacuate those casualties to the ERs. Thereby, evacuation resources were saved and the ER load was reduced. The authors recommend that preparedness of the population under missile attacks, as well as other disaster scenarios, which resulted in a high rate of mental casualties, will be focused in the activation of CSCs in the format which has been described in this article.
