The after-effects of a disaster

[wolf]

The majority of people affected by a disaster are actually pretty resilient. Meet their basic needs for safety, food, water, and shelter, and they do well. It's unlikely that folks who didn't need medications before the hurricane struck will need them in the aftermath. It's mostly about supportive counselling, in some cases specialized grief counselling, and doing things that will normalize the experience for them. Understanding stress reactions actually does a lot to help people through such experiences. Dealing with a natural disaster is actually easier than a terrorist event, but even that has it's own challenges. Lots of folks have a significant crisis of faith under these circumstances, but that's why we have Chaplains on the team who are specifically trained in disaster response. (A lot of well-meaning, untrained preachers say a lot of dumb things in the face of something like this ... particularly given that it was Gomorrah on the Gulf that got wiped off the face of the Earth.)

Excerpted from a much longer email from the International Critical Incident Stress Foundation

3. Once deployed, effective mental health response should follow the hierarchy of needs described by Abraham Maslow:
a. Meet physiological needs for shelter, food, water, clothing.
b. Meet basic needs for safety, security, and medical care.
c. Meet basic needs to re-establish family and other interpersonal connections. Reuniting families must take priority over all other such support. For rescue and recovery personnel, the establishment of "peer" and mental health support should be emphasized.

4. The principles of psychological first aid are useful guidelines for planning support services beyond that mentioned above:
a. Assess need, assess impairment
b. Stabilize (try to prevent further deterioration of psychological/behavioral functioning through meeting basic needs as described above)
c. Assess need for further support
d. Offer information, education, reassurance, as indicated
e. Connect with sources of continued support
f. Diagnostic and traditional "psychotherapy" functions are not included herein, but are considered as later points on an overall continuum of care.

It's pretty basic stuff as far as crisis services goes ...

One of the biggest tools that are at "our" disposal is the distribution of information. Not knowing what's going on breeds fear and uncertainty. There's a segment of what I do called a "Crisis Management Briefing" which gives accurate factual information about the event, as well as education on expected reactions ... basically teaching people that they are having NORMAL reactions of a NORMAL person who has been exposed to an ABNORMAL event.

The training I have was originally developed for use with emergency services personnel. It includes "pre-incident education" (knowing about this stuff going in can help you deal with your reactions), "demobilization" (talking to people as they are coming off a duty shift or off a disaster ground), "defusing" (a structured group discussion within 24 hours of the event, talking over what happened, but prepping people for what they might likely experience) and "debriefing" (also a structured group discussion that focuses on more on what they have been thinking/feeling since the event).

There are other segments that deal with children families of the emergency service workers, as well as spiritual support.

The same process can also be used for civilians.

Right now I don't know at which point I might be called in for assistance, but am prepared to go down South if my team is requested to do so.

[Cyclefrance]

I suppose it does come down to the basics when you think of it - get the fundamental needs satisfied and that must do a lot to influence a person's thoughts about where he is best off. The cruise ships under such circumstances would represent an unknown compared to what may have been achieved/received so far and instead of providing extra security as the authorities expect the choice for the individual isn't so clear-cut as he would be removed from the present comfort zone and that isn't going to be attractive.

Do wonder where this will all end. Last night's news on UK TV concentarted on the massive pollution in the area - water mixed with harmful chemicals, rotting food, corpses, sewage, etc, causing the whole area to need to be evacuated and a first estimate of at keast 3 months to clear up. Add to that, this morning we heard that 25,000 body bags were being sent to the area - irrespective of the current number of assessed fatalities. Really leaves you with heavy mixed emotions at the scale of the disaster.

[tw]

Originally Posted by wolf

The majority of people affected by a disaster are actually pretty resilient. Meet their basic needs for safety, food, water, and shelter, and they do well. It's unlikely that folks who didn't need medications before the hurricane struck will need them in the aftermath. It's mostly about supportive counselling, in some cases specialized grief counselling, and doing things that will normalize the experience for them.

I am rather surprised in that list of actions, that psychological triage does not appear to be part of the process. I would have expected 'psychological triage' to be implemented as part of a system when disasters were large. Or is such triage really inherent in the response?