Background International humanitarian aid workers providing care in emergencies are subjected to numerous chronic and traumatic stressors. Objectives To examine consequences of such experiences on aid workers' mental health and how the impact is influenced by moderating variables. Methodology We conducted a longitudinal study in a sample of international non-governmental organizations. Study outcomes included anxiety, depression, burnout, and life and job satisfaction. We performed bivariate regression analyses at three time points. We fitted generalized estimating equation multivariable regression models for the longitudinal analyses. Results Study participants from 19 NGOs were assessed at three time points: 212 participated at pre-deployment; 169 (80%) post-deployment; and 154 (73%) within 3–6 months after deployment. Prior to deployment, 12 (3.8%) participants reported anxiety symptoms, compared to 20 (11.8%) at post-deployment (p = 0·0027); 22 (10.4%) reported depression symptoms, compared to 33 (19.5%) at post-deployment (p = 0·0117) and 31 (20.1%) at follow-up (p = .00083). History of mental illness (adjusted odds ratio [AOR] 4.2; 95% confidence interval [CI] 1·45–12·50) contributed to an increased risk for anxiety. The experience of extraordinary stress was a contributor to increased risk for burnout depersonalization (AOR 1.5; 95% CI 1.17–1.83). Higher levels of chronic stress exposure during deployment were contributors to an increased risk for depression (AOR 1·1; 95% CI 1·02–1.20) comparing post- versus pre-deployment, and increased risk for burnout emotional exhaustion (AOR 1.1; 95% CI 1.04–1.19). Social support was associated with lower levels of depression (AOR 0·9; 95% CI 0·84–0·95), psychological distress (AOR = 0.9; [CI] 0.85–0.97), burnout lack of personal accomplishment (AOR 0·95; 95% CI 0·91–0·98), and greater life satisfaction (p = 0.0213). Conclusions When recruiting and preparing aid workers for deployment, organizations should consider history of mental illness and take steps to decrease chronic stressors, and strengthen social support networks.
Lopes Cardozo B, Salama P (2001) Mental health of humanitarian aid workers in complex emergencies. In: Danieli Y, ed. Sharing the front line and the back hills: international protectors and providers: peacekeepers, humanitarian aid workers and the media in the midst of crisis. Amityville, NY: Baywood Publishing. pp. 242–255.
Eriksson CB, Lopes Cardozo B, Foy DW, Sabin M, Ager A, et al.. (2012). Pre-deployment mental health and trauma exposure of expatriate humanitarian aid workers: Risk and resilience factors. Traumatology Published online before print？April 16, 2012.
Eriksson CB, Bjorck J, Abernethy A (2003) Occupational stress, trauma, and adjustment in expatriate humanitarian aid workers. In: Fawcett J, ed. Stress and trauma handbook: strategies for flourishing in demanding environments. Monrovia, CA: World Vision International. pp. 68–100.
Centers for Disease Control and Prevention (CDC) (2010) Behavioral Risk Factor Surveillance System questionnaire 2000. Atlanta, GA: US Department of Health and Human Services, CDC, National Center for Chronic Disease Prevention and Health Promotion, Available: http://www.cdc.gov/brfss/questionnaires/？questionnaires.htm. Accessed, 2011 Nov 29.
Sandanger I, Moum T, Ingebrigtsen G, Sùrensen T, Dalgard OS, et al. (1999) The meaning and significance of caseness: the Hopkins Symptom. Checklist-25 and the Composite International Diagnostic Interview II. Soc Psychiatry Psychiatr Epidemiol 34: 53–59.
Mollica RF, Wyshak G, de Marneffe D, Khuon F, Lavelle J (1987) Indochinese versions of the Hopkins Symptom Checklist-25: a screening instrument for the psychiatric care of refugees. Am J Psychiatry 144: 497–500.
Ehrenreich JH (2001) Coping with disasters: a guidebook to psychosocial intervention. Rev ed. Old Westbury, NY: State University of New York. Available: http://www.toolkitsportdevelopment.org/h？tml/resources/7B/7BB3B250-3EB8-44C6-AA8E？-CC6592C53550/CopingWithDisaster.pdf. Accessed 2011 Nov 29.