Psychological First Aid and Psychosocial Support Basic Introduction

Psychological First Aid and Psychosocial Support Basic Introduction Module for PSS teamleaders 4 hrs

Introduction Tour de table: Each person introduces him/herself briefly

What is a disaster ? According to UNISDR (United Nations Office for Disaster Risk Reduction, 2009, p. 9): a disaster is a “serious disruption of the functioning of a community or a society involving widespread human, material, economic or environmental losses and impacts, which exceeds the ability of the affected community or society to cope using its own resources”. 3

(Mass)Emergency All types of crises and incidents a local or regional jurisdiction can handle mainly within its usual means, although they are of larger scale, impact and complexity than routine dispatch problems (e. g. a bus accident): Also situations when help from outside is needed but infrastructure is intact. 4

Disaster The local/regional/affected institutions and organisations are overcharged with the situation and need substantial support from outside. An example of “routine disasters” is the 2004 series of hurricanes in Florida. Destruction of infrastructure versus intact infrastructure as an important aspect for deciding reception centre or evacuation centre type of intervention. 5

Catastrophe Local/regional/affected institutions and organisations are nonfunctional (any more), most actions have to be organised and/or carried out from outside of the directly affected region (e. g. the 2004 Tsunami). Massive destruction of infrastructure, need of longterm shelters. 6

Crisis • The term“crisis”may be used in any of the three event complexity levels. • A crisis entails undesirable circumstances, which appear to be characterized by significant value conflict, great uncertainty, and time pressure (Hermann, 1963; 7

Crisis The term “crisis” is used to cover not only the objective elements of the events, but also the subjective perception of decisionmakers and affected populations. Each of the event types can result in a crisis. 8

Basic principles of social support Sphere social indicators – 1 • Access to information • Maintain normal cultural and religious events • Formal or informal schooling for children and recreational activities (safe places) • Participation in concrete, purposeful activities • Shelter for displaced, with the aim of keeping families and communities together

Case Example (Italy) • After a large earthquake about 500 people are waiting in front of the morgue in order to be allowed in for identification procedures • The PS teams establish places of worship, places where people can sit down, eat, drink, places for children and accompany the families to the viewings

Case Example (Italy) Shelters for 15000 people are established • The PS teams suggest to vote for a major in each shelter, to establish places of social reunion in the shelters, and schools and kindergartens for children…. • Funerals are organised in a culturally appropriate manner • Regular information is given to the inhabitants of the shelter on the danger of further earthquakes, the further procedures of recovery as well as injurance questions

• Command structures may vary extremely in different national contexts The same applies for responsibilities and legal background. • Psychosocial interventions have to be embedded into the given structures and adapted accordingly, there is no one fits all solution • In the following one example is given in order to start a discussion

Discuss different command structures and responsibilities in the different European countries (small groups)

Elements of (effective) psychosocial support Hobfoll (2007) • • • Safety Connectedness Self and collective efficacy Calm Hope

Safety • • Create a safe place Establish a trustful relationship Stay with them Give open and honest information

Safety: How to give information • Give regular information about facts, rescue and how to proceed as well as anything else that is needed • Keep it short and simple • Tell the truth (you do not have to say everything but what you say must be true) • Do not give too deatailled information in the beginning but let yourself be guided by the persons´ questions

Self and collective efficacy: Regaining control Help people to regain control, let them be active wherever possible-give them tasks they are able to fulfill

Calm: Stress reduction • Help them to gain distance to the event for some moments, reestablish routines and normalcy as soon as possible • Children: give them possibilities to play and divert themselves

Connectedness • • Help them to connect to each other Reunite families as soon as possible Strengthen social networks Try to bring in friends/relatives who can support

Hope • Help them to take small steps into the future • Plan little steps like how and with whom to return into one´s house, which music to play at the funeral etc.

use case examples in the trainer handbook to explain the elements

• In order to provide the 5 Hobfoll elements certain structures have proven to be useful • We name them intervention formats or PSS modules

Event types and Intervention formats • We differentiate mainly between two event types • Mass emergencies without damage to infrastructure • Disasters with damage to infrastructure 24

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Intervention format: „Humanitarian Assistance Center“ A HAC is a focal point for the provision of information and assistance to all those affected by an emergency, and also provides support to survivors of an emergency. 26

Intervention format: Humanitarian Assistance Center The survivors include those injured – from those with critical injuries requiring long-term hospitalisation to the walking wounded who may be to self-treat with basic medication and equipment at home – and those not physically affected, but traumatised by the emergency, including those directly involved, as well as witnesses and local responders, families and friends. 27

Intervention format: Humanitarian Assistance Center A HAC is only one part of the emergency response. Other, more immediate sources of information and help may be provided in the first 24 hours (casualty bureau, rest centre, family and survivors’ reception centre) (HAC guidance, 2009) 28

Casualty Bureau • Timeframe: Immediate • Tasks: Initial point of contact for receiving/assessing information about victims, to: – inform the investigation– trace and identify people – reconcile missing persons – collate accurate information for dissemination to appropriate parties. • Responsibility: Police. 29

Call Centre • Timeframe: Immediate • Tasks: a center where calls are collected from people who are missing somebody. Personal data of missing and their familes are collected and given to the casualty bureau • Responsibility: Police 30

Telephone Helpline • Timeframe: Immediate • Tasks: a telephone line where everybody in need related to the event can call and ask for information and advice • Responsibility: Organisation in charge, authorities 31

Survivors Reception Centre • Timeframe: Immediate • Tasks: A secure area in which survivors not requiring acute hospital treatment can be taken for short-term shelter and first aid. Evidence might also be gathered here. • Responsibility: Organisation in Charge of Immediate response, Authorities. 32

Family and Friends Reception Centre • Timeframe: first 12 hours • Tasks: To help reunite family and friends with survivors – it will provide the capacity to register, interview and provide shelter for family and friends. Responsibility: organisation in charge, authorities. • Responsibility: Organisation in Charge, Authorities. 33

Rest Centre • Timeframe: first 12 hours • Tasks: A building designated or taken over by the local authority for temporary accommodation of evacuees/homeless survivors or relatives and friends, with overnight facilities. • Responsibility: Organisation in Charge, Authorities. 34

Information Points • A space where regular information can be given to the affected group, can be part of a reception center or evacuation center, can be face to face information, written information and/or digital information depending on target groups, context and resources. • Most important: Honest information, secure information and establishment of a dialogue with the affected group(s) 35

Mobile Teams • Mobile teams can be used for: needs assessment, vulnerability assessment, direct psychosocial support to families who have lost someone etc • Mobile teams should be multiprofessional and put together from those professions that are most needed at the given moment 36

Discuss other formats according to your experiences • Call Centres • Telephone helplines • Support and Information. Website • Etc.

Simulation Exercise (half hour up to one hour) Exercise step 1 Translate the formats into your structures • Take a card for each of the formats you want to use • Write a “worksheet for each format including the “name” and structure of this format in your Country/organization, the responsibility in your country and organization, name main tasks 38

Simulation Exercise (half hour up to one hour) Exercise step 2 • Take two different event types, eg flooding in a village, , bus accident, terrorist attack in a city (Madrid film) and pandemic and develop a short image of an intervention plan including the relevant PSP module cards. 39

Make an Intervention Plan what activities are needed immediately and those that can come later and work out which helpers are needed - members of the community/ community leaders/volunteers/trained PSS personnel/mental health professionals. Make an initial estimate on how long the intervention might be needed. Involve all relevant groups and stakeholders in planning for psychosocial care and support. 40

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