Mental Health Service Utilization After Natural Disasters: A Systematic Review.

OBJECTIVE

Natural disasters are associated with new-onset mental disorders and distress and may exacerbate preexisting mental health issues. To date, no systematic review has examined rates and correlates of mental health service (MHS) use among adults exposed to natural disasters. This study aimed to synthesize findings examining MHS use among adults exposed to natural disasters.

METHODS

The review was preregistered with PROSPERO (CRD42023430815). PsycInfo, MEDLINE, Embase, CINAHL, and Scopus were searched to identify studies. Studies reporting rates or correlates of MHS use among adults exposed to natural disasters were eligible for inclusion. Narrative syntheses summarized study findings, and the Mixed Methods Appraisal Tool guided quality assessments.

RESULTS

Forty-one articles (representing 39 studies) were identified across 18 countries. Studies were conducted in varied postdisaster settings and were characterized by considerable methodological heterogeneity. Rates of postdisaster MHS use were generally low (<10%) among general population samples but higher among samples with greater degrees of disaster exposure. Among participants reporting postdisaster MHS use, nonspecialist primary health care services were utilized most frequently. A substantial proportion of participants reporting distress or disorder did not use MHSs. Few consistent correlates of MHS use were identified.

CONCLUSIONS

Rates of postdisaster MHS use are likely to depend on disaster-specific contextual factors. Generally, most adults exposed to natural disasters do not utilize MHSs, although rates appear to increase as a function of exposure severity. Mental health recovery efforts may benefit from prioritizing nonspecialist primary health care services and utilizing outreach approaches targeted toward groups with high degrees of exposure severity.