Referrals to mental health and other health care professionals are made as workers encounter survivors with severe disaster reactions or complicating conditions. The following reactions, behaviors, and symptoms signal a need for the worker to consult with the appropriate professional and, in most cases, to sensitively refer the survivor for further assistance.
Disorientation - dazed, memory loss, inability to give date or time, state where he or she is, recall events of the past 24 hours or understand what is happening
Depression - pervasive feelings of hopelessness and despair, unshakable feelings of worthlessness and inadequacy, withdrawal from others, inability to engage in productive activity
Anxiety - constantly on edge, restless, agitated, inability to sleep, frequent frightening nightmares, flashbacks and intrusive thoughts, obsessive fears of another disaster, excessive ruminations about the disaster
Mental Illness - hearing voices, seeing visions, delusional thinking, excessive preoccupation with an idea or thought, pronounced pressure of speech (e.g., talking rapidly with limited content continuity)
Inability to care for self - not eating, bathing or changing clothes, inability to manage activities of daily living
Suicidal or homicidal thoughts or plans
Problematic use of alcohol or drugs
Domestic violence, child abuse, or elder abuse
