Investigating the Aftershock of a Disaster: A Study of Health Service Utilization and Mental Health Symptoms in Post-Earthquake Nepal

Abstract

Background: In 2015, a 7.8 magnitude earthquake struck Nepal, causing unprecedented damage and loss in the mountain and hill regions of central Nepal. The aim of this study was to investigate the association between healthcare access and utilization, and post-disaster mental health symptoms. Methods: A cross-sectional study conducted with 750 disaster-affected individuals in six districts in central Nepal 15 months post-earthquake. Anxiety and depression were measured through the Depression, Anxiety and Stress Scale (DASS-21). Healthcare utilization questions examined types of healthcare in the communities, utilization, and approachability of care providers. Univariate analyses, ANOVAs and Tobit regression were used. Results: Depression and anxiety symptoms were significantly higher for females and individuals between 40–50 years old. Those who utilized a district hospital had the lowest anxiety and depression scores. Participants who indicated medical shops were the most important source of health-related information had more anxiety and depression than those who used other services. Higher quality of healthcare was significantly associated with fewer anxiety and depressive symptoms. Conclusions: Mental health symptoms can last long after a disaster occurs. Access to quality mental health care in the primary health care settings is critical to help individuals and communities recover immediately and during the long-term recovery.

Health Impact and Risk Factors Affecting South and Southeast Asian Women Following Natural Disasters: A Systematic Review

“…The most common research method was the quantitative approach, which included 10 quantitative descriptive studies and four quantitative non-randomised studies. All the studies were conducted in lower-middle-income countries: Nepal (n = 6) [ 27 , 28 , 29 , 30 , 31 , 32 ], Pakistan (n = 4) [ 33 , 34 , 35 , 36 ], India (n = 2) [ 37 , 38 ], Indonesia (n = 2) [ 39 , 40 ], Sri Lanka (n = 1) [ 41 ], and Bangladesh (n = 1) [ 42 ]. Among these, Nepal and Bangladesh have recently risen up from low-income country status to lower-middle-income countries.…”

“…The majority of the studies (14/16) included disaster-affected men and women as the study participants and the other two reported women in particular. One study did not report the age range, although the study included adult community members [ 31 ]. Most of the studies (n = 8) were published between 2018 and 2019, one in 2020, and seven between 2010 and 2012.…”

“…The majority (n = 8) of retrieved studies strongly identified the association between depression, anxiety, and common mental disorder (CMD) in women following natural disasters [ 28 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 42 ]. All these studies measured/observed significant scores of depressions (mean range of score 9.88–29.14), anxiety (10.97), and CMD (General Health Question score of 4 and above, mean score of distress 11.2) in disaster-affected participants using a variety of scales including the Depression Anxiety Stress Scale (DASS)-21, the Patient Health Questionnaire-9 (PHQ-9), the Beck Depression Inventory-II (BDI-II), the General Health Questionnaire (GHQ 12), and the Centre for Epidemiological Studies Depression Scale (CES-D).…”

Post-traumatic Stress Symptoms in Adolescents Exposed to the Earthquake in Lombok, Indonesia: Prevalence and Association With Maladaptive Trauma-Related Cognition and Resilience

“…Developing countries have started integrating mental health and psychosocial support in their disaster preparedness and response (15)(16)(17). However, recent studies showed that mental health problems especially PTSD, depression, and anxiety were still relatively high in these countries (18,19). Adolescents are vulnerable to their surroundings and may not have adequate knowledge of how to cope with mental health issues and what to do in response to natural disasters.…”

Breaking Through Barriers and Building Disaster Mental Resilience: A Case Study in the Aftermath of the 2015 Nepal Earthquakes

“…In fact, one study evaluated MHPSS responses and their long-term implications [8], while another focused on the coordination of activities, the leadership of MHPSS programs, as well as service delivery [15]. Some studies have attempted to answer issues concerning service utilization and mental health outcome [16], social cures for post-traumatic stress [17], and religious interventions [18]. Another recent study explored the mental health impact from earthquakes and resilience amongst earthquake-affected villages, stating that 46% of survivors exhibited moderate to high resilience [19].…”