WHAT IS A DISASTER?
-A DISASTER IS DEFINED AS TRAUMA THAT OVERWHELMS A COMMUNITY’S ABILITY TO COPE.
Following a disaster, damage to social or community infrastructural components such as food systems and medical services will result in many acute consequences for one's psychosocial well being.
Acute Mental Health Effects include the following:
1. Trauma and Shock
2. Acute Stress Disorder/Post Traumatic Stress Disorder
3. Strains on Social relationships
4. Depression
5. Anxiety
6. Aggression and Violence
7. Loss of personally important places
8. Loss of autonomy and control
9. Substance Abuse (alcohol, nicotine products)
10. Feelings of helplessness, fear and fatalism
Tips to Support Individuals in the Aftermath of a Disaster:
1. Connect children, women and the elderly with their immediate family members (reconnect families as soon as possible) and ensure that they are removed from the impact zone to a safe environment (protected shelter)
2. Injured persons, hysterical persons, and persons displaying psychotic symptoms, disabled person, those with chronic medical illnesses & mental disorders and the elderly who are decompensating, should be transported and attended to immediately in Emergency Department of the general medical hospital.
All injured persons should be triaged immediately and referred appropriately to the department of surgery, internal medicine, psychiatry based on the assessment
3. Stable patients should be closely supervised at a protected shelter
4.. Ensure that persons basic needs are met in the impact zones, that there is access to water, shelter, food, and adequate clothing, medical supplies
Psychological First Aid (PFA)
PFA is an evidence informed preventive intervention. It is an humanitarian approach utilized by first responders to interact with persons, who have survived/lived through, a major disaster.
• Support and reconnect early, facilitating recovery of persons
• Widespread dissemination
• Adopted by The American Red Cross
• Targets children, adolescents, adults and families
• Modularized, offers scripts, tip sheets and activities
GOALS OF PFA
•Safety
•Calming
•Self-Efficacy
•Connectedness
•Hope/Optimism
PFA - INFORMATION GATHERING
• Nature and severity of experiences—what is the child’s/adult’s recent experience
• Death of a loved one?
• Concerns about the immediate post-disaster circumstances/ongoing threat?
• Separation from or concerns about the safety of family/close friends? Child separations
• Physical illness and need for medications – immediate priority?
PFA - INFORMATION GATHERING
• Other losses incurred as a result of the disaster (home, cherished belongings, pets)?
• Feelings of guilt or shame (re: personal response)?
• Child’s distorted sense of responsibility?
• Thoughts about causing harm to self or others?
• Current social/support network
• Prior alcohol or drug use or psychiatric problems?
• Prior exposure to trauma and loss? • Triage – identifying more severe mental disorder
PFA BASICS - SAFETY (FIRST)
• Relocate people to a safe place and make it clear that it is safe (delivery of appropriate medical care is important)
• Reconnect families – parents and children
• Educate about how to make their environment safe/safer
• Provide an accurate (updated), consistent, unified voice to help quantify/circumscribe ongoing threat
PFA BASICS - SAFETY (FIRST)
• Engage/Inform the media re: importance of conveying message of safety and resilience-promoting behaviors.
• Encourage individuals to limit exposure to news media overall
• Educate parents regarding limiting and monitoring news exposure in children
• Be attentive to predatory activities directed toward unmonitored children
CALMING
• Help people solve most pressing concerns
• Give information on whether family and friends are safe
• Clarify if danger has passed
• Psycho-education about the following topics
• Post-trauma reactions that are understandable and expectable
• Anxiety management techniques for common post-trauma problems
• Reestablish routines and structure (especially important for children)
• Limit the media exposure to the post-disaster environment/impact zone (print, electronic and social media)
• Teach parents to talk with children about “what they see and hear.”
CALMING FOR ADULTS AND CHILDREN
• Assist with anger management
• Address highly negative emotions (guilt and shame)
• Help with sleep problems
• Address alcohol & substance use (nicotine, marijuana)
• Address traumatic reminders & help children understand differences between traumas that have ended and reminders
SUPPORT EFFICACY - CHILDREN & ADOLESCENTS
• Encourage them to talk with parents/caregivers or other trusted adults about how they are feeling.
• Get involved in enjoyable activities with other children / siblings
• Help with cleaning, repairs, or other chores to support your family and community
CONNECTEDNESS
• Enhance access to primary support persons, family and significant others. Especially important for children
• Help individuals find/communicate with loved ones (cell phones, web, etc.)
• Encourage use of immediately-available support persons
• Identify/assist vulnerable populations:
• Those lacking strong support (or access to their usual support)
• Those isolated due to illness, mental illness, socioeconomic constraints
• Children who have less capacity to communicate
HOPE/OPTIMISM
• Encourage programs that restore sense of normalcy
• Develop/Publicize problem solving programs to aid the victims
• Support rebuilding of local economies/businesses
• Role for community leaders (e.g., churches, community centers) in:
• Encouraging link-up with resources, cooperation
• Coping behaviors (communication) and hope thru role modeling
• Memorializing and making meaning of the disaster
• Accepting necessary life and environmental changes
• Help children understand that disasters are powerful, but short-lived and relatively rare