Why social media is an imperative for disaster psychiatry

Hidden amongst all the intense media coverage surrounding Facebook’s IPO, there was a news item that was covered so briefly that if you blinked you may have missed it: Facebook’s CEO, Mark Zuckerberg, took a trip to Japan and during this visit told Japan’s Prime Minister that the terrible Tsunami that had struck the country in 2011 had inspired him to find ways that the social network could help people after natural disasters.

Disasters, whether unforeseen acts of nature or man-made atrocities, have an adverse impact on the survivors and often cause widespread disruption, displacement and disability. Epidemiological studies have documented elevated rates of mental health disorders, such as anxiety disorders, posttraumatic stress disorder and substance abuse in post disaster settings.

In addition to essential basic resources such as food, shelter and water, connecting with one’s social support, whether they be family, community, school or friends, are important resources which help survivors recover in the aftermath of a disaster.  Such social support offers great protection to survivors in curbing the development of these adverse mental health consequences.

In short, disaster survivors are likely to do better if they feel, or are helped to feel, safe and connected to others.

This raises the key question: Can social media bolster the social networks of post-disaster survivors and, in turn, prevent the negative mental health consequences of exposure to disaster?

Social media have, in recent years, played an increasing role in disaster management.   They have been used as ways to disseminate crucial information (social media sites rank as the fourth most popular source to access emergency information) and also, more actively, as emergency management tools (i.e. using social media to receive victim requests for assistance or monitoring user activities to establish situational awareness.)

Here are some observations worthy of note:

1. Researchers have hypothesized that social media offers psychological benefit to disaster survivors as their involvement in the online response to the disaster satisfies their psychological need to contribute. For example, after the 2010 Haitian earthquake, disaster survivors used social media to tell their stories and this, in turn, drove the mainstream media’s response to the tragedy.

2. In a case study of the adoption of technology in the aftermath of Hurricane Katrina in New Orleans, online spaces become virtual instantiations of the damaged and broken physical environments from which survivors were now barred. These virtual instantiations of physical communities were used as points of connection and sites to exchange social support.

3. Research into why the general public uses social media during disasters shows that maintenance of a sense of community and seeking emotional support and psychological healing (through virtual communities and relationships) as being among the most common reasons.

4. Information and communication technology researchers have identified a new online practice around disaster response—virtual memorials being created by “image aggregators” when new Flickr groups are created immediately after a disaster.

5. After the shootings at Virginia Tech and Northern Illinois University, students participated in numerous online activities related to the shootings. Students perceived sharing grief and support over the internet as being beneficial to their recovery (although we have no evidence that such internet usage actually affected their well being.)

Old wine, new bottle?

For millennia, humans have been driven to gather, share testimony and memorialize in the aftermath of disaster.   Anybody who works with trauma survivors can speak to the power of bearing witness to their trauma narrative and the healing that occurs when a survivor gives their testimony and how integral that is to their psychological recovery.

Perhaps social media is just shaping the way we do this, not changing what we are trying to do.

But I would argue there is more to the story than that. Mental health professionals know too well the vital importance of increasing access to assistance for survivors in post disaster settings and, in this regard, social media technology offers unbridled promise.

Social media relies on peer to peer networks that are collaborative, decentralized and community driven—the potency of this unique communication, in helping survivors of disasters, remains untapped. In addition, social media can be accessed at low cost, information can be rapidly transmitted through a wide community and the online access creates ways for people from far afield to participate in the forum.

Of course, there are many potential down sides to such communication: misinformation, blind authorship, presentation of opinion as fact, and privacy and security concerns being just a few. And then there is the digital divide—access to social media is predicated on the assumption that the disaster survivors have access to the necessary tools. Those with a low socioeconomic status are among those who need the most support and services after a disaster and, of course, least likely to have the means to purchase the technology needed to access social media.  So would this technology really be increasing access to help for those who need it or simply offering an alternative type of support for those who may have tapped into other sources of social support if the social media option did not exist?

So, can social media bolster the social networks of post-disaster survivors and prevent the negative mental health consequences of exposure to disaster?

Well, the answer is we don’t know until we can actually demonstrate that such use of social media directly contributes improved mental health outcomes for survivors of disaster.

Still, increasing access to assistance for survivors in post-disaster settings remains an imperative for disaster psychiatry and the lure of integrating social media technology into our efforts remains very strong.

Shaili Jain is a psychiatrist who blogs at Mind the Brain on PLOS Blogs, where this article originally appeared on January 24, 2013.

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