Geriatric Mental Health Disaster and Emergency Preparedness

126 Geriatric Mental Health Disaster and Emergency Preparedness
with cohesion and, later, with conflict ( Vlahov, 2002). While the degree of
integration in a social network is postulated to have a direct effect on overall
well-being, regardless of stress (Kawachi & Berkman, 2001), positive
social support is vital to psychological wellness following a disaster (Norris
& Kaniasty, 1996).
Studies of social support typically delineate three phenomena: social
integration, social network structure, and the functional quality of social
relationships (Gottlieb, 1985; House, Umberson, & Landis, 1988). The operation
of social support at the community, social network, and interpersonal
levels maps to different effects on mental health via belongingness
(community level), bonding (social network level), and binding (interpersonal
level; Lin, Ye, & Ensel, 1999). The functions of social support have
been described as providing instrumental or tangible aid, emotional support,
informational support, and appraisal support (House, 1981). In a study
of social support mobilization following Hurricane Hugo in 1989, Kaniasty
and Norris (1995) found that disaster victims received and provided more
support than nonvictims, that those with greater disaster-related losses
received more support, and that instrumental support was the most relevant
type of support provided. In a subsequent study of Hurricane Hugo
and Hurricane Andrew, Norris and Kaniasty (1996) found that perceived
social support mediated the relationship between received social support
and psychological distress following exposure to a disaster. Received support
exerts a long-term positive effect on psychological distress after a
disaster when individuals perceive that social support continues to be
available to them; if, in the stress of disaster, individuals perceive their
support network has deteriorated, the stress-buffering effects of social support
may not operate (Norris & Kaniasty). These studies point to the importance
of maintaining community relations during a disaster, mobilizing
social support, and maintaining network ties to maximize received and perceived
support available to the affected community.
In addition to social support, social capital is thought to buffer the
effects of stress by providing access to benefits through social networks,
thereby enhancing an individual’s coping skills (Hawe & Shiell, 2000). Social
capital develops from trust and reciprocity and operates at both the micro
and macro levels, allowing the exchange of assets, opportunities, and
other benefits to network members (Hawe & Shiell). At the micro level,
social capital is a function of integration in a network and linkages outside
an immediate network while at the macro level it can be seen as a synergy
between the interests of network members and the actions of the larger
society and the integrity of institutions to act independently of vested in-