De-escalating anxiety in disasters and conflicts: The role of mental health professionals

Dear Editor, Disasters and conflicts for example, wars are among one of the most disruptive human experiences, often reshaping national identity and public behavior. Despite numerous peace accords and conventions after World War II, war crimes and other transgressions have persisted worldwide.[1] Recently, in April 2025, following a fatal militant attack in Pahalgam, India and Pakistan have further escalated their conflict, exchanging gunfire across the Line of Control and downgrading diplomatic ties. This has raised worries of a wider military conflict between the two nuclear-armed countries. Beyond bilateral tensions, India has faced multiple disasters including a landslide in Wayanad district (2024), an Air India plane crash (2025), a Telangana chemical factory explosion (2025), and so on in the past one year. These events highlight a crucial gap, while India’s disaster response systems emphasize rescue and rehabilitation, systematic mental health integration remains limited. There is a dire need to address disaster- and conflict-related mental health effects in the Indian setting, since even populations that are not actively participating in conflict incur tremendous emotional and psychological trauma. THE PROBLEM Psychiatric conditions like depression, post-traumatic stress disorder (PTSD), and anxiety disorders are common among civilians and military personnel residing in various disasters, conflict, and war zones.[2] The 24-hour news cycle, social media, and constant exposure to violent images have intensified the psychological impact of conflict. Real-time coverage has blurred the line between direct and indirect trauma, leading to emotional distress and panic attacks even among people far from conflict zones. Studies show that accessing social media during violent incidents increases the possibility of developing acute stress disorder and symptoms similar to PTSD.[3] A 2019 systematic review and meta-analysis by Charlson et al.[4] found that psychiatric morbidity is high in communities impacted by conflicts. Point prevalence rates for PTSD and depression in conflict situations were 22.1% and 18.3%, respectively. Furthermore, more than half of PTSD sufferers had comorbid depression. During and after disasters and war-like events, certain groups are more vulnerable than others. A systematic review by Hazer and Gredebäck in 2023 found that children exposed to war and displacement had higher rates of PTSD symptoms, sleep disturbances, emotional dysregulation, and poor academic performance.[5] Older populations are more susceptible due to social isolation, restricted access to healthcare, and a higher prevalence of chronic illness.[6] Those with pre-existing mental health illnesses are particularly at risk since conflict often disrupts continuity of care. Vicarious trauma is also commonly experienced by first responders, such as journalists and medical professionals. A review of PTSD in journalists conducted by Flannery in 2022 found that journalists who reported on violent events were more likely to experience depressive symptoms, substance use, and trauma symptoms.[7] CURRENT GAPS Despite the increasing recognition of mental health needs during disasters and conflicts, systematic integration of Mental Health and Psychosocial Support Services (MHPSS) into India’s disaster management protocols remains limited.[8,9] Existing frameworks, including national and state disaster plans, often focus on physical rescue and rehabilitation, with psychological care addressed only as an adjunct.[8] First responders and frontline workers rarely receive structured training in psychological first aid, resulting in missed opportunities for early intervention. Moreover, there is an absence of culturally validated screening tools for identifying distress, trauma, or functional impairment in diverse Indian populations. Community-based intervention models are scarce, and coordination between mental health professionals and local governance systems is weak. Post-disaster psychological care often remains fragmented, reactive, and short-term, rather than being a sustained component of recovery and resilience building. KEY SOLUTIONS To strengthen India’s disaster response, there is a need to embed MHPSS within the National Disaster Management Guidelines and state-level preparedness plans.[9] This integration should ensure that mental health care is recognized as a core pillar of emergency response, not an afterthought.[9] Training programs for healthcare workers, first responders, and community volunteers are essential to equip them with basic skills in psychological first aid, stress management, and referral pathways. A community-based, culturally sensitive approach, leveraging local resources and peer networks, can enhance the acceptability and sustainability of interventions. Standardized screening tools, including the General Health Questionnaire (GHQ-12),[10] or the Patient Health Questionnaire (PHQ-9),[11] can be used to identify patients who require special attention and to assess the intensity of symptoms. Community health workers, mobile mental health clinics, and telepsychiatry can help close access gaps for populations in border regions. The recent disasters and conflicts in India underscore the need for policymakers and mental health professionals to prioritize the systematic integration of mental health in disaster response. Professional organizations, such as psychiatric and psychological societies, can play a pivotal role in advocacy, guideline development, and capacity building. By fostering collaboration between government agencies, healthcare providers, and communities, India can move toward a model of disaster preparedness that is inclusive, culturally sensitive, and trauma-informed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.