Psychiatrists' role in disaster situations: A narrative review of empirical evidence

Disaster exposure is widespread, and a significant portion of those who experience severe impacts may develop mental health distress and clinical conditions. Psychiatrists may play crucial roles in multidisciplinary emergency response teams supporting both survivors and other responders. However, no previous study has yet explored the evidence discussing and supporting these roles. We aimed to synthesize available evidence featuring the roles of psychiatrists in disaster response in order to guide future research, training and public policy. We conducted a narrative review applying a Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)-guided search of four databases: MEDLINE, Embase, PsycINFO and the Cochrane Library, using a strategy combining disaster-related terms with those related to psychiatric and psychological crisis interventions. We included in this review original quantitative, qualitative and mixed-methods studies reporting interventions during or after disasters in which psychiatrists played an active role. After removing duplicates, 2318 titles and abstracts were screened, 125 articles underwent full-text review and 14 studies ultimately met the criteria for inclusion. Psychiatrists played a multifaceted and crucial role in diverse disaster settings worldwide, providing direct clinical care, leading and coordinating mental health responses, generating research, building local capacity and offering expert supervision. Psychiatrists have been shown to serve important roles in disaster settings, but more research is needed to better understand their specific contributions and plan their most appropriate integration as essential and unique members of multidisciplinary response teams.