While Hurricanes Harvey and Irma leave communities quaking, the physical damage, emergency response and charitable aid typically take the headlines. Less familiar and less obvious – but equally important is "psychological first aid".
While property insurers sweep in to assess the damage and begin the process of helping people rebuild, is there a role for life and health insurers to help mitigate the less tangible, but longer-lasting mental and physical health risks that occur after such devastating events?
The World Health Organization reports that people suffer a wide range of mental health problems during and long after emergencies. Whether it's a hurricane, a towering inferno, tsunami or terror attack like the world-altering 9/11 we remember this week – all such disasters carry hidden dangers that can increase risks for mental and physical health including posttraumatic stress disorder (PSTD), risk of suicide, greater infection rates, depression and other complications that stem from things like lack of access to medicine or undue physical exertion.
There is consensus among experts who've studied the impact of disasters on mental health that a mental health response should be an essential integrated piece of the overall emergency response.
Such a response might be case identification, triage and interventions consistent with the approaches for established emergency response. Early interventions for psychological distress should focus on wellness and meeting basic psychological needs (provide information on resources and facilitate networking), offering psychological debriefing in individual or group sessions and crisis counselling.
Psychiatric disorders may be an exacerbation of a pre-existing condition or a new onset disaster-related disorder. PSTD is the most common psychiatric disorder associated with disaster trauma. It's estimated to occur in over 30 percent of exposed individuals and can result from being in direct danger, being an eyewitness to trauma or having a close relative or friend in danger.
Major depression has also been reported in about 25% of survivors. Disaster mental health studies also report stress and adjustment disorders, bereavement, and substance use disorders in individuals presenting at shelters and family assistance centers. An estimated 40 percent of distressed individuals have pre-existing psychiatric conditions and the majority of alcohol and substance use disorders are pre-existing rather than new onset.
Today Swiss Re has increasingly sophisticated modeling tools that help us assess things like flood risk and understand the extent of damage in a disaster. In the case of the 2016 Canadian wildfires – the worst insured catastrophic event of my home country – 88,000 people were forced out of their homes. Swiss Re was able to pre-pay a portion of the claims in order to help local insurers get cash in the hands of evacuees immediately – when they needed it the most.
In our increasingly connected, technological future, could we see a world where life and health insurers provide similar personal and timely support to policyholders affected by disaster and trauma? Today Siri can direct us to the best restaurant. Life and health insurers know where their policyholders live so why not use our expertise and risk-management know how to channel resources and help to them after a disaster? This is a way our industry can add value, even before a claims is made. In the process we build our reputation for doing good and help prevent conditions that can become more serious.
Finally, let's not forget that events like Harvey, Irma and 9/11 are also great reminders of why we are working to close the protection gap – so when disaster does strike, and people lose lives or the ability to work – their families and loved one can forge ahead with some financial footing to make a difficult journey more bearable.
North CS Pfefferbaum B. Mental health response to community disasters. A systematic review. JAMA 2013; 310:507-518