This paper discusses the vital role of disaster psychiatry in the evolving structures for preparedness and response in the fields of disaster management. The authors address the role of science and experience in addressing the tragedies of mass catastrophe, the need for systems and the challenges of integrating mental health contributions into the practical requirements for survival, aid, emergency management and ultimately recovery. The human face of disaster and the understanding of human strengths and resilience alongside the protection of, and care for, those suffering profound trauma and grief are central issues.