Prehospital and Disaster Medicine

Original Research

The Impact of Recurrent Disasters on Mental Health: A Study on Seasonal Floods in Northern India

Tim R. Winda1a2a4 c1, Pooran C. Joshia3, Rolf J. Klebera2a4 and Ivan H. Komproea1a4

a1 Department of Research and Development, World Health Organization Collaborating Centre, HealthNet TPO, Amsterdam, the Netherlands

a2 Arq Psychotrauma Expert Group, Amsterdam, the Netherlands

a3 Department of Anthropology, University of Delhi, Delhi, India

a4 Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, the Netherlands


Introduction Very little is known on the impact of recurrent disasters on mental health.

Aim The present study examines the immediate impact of a recurrent flood on mental health and functioning among an affected population in the rural district of Bahraich, Uttar Pradesh, India, compared with a population in the same region that is not affected by floods.

Methods The study compared 318 affected respondents with 308 individuals who were not affected by floods. Symptoms of anxiety and depression were assessed by the Hopkins Symptom Checklist-25 (HSCL-25). Psychological and physical functioning was assessed by using the Short Form-12 (SF-12).

Results The affected group showed large to very large differences with the comparison group on symptoms of anxiety (D = .92) and depression (D = 1.22). The affected group scored significantly lower on psychological and physical functioning than the comparison group (respectively D = .33 and D = .80). However, hierarchical linear regressions showed no significant relationship between mental health and the domains of functioning in the affected group, whereas mental health and the domains of functioning were significantly related in the comparison group.

Conclusion This study found a large negative impact of the recurrent floods on mental health outcomes and psychological and physical functioning. However, in a context with recurrent floods, disaster mental health status is not a relevant predictor of functioning. The findings suggest that the observed mental health status and impaired functioning in this context are also outcomes of another mechanism: Both outcomes are likely to be related to the erosion of the social and environmental and material context. As such, the findings refer to a need to implement psychosocial context-oriented interventions to address the erosion of the context rather than specific mental health interventions.

TR Wind, PC Joshi, RJ Kleber, IH Komproe. The impact of recurrent disasters on mental health: a study on seasonal floods in northern India. Prehosp Disaster Med. 2013;28(3):1-7 .

(Received November 15 2012)

(Accepted January 17 2013)


  • anxiety;
  • depression;
  • disaster mental health;
  • functioning;
  • India;
  • recurrent disaster;
  • recurrent floods


  • DSM-IV:Diagnostic and Statistical Manual of Mental Diseases, Fourth Edition;
  • HSCL-25:Hopkins Symptom Checklist-25;
  • SF-12:Short Form-12 health survey;
  • SF-36:Short Form-36 health survey


c1 Correspondence: Tim R. Wind, MSc Department of Research and Development World Health Organization Collaborating Centre HealthNet TPO 1074VJ, Amsterdam, the Netherlands E-mail


  Conflicts of interest: The authors have no disclosures or conflicts of interest to report.