Linking post-disaster mental health to the erosion of social fabric

This dissertation aimed to dissect the complex nature of post-disaster mental health problems. Current (research) perspectives define disaster mental health as a construct that is determined on a single level: either as a construct on the individual level, or as a construct within the disaster-affected context. In contrast, this dissertation empirically showed that the ‘cross-level interplay’ between the disaster-affected social context and the individual process (i.e. the individual disaster experience, coping effort and social support) determines individual disaster mental health problems. This conceptualization sheds light on four challenges that have been highlighted by other scholars in the current disaster literature. Out of the four challenges, the main added value of this dissertation is to reveal the mechanisms via which living in a disaster-affected social community is associated with mental health problems. These cross-level mechanisms can be indirectly salutary. Specifically, our findings suggest that in communities with high structural social capital, individuals have faith in the social context (high cognitive social capital) to address disaster-related demands (high collective efficacy), and therefore employ fewer individual psychosocial resources (i.e. coping strategies and social support). Ultimately, this “conservation of individual psychosocial resources” in a salutary social context is related to less posttraumatic stress. We showed that not adopting such a cross-level perspective has serious methodological consequences for disaster mental health research. These methodological consequences help to explain the great variation in mental health outcomes across disaster studies hitherto.