Psychological First Aid as a Means of Crisis Resolution
SOME DISASTER VICTIMS MAY PRESENT SOME OF THE SAME CHALLENGES TO PUBLIC SAFETY AS THOSE POSED BY EMOTIONALLY DISTURBED PERSONS.
Past disaster relief operations have shown people who have been impacted by catastrophic events may exhibit behaviors and attitudes that, under normal circumstances, are associated with the mentally ill. Here are some things to keep in mind whenever you interact with people during disaster relief operations:
- Intense, oftentimes irrational emotions are ENTIRELY NATURAL amidst the kind of life altering devastation that disasters bring.
- As public safety, you may become the object of people’s rage and frustration at what they perceive to be an unwillingness or inability on the part of government authorities to help them.
- It’s not about you! It’s about the disaster!
In times of disaster, you can provide a critical service by providing support in the form of psychological first aid. The following is a list of things to do, as well as what you should avoid doing:
DO:
Promote Safety:
- Help people meet basic needs by directing them to food and shelter, and by obtaining emergency medical attention as needed.
- Provide repeated, simple, and accurate information onhow to get these basic needs.
Promote Calm:
- Listen to people who wish to share their stories and emotions, and remember that there is no right or wrong way to feel.
- Display sincere kindness in your demeanor toward them. Treat them as you would want your loved ones to be treated if they were in the same situation.
- Be friendly and compassionate even if people are being difficult.
- Offer accurate information about the disaster or trauma and the relief efforts underway to help victims understand the situation.
Promote Rapport:
- Introduce yourself if they do not know you.
- Ask the person what they would like to be called, and do not use nicknames or first names without permission. With some cultures it is important to always address the person as Mr. or Mrs.
- Use words like please and thank you.
- Do not make general statements about the person’s character; for example, you would not want to say “you’re a brave person” during a time when they may be feeling quite afraid and unsure.
- Avoid flattery and excessive complements.
Promote Connectedness:
- Help people contact friends and loved ones whenever circumstances allow it.
- Keep families together. Keep children with parents or other close relatives whenever possible, and understand that the way of responding to trauma will vary with levels of development.
Promote Help:
- Be aware of the types and locations of government and nongovernmental services and direct people to those services that are available.
DO NOT:
- Force people to share their stories with you, especially very personal details.
- Give simple reassurances like “everything will be OK” or “at least you survived.”
- Tell people what you think they should be feeling, thinking, or how they should have acted earlier.
- Tell people why you think they have suffered by alluding to personal behaviors or beliefs of victims.
- Make promises that may not be kept.
- Criticize existing services or relief activities in front of people in need of these services
STAY SAFE!!! The recommendations that follow are intended only as possible suggestions that in no way override your knowledge, training, and experience for how to avoid danger.
Look for signs of agitation and increased stress. People in such phases of response to disaster may:
- Challenge or question your authority, in which case you might:
- Answer the question calmly
- Repeat your statement calmly
- Refuse to follow directions, which can sometimes be responded to through:
- not immediately asserting control. Rather, let the person gain control of him or herself
- Remaining professional
- Restructuring your request in another way
- Giving the person time to consider your request and perhaps pose alternatives
- Lose control and become verbally agitated, to which you might,
- Reply calmly.
- State that you may need assistance to help them.
- Become Threatening:
- If the person becomes threatening or intimidating and does not respond to your attempts to calm them, take the appropriate actions to keep yourself and others safe.
Information adapted for public safety from “Nebraska Disaster Behavioral Health Psychological First Aid Curriculum” at SAMHSA.
Summary: People in the midst of disasters, or immediately following, will often have strong feelings of confusion, fear, hopelessness, sleeplessness, anxiety, grief, shock, guilt, shame, and loss of confidence in themselves and others. Your early contacts with them can help to restore some degree of calm and to avoid further risk or traumatization.
Your goal in providing psychological first aid is to promote an environment of safety, calm, and hope.