AbstractObjectivePsychological assessment after disasters determines which survivors are acutely distressed or medically compromised and what kind of assistance is needed (whether practical or psychological). A mental health triage tool can help direct more people to the appropriate type of help. The purpose of this study was to determine the effectiveness of the Fast Mental Health Triage Tool (FMHT) and the Alsept-Price Mental Health Scale (APMHS) among public health workers and Medical Reserve Corps (MRC) volunteers in conducting mental health triage. Both tools screen for ability to follow simple commands, chronic medical conditions, mental health conditions and services, occult injuries, and traumatic events in the past year. Both were designed for use in disasters where mental health resources are scarce and survivors are already medically triaged.MethodsVolunteers (n = 204) and workers (n = 66) were randomized into 3 groups, with 79 participating. Fifty-nine raters completed 20 each of 1180 mental health clinical vignettes of disaster survivors.ResultsThe survey presenting the vignettes was highly reliable at 0.771; the study model was parallel between baseline and treatment; and the interclass correlation among the raters was high at 0.852. Each rater triaged the same cases, but the rater was randomly assigned to use FMHT, APMHS, or no tool or scale. Between-subject effect for the tools used was significant (P = .039). The FMHT was significantly better than no tool in correct mental health triage, 67.3% to 51.5% (P = .028).ConclusionThe incorporation of a temporal component should be evaluated for potential inclusion in existing mental health triage systems. (Disaster Med Public Health Preparedness. 2013;7:20-28)

This article describes a therapy group for the male partners of women in treatment for sexual or physical abuse. The partners came to see themselves as the secondary victims of the original abuse as their relationships and families were disturbed for long periods during their wives' treatment. The group validated the men's experiences, gave them an emotional outlet, educated them about their wives' dynamics, and assisted them in sustaining their relationships. This article presents a typical profile and specific outcomes gathered from 16 participants over a 4 ! h-year period and describes our therapeutic approach.

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Reconciliation between incest perpetrator and victim is rarely noted in the literature. The authors report their work with an uncle and niece who were able to reconcile many years after the incest had occurred. The niece entered treatment and initiated the confrontation and eventual reconciliation with her uncle. Only because he acknowledged the incest and his responsibility for it was reconciliation possible. Case histories, therapeutic issues, legal and ethical ramifications, and case management factors are presented. The authors offer this case history with the hope that their collaboration may generate some new ideas for others working toward reconciliation between victim and perpetrator.

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