Skip Navigation Bar

You are here: Home > Psychological Issues for Radiation Emergencies

Psychological Issues for Radiation Emergencies

Federal Guidance - HHS
Federal Guidance - HHS Collaborations
Other Federal Guidance
International Guidance
Issues for Health Care Providers
Issues for Affected Populations
Psychological Phases of Response to a Disaster
Other Resources

Federal Guidance - HHS

CDC Traumatic Incident Stress: Information for Emergency Response Workers (HHS/CDC/NIOSH)
Behavioral Health (HHS)
Guidance from Substance Abuse and Mental Health Services Administration (HHS/SAMHSA)
Coping with a Disaster or Traumatic Event: Trauma and Disaster Mental Health Resources (HHS/CDC)
Traumatic Incident Stress: Information For Emergency Response Workers (HHS/CDC, October 2001)

Federal Guidance - HHS Collaborations

Integration of Mental and Behavioral Health in the Federal Disaster Preparedness, Response, and Recovery: Assessment and Recommendations, A Report of the Disaster Mental Health Subcommittee of the National Biodefense Science Board, Sept 2010 (PDF - 143 KB)
National Child Traumatic Stress Network (HHS/University of California at Los Angeles (UCLA)/Duke University)
- Psychological First Aid: Field Operations Guide (National Child Traumatic Stress Network and the National Center for PTSD, 2nd edition, 2008)

Other Federal Guidance

Psychological First Aid in Radiation Disasters (CDC/ online course) (HHS/CDC)
National Center for Posttraumatic Stress Disorder (PTSD) (Department of Veterans Affairs)
- For the public
- For Professionals
Psychological and Behavioral Issues Healthcare Providers Need to Know when Treating Patients Following a Radiation Event (PDF - 107 KB) (Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences)
Psychological and Behavioral Issues Healthcare Providers Need to Know when Managing a Chemical, Biological, Radiological or Nuclear (CBRN) Event (PDF - 197 KB) (Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences)

International Guidance

A Framework for Mental Health and Psychosocial Support in Radiological and Nuclear Emergencies (WHO, 2020)
- View Webinar accompanying this monograph
- Webinar Nov 27, 2020, About Launch of WHO Framework on Mental Health and Psychosocial Support in Radiological and Nuclear Emergencies (Youtube - 1:27:17)
IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings (Inter-Agency Standing Committee, 2007)
Emergency Preparedness and Response: Generic Procedures for Medical Response during a Nuclear or Radiological Emergency (PDF - 2,225 KB) (Section E: Psychological Support, pp. 91 - 99, IAEA, April 2005)

Issues for Health Care Providers

Supporting the Responding Clinicians and Staff
- Preventing and Managing Stress: Tips for Disaster Responders (HHS/SAMHSA)
- Emergency Responder Self-care Plan: Behavioral Health PPE (HHS/ASPR)
- Supporting Clinician Well-Being during COVID-19 (National Academy of Medicine and American Public Health Association, May 7, 2020, Webinar and transcript)
  - Although this webinar is about the COVID-19 response, some of the issues about clinician needs, support, and resilience could be relevant during a large radiation incident
Psychological First Aid
- A 1-day orientation in psychological first aid (PFA) for first responders (World Health Organization, 2011)
- Psychological First Aid (PFA) Tutorial (Univ. of Minnesota School of Public Health mobile app and web site)
- Providing Psychological First Aid (PFA) (PDF - 40 KB) (New York City Department of Health and Mental Hygiene)
- Psychological First Aid (PDF - 2.9 MB) (National Child Traumatic Stress Network, National Center for PTSD, 2006)
- Psychological First Aid (PFA) (Minnesota Department of Health)
- Listen, Protect, Connect Program
  - Research results
    - Ramirez M, Harland K, Frederick M, Shepherd R, Wong M, Cavanaugh JE. Listen protect connect for traumatized schoolchildren: a pilot study of psychological first aid. BMC Psychology 2013;1:26.
    - Chandra A, Kim J, Pieters HC, Tang J, McCreary M, Schreiber M, Wells K. Implementing psychological first-aid training for medical reserve corps volunteers. Disaster Med Public Health Prep. 2014 Feb;8(1):95-100. [PubMed Citation]
  - Program descriptions
    - Psychological First Aid for Students and Teachers: Listen, Protect, Connect - Model and Teach (PDF - 429 KB) (DOE)
    - Listen, Protect and Connect: Family to Family, Neighbor to Neighbor: Psychological First Aid for the Community Helping Each Other (PDF - 2.1 MB) (Los Angeles county Department of Public Health Emergency Preparedness and Response Program)
    - Listen, Protect, Connect--Model and Teach: Psychological First Aid for Students and Teachers (PDF - 2.03 MB) (UCLA and others)
    - Listen, Protect, and Connect: Psychological First Aid for Children and Parents-Helping You And Your Child In Times Of Disaster (PDF - 884 KB) (UCLA and others)
Responder Willingness to Serve during Radiation Disasters
- Yoshida K, Orita M, Goto A, Kumagai A, Yasui K, Ohtsuru A, Hayashida N, Kudo T, Yamashita S, Takamura N. Radiation-related anxiety among public health nurses in the Fukushima Prefecture after the accident at the Fukushima Daiichi Nuclear Power Station: a cross-sectional study. BMJ Open. 2016 Oct 24;6(10):e013564. [PubMed Citation]
- Konishi E, Nagai T, Kobayashi M, Mitsumori Y, Ono W, Asahara K, Porter SE. Post-Fukushima radiation education for public health nursing students: a case study. Int Nurs Rev. 2016 Jun;63(2):292-9. [PubMed Citation]
- Noto Y, Kitamiya C, Itaki C, Urushizaka M, Kidachi R, Yamabe H. Role of nurses in a nuclear disaster: experience in the Fukushima Dai-ichi nuclear power plant accident. Int Nurs Rev. 2013 Jun;60(2):196-200. [PubMed Citation]
- Balicer RD, Catlett CL, Barnett DJ, Thompson CB, Hsu EB, Morton MJ, Semon NL, Watson CM, Gwon HS, Links JM. Characterizing hospital workers' willingness to respond to a radiological event. PLoS One. 2011;6(10):e25327. [PubMed Citation]
- Sheikh S, McCormick LC, Pevear J, Adoff S, Walter FG, Kazzi ZN, Radiological preparedness-awareness and attitudes: a cross-sectional survey of emergency medicine residents and physicians at three academic institutions in the United States. Clin Toxicol (Phila). 2012 Jan;50(1):34-8. Epub 2011 Dec 19. [PubMed Citation]
- Becker SM, Middleton SA. Improving hospital preparedness for radiological terrorism: perspectives from emergency department physicians and nurses. Disaster Med Public Health Prep. 2008 Oct;2(3):174-84. [PubMed Citation]
- Veenema TG, Walden B, Feinstein N, Williams J. Factors Affecting Hospital-based Nurses' Willingness to Respond to a Radiation Emergency. Disaster Med Public Health Prep. 2008 Dec;2(4):224-9. [PubMed Citation]

Issues for Affected Populations

Carr Z, Maeda M, Oughton D, Weiss W. Non-radiological impact of a nuclear emergency: preparedness and response with the focus on health. Radiat Prot Dosimetry. 2018 Dec 1;182(1):112-119. [PubMed Citation]
Social, psychological, and behavioral responses to a nuclear detonation in a US city: implications for health care planning and delivery. Dodgen D, Norwood AE, Becker SM, Perez JT, Hansen CK. Disaster Med Public Health Prep. 2011 Mar;5 Suppl 1:S54-64. [PubMed Citation]
Gouweloos J, DückersM, te Brake H, Kleber R, Drogendijk A. Psychosocial care to affected citizens and communities in case of CBRN incidents: a systematic review. Environ Int. 2014 Nov;72:46-65. [PubMed Citation]

Psychological Phases of Response to a Disaster

A graph showing timeline of phases of the psychological responses to disasters

This graphic represents a hypothetical timeline and framework for understanding potential phases of the community psychological responses to major disasters of various types.
It is adapted from Zunin and Myers as cited in DeWolfe DJ., Training Manual for Mental Health and Human Service Workers in Major Disasters (PDF - 400 KB) (2nd ed., HHS Publication No. ADM 90-538, published in 2000, Section 2, page 5), and presented on the HHS/SAMHSA web site. (Accessed Mary 31 2021)

Other Resources

From Radiological Incidents to Nuclear Calamities: Social, Behavioral, and Risk Communication Issues in Radiation Emergencies, Lecture by Steven Becker, Ph.D. (1 hour:09 min video for 10th Annual IDMH conference, SUNY New Palz, April 19, 2013)
Chernobyl at Twenty (NCRP Program Presentation No. 42), National Council on Radiation Protection and Measurements, Bethesda, MD, 2006.
Becker SM. Emergency Communication and Information Issues in Terrorism Events Involving Radioactive Materials. (PDF - 89 KB) Biosecurity and Bioterrorism. 2004;2(3): 195-207.[PubMed Citation]
Preparing for the Psychological Consequences of Terrorism: A Public Health Strategy, Committee on Responding to the Psychological Consequences of Terrorism, Butler AS, Panzer AM, Goldfrank LR, eds., Institute of Medicine of the National Academies, The National Academies Press, Washington, DC, 2003
Management of Terrorist Events Involving Radioactive Material (NCRP Report No. 138), National Council on Radiation Protection and Measurements, Bethesda, MD, 2001. (See Chapter 5: Psychosocial Effects of Radiological Terrorist Incidents, pp. 54-69.)
Becker SM: Psychosocial Effects of Radiation Accidents. In: Gusev IA, Guskova AK, Mettler FA Jr, eds.: Medical Management of Radiation Accidents, 2nd ed. Boca Raton, Fl: CRC Press, 2001, pp. 519-525.