The challenges of purpose in the face of chaos: commentary paper by Professor Beverley Raphael.

This paper addresses the issues and purposes of psychiatric research into disaster. Purposes include those that are focused on basic scientific questions, such as the role of disaster stressors in contributing to the development of psychiatric morbidity, and research attempting to identify the level of mental health need. There is also intervention research but this is limited in the acute emergency and longer term. These questions and the methodologies to address them, overlap significantly. Many studies use different measures of exposure, disorder and other disaster variables. There is also a wide range of population groups studied, making comparison of findings difficult. Thus, for these large scale events affecting populations, studies may not readily meet either the purposes of affected populations or government funders. Nor are interventions systematically operationalized to promoted replication. Challenges lie in the diversity of researchers, the pluralistic nature of Western society and the rapid development of the field. It is suggested that a set of disaster mental health research standards, based on core principles and data, would facilitate national and international collaboration and the interests of individual researcher. This could lead to comparable studies that could progress the field, while at the same time fostering innovations which could link to these research programmes. Strategic partnerships with government and other funders, as well as affected communities, could strengthen advocacy and commitment for disaster mental health research.