| Objective To learn the situation of public emergencies that the residents of urban communities experienced in China from January 2007 to March 2009, and their subjective and objective demand for mental health service after public emergencies. Meanwhile, to probe the influence factors on the mental health service needs, then to provide scientific basis for carrying out a variety of targeted mental health services in future.Methods According to the classification of public emergencies(natural disasters, accident disasters, public health events and social security incidents) and the distribution of public emergencies happened in 2007 in China, taking account of the eastern, middle and western regions across the country, Liaoning, Zhejiang, Anhui, Guangdong, Chongqing, Xinjiang, six provinces (autonomous regions and municipalities) were selected as study areas, and then select the capital city and another city which affected by the public events in each province as the research sites. Permanent residents among 15 to 60 years old in urban communities (whose residence time are over 6 months) of these areas were targeted population. Using multi-stage stratified sampling method,9670 people among the targeted population were selected to do the face to face questionnaire survey in April,2009. The questionnaire includes four parts, they are the basic information of targeted population, the public emergencies situation of the urban community residents experienced from January 2007 to March 2009, the urban community residents'objective demand for mental health service after public emergencies (with physical and psychological reactions occurred within one month after the experienced public emergencies to measure) and the urban community residents'subjective demand for mental health service after public emergencies. Use Epi Data 3.1 for data inputting and checking, use SAS 9.1 software for data description and analysis.Results1. Basic Information:9670 urban residents conducted the survey,9227 werevalid response with the rate of 95.42%. The gender and age distribution were balance, more than 90% were Han nationality and 71.25% were married. The majorities were high school/technical secondary school/vocational school and junior high school education level. The percentages of business service employees, the jobless, and the clerks were more than 10%.2. From January 2007 to March 2009, the public emergencies which had the greatest impact on urbans residents were as follows:natural disasters (such as the 5.12 earthquake, typhoon disaster and the 2008 spring snow), public health events (such as milk powder incident), accident disasters (such as traffic accidents) and social security events (such as the financial crisis in 2008～2009 and 8.4 Kashgar assaulting police officers case). In the public emergency,77.18% of the survey was the role as "the person learn about the events indirectly through the media" and "the personnel participated in the rescue" was the fewest, only 1.93%.The time which the public emergencies occurred were focused on the 6 months to 1 year (71.83%), followed by 1 to 2 years (11.98%),2 to 6 months (7.47%).3. The external needs to psychological services after public emergencies among urban residents3.1 The residents'psychological reactions were more seriously than physical reaction which were caused by public emergencies (χ2=764.71, P<0.05). 68.44% of the residents reported that their physical condition affected by the incident. After the incident in a month, the main physical reactions were "do not usually sleep well" (9.54%), "more likely to feel tired" (7.47%) and "poor appetite than usual" (6.21%) and so on.88.78% of residents had psychological effects, influential/significant influential proportion was 18.78%. After the incident in a month, residents' main psychological reactions were "worried about this disaster that happening again" (25.53%), "could not help thinking of the disaster" (21.58%), "try to forget this disaster, do not want to remember it "(14.97%) and so on.3.2 In the four classification of public emergencies, the residents who experienced a public health emergency had the highest total average marks of physical and psychological reaction (2.01), followed by natural disasters and social security incidents (both 1.87), with the lowest accident catastrophe (1.79).3.3 In public emergencies as different roles, no matter what kind of event, whether in the body or the psychological response aspect, direct victims or the families of the victims were greatest affected by the incident, larger/great body and psychological response rate were 34.72% and 44.72% respectively followed by witnesses and personnel participated in the rescue and ambulance.4. The internal needs to psychological services after public emergencies among urban residents4.1 The forms of psychological services:42.55% of the residents mostly want to get psychological services through the media, followed by the relevant publicity materials (23.32%), the needs for the professional psychological services (such as individual counseling and group counseling services) were lower which were 17.35% and 3.46% respectively.4.2 Psychological service providers:40.87% of the residents hoped that providers were professionals, followed by family relatives (39.42%) and friends/ colleagues (17.41%).4.3 Psychological knowledge and skills:47.85% of the residents wanted to know "how to alleviate their psychological responses" followed by "common psychological reactions" (20.64%); for "how to seek professional counseling staff to help" and "how to help others to ease psychological reaction ", there were only 15.03% and 14.13% residents who would like to learn.4.4 The channels of distributing the psychological knowledge and skills:the residents were willing to choose television programs (57.72%), followed by chat (37.99%) and the Internet (32.65%). The residents had a lower acceptance rate of materials and seminars (28.06% and 23.33% respectively) and a lowest acceptance rate of psychological counseling, hotline and other ways (15.72% and 11.95% respectively).5. The impact factors on the urban residents' needs to psychological services after public emergencies.5.1 Impact factors on the external needs:after experiencing the public emergencies, women, older residents, with high education levels, the retired people, residents who experienced a public health emergency, the immediate victims of the incident or the families of the victims, events occurred in more than two years from the time we investigated had more seriously physical and psychological reactions, these people had strong demands for psychological services (P<0.05).5.2 Impact factors on the internal needs:5.2.1 The forms of psychological services:after the occurrence of public emergencies, male and older persons preference to choose media/publicity material to provide psychological services; youth, higher education residents, students, residents who experienced accident disasters and social security incidents, personnel who were involved in rescue and ambulance were more likely to choose team mental counseling and individual counseling; the events direct victims or the families of the victims were not willing to choose the professional psychological services (P<0.05).5.2.2 Psychological service providers:higher education residents, intellectual workers, people who experienced the public health emergency and who were involved in rescue and ambulance preferred professionals to provide psychological services; young people, people who experienced accident disasters and social security incidents dependent on friends highly; older persons, minority residents, the direct victims or the families of the victims and witnesses in the events dependent highly on family relatives (P<0.05).5.2.3 Psychological knowledge and skills:higher education residents, medical personnel, personnel who were involved in ambulance and rescue, people who experienced the public health emergency were more likely to know "how to seek professional counseling staff to help" and "how to help people reduce their psychological reaction "; minority residents, agricultural workers, the direct victims of the incident or the families of the victims were wiling to know" how to relieve their psychological reaction" (P<0.05).5.2.4 Way to obtain knowledge and skills:male, younger people, age mild cases, higher education residents, students, residents who experienced accident disasters were likely to get psychological knowledge and skills through the Internet; women, lower education residents, laborers, direct victims or the families of the victims in events were more interested in chatting form; older persons, minority population, lower education residents, laborers, direct victims or families in the events preferred to choose TV and radio programs; personnel who were participated in the rescue and ambulance were willing to accept promotional material (P<0.05).Conclusion1. While most people learn about the public emergencies through the media indirectly, and the incidents had happened for more than 6 months from the time we investigated, survey residents self reported that the greatest events which influence them were natural disasters (mainly for the 5.12 Wenchuan earthquake) and public health emergencies (such as milk powder incident).2. 90% of the population self reported that their physical and psychological condition had been influenced by the experienced events, and more than half of the residents experienced the events within one month had showed varied degrees of physical and psychological reactions. These point out that residents have a great need for psychological services after public emergencies.3. In a variety of psychological services, provide services through the media was still the first choice among the investigated residents, television programs and the Internet were the main transmission mode. For the professional services and relative knowledge such as group counseling and individual counseling, although the residents hoped professional to provide services subjectively, they still had a lower need for how to seek the psychological services. These point out that there is a big space to carry out professional psychological services. In normal circumstances, it is very necessary to enhance people's awareness of psychological services through psychological education.4. Gender, age, education, occupation, the type of public emergencies experienced, the different roles in the incident and other factors can affect the residents'objective and subjective needs for psychological services after the public emergencies, this suggests that psychological education and professional psychological services must be based on the characteristics of different groups of people targeted to carry out, in order to ensure its effective function.Suggestions1. To strengthen public health education, increase public awareness of psychological services and mental endurance.2. To popularize the psychological knowledge through school, community and mainstream media, to improve the breadth and depth of mental health education.3. To cooperate with mental health professional organizations to make full use of resources, to develop targeted mental health education activities and professional psychological services based on the understanding of different subgroups of residents.
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