16.4.1 Mental health problems due to life-threatening violence or accidents
For some people the effect of violence or major accidents on their long-term mental health will be very serious and they may develop one of the following mental illnesses:
- Depression (see Study Session 12)
- Anxiety (see Section 16.2 above)
- Alcohol misuse (see Study Session 14)
- Post-traumatic stress disorder.
In post-traumatic stress disorder (PTSD), the person remains very distressed because of the violence or accident they experienced. You can screen for PTSD by looking for the following symptoms:
- horrible and persistent memories or nightmares about the bad event
- unable to relax because they are expecting more bad things to happen
- avoiding anything that reminds them of the bad event.
The person with PTSD may not be able to work properly and they may develop problems in their relationships with other people. In Box 16.3 are some suggestions for how you can help when a person develops mental health problems as a result of life-threatening violence or accidents.
Box 16.3 How you can help with the mental effects of life-threatening violence or accidents
- Reassure the person — usually mental distress lessens with time
- Encourage family and friends to be supportive
- Talking about their experience doesn’t always help – let the person decide if they want to discuss it or not
- Encourage the person to continue with their normal activities as much as possible — having a routine is helpful
- If they are very severely distressed, refer to the next level health centre straight away
- If the person’s distress lasts for more than one month, screen for mental illness (depression, anxiety, alcohol problems, PTSD) and refer if signs of these disorders are present
- You can explain to the person and their family that PTSD can be helped by medication and by talking to a trained health worker.