trends

individuals

families

entire communities

Critical incidents or disasters affect

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People lose homes, belongings, and loved ones or be separated from family and community.

Victims will feel overwhelmed, confused or uncertain about what is happening.

- some may only be mildly distressed

-others may be severely distressed

-others still may not be distressed at all.

While witnessing violence, destruction or death is a normal occurrence in times of crisis, victims’ reactions vary:

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Most people will recover well over time after a disaster: basic needs are restored and receive support or help from those around them and/or PFA.

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People with either severe or long-lasting distress reactions may need more support than PFA alone, particularly if they cannot function in their daily life or if they are a danger to themselves or others.

- must be kept safe until the reaction passes

- until you can find help from health personnel, local leaders or other community members in the area.

Severely distressed people should not be left alone:

Critical incident stress or traumatic stress

can lead to significant physical and psychological impairment when left unattended. Not all critical events however, are critical events to everybody.

perception

The key is the victims’ __________ of danger of the event.

assistance

When victims perceive an event as distressing and dangerous, they need immediate

emotional wounds

can easily be reopened by future stressful events, providing early appropriate intervention strategies is crucial.

Traumatic Stress

can be mitigated through crisis intervention.

Crisis intervention

refers to any immediate attention designed to stabilize and bridge to additional supportive resources

Defusion

CISD/Psychological Debriefing

Psychological First Aid

Mental Health Personnel who give assistance to victims of disasters do either of the following:

Defusion

The process of talking it out to allow victims the opportunity to ventilate about their disaster related memories, stresses, losses, and methods of coping, doing so in a safe and supportive atmosphere.

Informal and immediate

done before the person/s has a chance to sleep

Informal and immediate

A starting point, requiring further intervention from ongoing support to scheduling and providing formal debriefing sessions

Psychological Debriefing

7 or 8 - step second level of intervention normally done within 72 hours of the critical incident.

Psychological Debriefing

Gives the victims the opportunity to talk about the experience, how it has affected them, brainstorm coping mechanisms, identify individuals at risk, and inform them about services available to them in their community.

Critical Incident Stress Debriefings (CISD)

are the most complex of the CISM interventions and should not be used in "routine" cases.

infection

Improper procedure with a cut might promote

Proper selection

of the necessary intervention is most important to be effective in mitigating the effects of stress

Inter-Agency Standing Committee (IASC) and the Sphere Project

recommends the use of Psychological First Aid rather than psychological debriefing

The IASC (established in 1992)

has been affirmed by the UNGA as the primary mechanism for interagency coordination of humanitarian assistance.

The Sphere Project

a community of humanitarian response practitioners which was established in 1997.

The IASC (established in 1992)

The Sphere Project

These groups’ recommendation is based on an evaluation conducted by the World Health Organization’s (WHO) mhGAP Guidelines Development Group.

The IASC (established in 1992)

The Sphere Project

Evidences made them conclude that psychological first aid rather than psychological debriefing should be given to people experiencing severe distress after being recently exposed to a traumatic event.

Psychological First Aid

a humane, supportive response to a fellow human being who is suffering and who may need support (SPHERE and IASC).

Psychological First Aid

an evidence-informed modular approach to help children, adolescents, adults, and families in the immediate aftermath of disaster and terrorism.

Psychological First Aid

It is designed to reduce the initial distress caused by traumatic events and to foster short and long-term adaptive functioning and coping

Psychological First Aid

distressed children and adults who have been recently exposed to a serious crisis event.

*scene of an accident

*in places where distressed people are served:

*health centers

*shelters or camps

*schools

*distribution sites

Wherever it is safe enough for one to do so:

sexual violence

For people who have been exposed to certain types of crisis events - _______ - privacy is essential for confidentiality and to respect the person’s dignity.

Respecting Safety, Dignity and Rights

Adapting what you do to take account of the person’s culture

Being aware of other emergency response measures

Looking after yourself

Providing PFA means helping in a responsible way:

Respect the safety of people that you help

means seeing to it that you avoid putting people at further risk of harm because of what you do. ensuring that the adults and children you are helping are safe and protected from physical or psychological harm

Adapt what you do to take account of the person’s culture

When working or helping people whose cultural background differ from yours, it is important to be aware of your own cultural background and beliefs so you can set aside your own biases.

Adapt what you do to take account of the person’s culture

Offer help in ways that are most appropriate and comfortable to the people you are supporting.

Since each crisis situation is unique, you need to adapt the use of this guide to the context, taking into consideration local social and cultural norms.

Dress

Language

Gender, Age and Power

Touching and Behaviour

Beliefs and Religion

Consider the following questions as you prepare to offer PFA in different cultures:

Dress

Do I need to dress a certain way to be respectful?

Will affected people be in need of certain clothing items to keep their dignity and customs?

Language

What is the customary way of greeting people in this culture?

What language do they speak?

Gender, Age and Power

Should affected women only be approached by women helpers?

Who may I approach? (head of the family or community?)

Touching and Behaviour

What are the usual customs around touching people?

Is it all right to hold someone’s hand or touch their shoulder?

Are there special things to consider in terms of behaviour around the elderly, children, women or others?

Beliefs and Religion

Who are the different ethnic and religious groups among the affected people?

What beliefs or practices are important to the people affected?

How might they understand or explain what has happened?

Be aware of other emergencyresponse measures

When hundreds or thousands of people are affected, different types of emergency response measures take place:

* search-and-rescue operations

* emergency health care

* shelter

* food distribution

* family tracing and child protection activities.

Psychological First Aid

is part of a broader response to large humanitarian emergencies (IASC, 2007).

Psychological First Aid

Be aware of what services and supports may be available so you can share information with people you are helping and tell them how to access practical help.

Psychological First Aid

When responding to a crisis situation, make sure that you follow the direction of relevant authorities managing the crisis.

Psychological First Aid

Remember not to get in the way of search-and-rescue or emergency medical personnel and know your role and the limits of your role.

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If you want to help in crisis settings, work through an organization or community group.

Acting on your own:

may put you at risk

may have a negative effect on coordination efforts, or you may not be able to link affected people with the resources and support that they need.

Good communication with people in distress

Preparation

Applying the PFA action principles: LOOK, LISTEN AND LINK

PROVIDING PSYCHOLOGICAL FIRST AID involves the following:

Good Communication

People who have been through a crisis event: may be very upset, anxious or confused; some may blame themselves for things that happened during the crisis.

Good Communication

The way you communicate with someone in distress is critical.

Being calm and showing understanding

can help people in distress feel more safe and secure, understood, respected and cared for appropriately.

Being calm and showing understanding

Listening to someone who may want to tell you his/her story can be a great support.

Do not pressure

anyone to tell you what they have been through

Do not pressure

some people may not want to talk about what happened or their circumstances.

Do not pressure

Just stay with them quietly, let them know you are there if they want to talk, or offer practical support like a meal or a glass of water.

Don’t talk too much

allow for silence- this may give the person space and time to think and reflect.

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To communicate well, be aware of both your words and body language: such as facial expressions, eye contact, gestures, and the way you sit or stand in relation to the other person.

Speak and behave in ways that take into account the person’s culture, age, gender, customs and religion.

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Consider your own health, and personal or family issues that may cause severe stress as you take on helping role for others.

Make honest decision about whether you can be ready to help in this particular crisis situation and at this particular time.

Prepare

Crisis situations can be chaotic and often need urgent action.

If possible, before entering a crisis site, try to get accurate information about the situation.

The crisis event

What happened?

When and where did it take place?

How many people are likely to be affected and who are they?

Learn about the following:

Available services and supports

Who is providing for basic needs like emergency medical care, food, water, shelter or tracing family members?

Where and how can people access those services?

Who else is helping? Are community members involved in responding?