Interpreting mental health experiences in disaster settings: a qualitative analysis of medical students' reflective narratives during flood response in Thailand.

Résumé

BACKGROUND: Disasters disrupt social systems, threaten physical safety, and generate substantial psychological distress among affected populations. Disaster psychiatry has often focused on psychiatric symptoms and service delivery, with less attention paid to the experiences of patients' families' experiences of suffering, caregiving, and recovery within disrupted social environments.METHODS: This qualitative interpretive study analyzed second-order reflective narratives written by sixteen medical students who participated in supervised psychiatric and mental health care during flood disaster responses in Southern Thailand. Inductive thematic analysis was conducted, following the six-phase framework of Braun and Clarke, to explore students' observations of patient experiences, family caregiving, and the social conditions influencing mental health during the disaster.RESULTS: Five interconnected themes emerged. First, participants observed that basic survival needs, including food, shelter, and access to medication, were essential foundations for psychological recovery. Second, narratives described lived experiences of suffering, uncertainty caused by displacement, illness, and disruption of daily life. Third, students observed varied forms of resilience and meaning-making as individuals sought hope and purpose amid adversity. Fourth, family caregiving emerged as a central source of relational dignity and continuity of care. Finally, reflections highlighted structural vulnerability and the limits of medicine, as poverty disrupted access to resources, and social inequalities shaped patient experiences, requiring broader social support.CONCLUSION: The findings suggest the importance of social and relational dimensions of disaster mental health experiences. Suffering, resilience, and recovery were closely intertwined with family relationships, community networks, and structural conditions. Recognizing these factors may support more holistic approaches to disaster mental health care, disaster response planning, and medical education.