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Introduction to Mental Health Preparedness

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Title: Introduction to Mental Health Preparedness


1
Introduction to Mental Health Preparedness
  • For local health department staff and
  • community volunteers

Developed by the North Carolina Center for
Public Health Preparedness
2
This program IS intended to
  • Make you aware that there are mental health
    consequences to disasters
  • Expose you to the common normal reactions that
    survivors have to disasters
  • Help you to anticipate these normal reactions
    of survivors
  • Show you what you can do to assist survivors
    immediately following a disaster

3
Introduction to Disasters and Normal Responses
4
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5
Consequences of disasters
  • Physical -- destruction, injury and death
  • Mental Health various forms of stress are
    common
  • More mental health injuries than physical
    injuries
  • Mental health of community before disaster will
    determine how resilient after disaster
  • Disaster mental health services are vital
    component of planning and response

6
Implications for public health
  • Potential for high ratio of mental health
    casualties
  • Immediate mental health services delivered by
    non-mental health personnel
  • With specialized training, public health
    workers and volunteers can provide basic crisis
    intervention

7
Definition of a disaster
  • A disaster is an occurrence such as
  • Hurricane, tornado, flood, earthquake
  • Explosion, hazardous material accident
  • War, fire, famine or epidemic
  • A disaster
  • causes human suffering
  • creates collective human need
  • requires outside assistance to alleviate

8
Traumatic Events
  • Natural Disasters
  • Technological disasters
  • Disasters of human intention
  • Other interpersonal violence
  • Sudden traumatic loss

9
Post-Traumatic Stress Disorder (PTSD)
  • ¾ of the US population will be exposed to some
    event in their lifetime that meets the stressor
    criteria for post-traumatic stress disorder

10
Defining Traumatic Stress
  • Traumatic stress refers to the emotional,
    cognitive, behavioral and physiological
    experiences of individuals who are exposed to, or
    who witness, events that overwhelm their coping
    and problem solving abilities.
  • Lerner Shelton, 2001

11
Typical disaster response patterns
  • Cognitive
  • 1. Distractibility
  • 2. Duration, sequence, distortion
  • 3. Declining school work
  • performance
  • 4. Recurrent intrusive recollections
  • 5. Flashbacks, nightmares

12
Typical disaster response patterns
  • Behavioral
  • 1. Clinging, isolation
  • 2. Thrill seeking behaviors
  • 3. Re-enactments of the trauma
  • 4. Increased substance abuse
  • 5. Hyper-vigilance
  • 6. Elevated startle reflex

13
Typical disaster response patterns
  • Physical
  • 1. Shock symptoms
  • 2. Insomnia
  • 3. Loss of appetite
  • 4. Headaches
  • 5. Muscle weakness
  • 6. Elevated vital signs

14
Typical disaster response patterns
  • Affective
  • 1. Depression, anxiety
  • 2. Numbness
  • 3. Constricted affect
  • 4. Guilt, shame, fear
  • 5. Intolerance of fear response
  • 6. Global pessimism

15
Psychological Reactions to disasters ---- First
phases
  • Threat
  • Warning
  • Impact

16
Psychological Reactions to disasters ---- Next
phases
  • Heroic
  • Honeymoon
  • Inventory

17
Psychological Reactions to disasters ---- Final
phases
  • Disillusionment
  • Reconstruction
  • Recovery

18
Resistance, Resilience, Recovery
  • Resistance defend against manifestations of
    distress, impairment or dysfunction
  • Resilience Rebound rapidly effectively from
    psychological distress
  • Recovery regain the ability to function
    adaptively in the wake of distress, impairment or
    dysfunction

19
Healthy coping skills
  • Ability to orient oneself rapidly
  • Planning and execution of decisive
  • action
  • Appropriate use of assistance resources
  • Tolerance of uncertainty without
  • resorting to impulsive action
  • Appropriate expression of painful
  • emotions

20
Unhealthy coping skills
  • Excessive denial and avoidance
  • Impulsive behavior
  • Over-dependence
  • Inability to evoke caring feelings from
  • others
  • Emotional suppression
  • Substance abuse

21
Cultural factors influence disaster reactions and
coping skills
  • National origin
  • Customs and traditions
  • Length of residency
  • Language
  • Age and generation
  • Gender
  • Religious and Political
  • beliefs
  • Perceptions of family community
  • Health, well-being, disability, physical
    ability or limitations
  • Socio-economic status
  • Education level
  • Geographic location

22
Mental Health Preparedness Action Steps
23
Essential attributes and skillsyou bring to
assist survivors
  • Good listening skills
  • Patience
  • Caring attitude
  • Trustworthiness
  • Being approachable and
  • culturally sensitive
  • Non-judgmental
  • Flexible and tolerant of chaos

24
Psychological First Aid (PFA)
  • Approach for assisting people in immediate
    aftermath of disaster
  • Designed to reduce the initial distress for
    children, adolescents, adults, and families
  • Begins immediately following the disaster

25
Psychological First Aid Core Principles
  • Contact and engagement
  • Safety and comfort
  • Stabilization
  • Information gathering
  • Practical assistance
  • Connection with social supports
  • Information on coping
  • Linkage with collaborative services

26
Psychological First Aid for firstresponders
what you can do
  • Promote
  • 1. Safety
  • 2. Calm
  • 3. Connectedness
  • 4. Self-efficacy
  • 5. Help

27
Psychological First Aid for first responders
  • What you should NOT do
  • Force people to share their stories with you
  • Give simple reassurances like Everything will
    be OK
  • Tell people why you think they have suffered
  • Make promises that can not be kept
  • Criticize existing services or relief efforts
    in front of people in need of these services

28
Managing intense emotions
  • Communicate calmly
  • Communicate warmth
  • Establish a relationship
  • Use concrete questions to help person focus
  • Come to agreement about something
  • Speak to person with respect
  • Seek immediate assistance if person becomes
    threatening or does not respond

29
Making referrals
  • Referral is the act of recommending that a
    person speak to a professional who is more
    competent to handle the difficulties and
    complexities of his/her needs
  • Refer in consultation with your supervisor or the
    person who is in charge

30
Making referrals
  • Person hints or talks openly about suicide
  • If there is possibility of child abuse or any
    criminal
  • activity
  • Person seems to be socially isolated
  • Person has imaginary ideas or feelings of
    persecution
  • Problem is beyond your training or capabilities
  • Person engages in risky or threatening behavior
  • Recognize that people who talk about suicide
    are
  • the ones who ultimately commit suicide
  • Take all threats seriously and refer in
    consultation with
  • your supervisor or the person in charge

31
Confidentiality
  • Helping a person builds on trust and respect
  • All discussions are confidential and private
  • Personal information should not be discussed
    without consent
  • Exception In extreme emergency when judged
    person will harm self or others.

32
Additional Resources
  • John Hopkins Center for Public Health
    Preparedness
  • www.jhsph.edu/preparedness
  • Substance Abuse and Mental Health Services
  • Administration (SAMHSA)
  • www.samhsa.gov
  • Psychological First Aid Field Operations Guide,
    National
  • Center for PTSD
  • www.ptsd.va.gov
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