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Key Topics

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Key Topics What is Psychosocial Mental Health, Psychosocial & Disaster Psychological First Aid Sence of Place Stress & Crisis FACT Team – PowerPoint PPT presentation

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Title: Key Topics


1
Key Topics
  • What is Psychosocial
  • Mental Health, Psychosocial Disaster
  • Psychological First Aid
  • Sence of Place
  • Stress Crisis
  • FACT Team

2
What is psychosocial?
3
  • The need to provide psychosocial support to
    victims of disasters was recognised in 1980s
  • First consultation on psychological support was
    held in Copenhagen in 1991
  • In 1993 the General Assembly recommended the
    IFRC to give high priority to psychological
    support issues and strongly advocate the
    implementation of psychological support programs
    in National Societies and- Reference centre for
    Psychological support was established

4
International Federation of Red Cross and Red
Crescent Societies
  • "Underneath the relief blankets many people are
    still cold, not physically, but emotionally. In
    addition to their physical needs, people affected
    by disasters and other stressful life events have
    important mental (psychological) and social needs
    which frequently remain unmet ." ( From the first
    Consultation on Psychological Support,
    Copenhagen, May 1991)

5
  • World Health Organization Definition of Health
    and psychosocial
  • A state of complete physical, mental and
    social well-being and not merely the absence of
    disease or infirmity.
  • Psychosocial refers to the dynamic,
    interconnected relationship among psychological
    feelings and social and cultural experiences.

6
Definition of Psycho-social
  • PSYCHO (logical) refers to the mind and the soul
    of a person. This involves internal aspects such
    as feelings, thoughts, beliefs, attitudes and
    values.
  • SOCIAL refers to a persons external
  • relationships and environment.
  • This includes interactions with others, social
    attitudes and values (culture) and
  • social influences of family, peers, school and
    community.

7
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8
  • The World of A Person

Relationships, activities and spirituality are
linked to build my person and inner resources.
The capacity to use these inner resources is my
RESILIENCE.
  • Resilience is
  • The capacity to manage oneself when faced with
    difficult circumstances.
  • The capacity to transform oneself in a positive
    way.
  • The capacity to recover or rebound.

When I fall, I am able to get back up and stand
on my feet. This is resilience.
9
When there is a traumatic event the world of the
person is disrupted.
Relationships are affected
Mistrust and loss
Insecurity and fear
Activities are affected
MY PERSON IS DISRUPTED
Spirituality are affected
Hopelessness and Confusion
10
Psychological Social/Cultural
  • Emotions
  • Feelings
  • Thoughts
  • Beliefs
  • Perceptions
  • Behavior
  • Traditions
  • Values
  • Upbringing
  • Relationships
  • Obligations
  • Family
  • Community

11
Disaster is a major life stress of extreme
severity
  • loss of
  • Life (orphans, widows, widowers)
  • Livelihood
  • Physical functioning Injuries and disability
  • Shelter , food, livestock
  • Access to health care
  • Access to education
  • Leaders and community structures

12
So, following a disaster
  • We have to cope with
  • The pre-existing mental disorders in the general
    population and within any hospital services in
    the area
  • Normal psychological responses to the disaster,
  • Additional mental disorders caused by the
    disaster and its attendant physical and social
    effects
  • Loss of pre-existing health, social and
    educational infrastructure and human resource

13
Therefore the common mental health problems in a
disaster populations include
  • Universal normal response to the abnormal stress
    (disaster)
  • Grief and Bereavement
  • Depression
  • Anxiety
  • PTSD-Post Traumatic Stress Disorders
  • Psychosis
  • Substance abuse
  • Mental retardation
  • epilepsy

14
Disaster Mental Health
  • The goal is to prevent the development of
    long-term, negative psychological consequences of
    a disaster.

15
CYCLE OF DISASTERS (Quarantelli, 1968)
Rehabilitation
Reconstruction
Prevention
Mitigation
Preparedness
16
CYCLE OF DISASTERS (Quarantelli, 1968)
Rehabilitation
Reconstruction
Development
Prevention
Mitigation
Preparedness
17
Cycle of Disasters
  • Assessment
  • Information
  • Crisis intervention
  • Psychological First Aid
  • Defusing
  • Rapid Response
  • Psychological First Aid
  • Crisis intervention
  • Information

Response
0-96 Hours
Event
Disaster Mental Health
Warning
24 Hours
  • Preparation for psychosocial response in time of
    disaster based on SPHERE standard/ISAC guidelines
  • Procedures and Protocols

18
Basic Principles
  1. Intervene immediately.
  2. Interventions are time limited and brief.
  3. The practitioner role is active.
  4. Symptom reduction is primary goal.
  5. Practical information and tangible support are
    provided.
  6. Social support is mobilized.
  7. Expression of feelings, symptoms, and worries is
    encouraged.
  8. Effective coping is supported to restore a sense
    of competency as early as possible.
  9. Cognitive issues about reality testing and
    confronting the experience are addressed.

19
Psychosocial Support
20
Psychosocial Support is .
  • A multidisciplinary, community based process that
    promotes the restoration of social cohesion and
    infrastructure, as well as the independence of
    individuals and groups.
  • An approach that serves to prevent pathological
    developments and further social dislocation.

21
Cycle of Disaster
Rehabilitation
  • Assessment
  • Information
  • Informal schooling for children
  • Linking
  • Community consultation

Psychosocial Care
Reconstruction
  • Psychological first aid
  • Information
  • Schooling for children and adolescents
  • Linking
  • Community resilience activities
  • Referrals

22
Cycle of Disasters
Mitigation
  • Community resilience activities
  • Community income generation activities
  • Referrals and community based psychological
    interventions
  • National structure developed
  • National procedures and protocols.

Preparation
Psychosocial Care
  • Capacity Building
  • School Plans
  • Family Plans
  • Community mapping
  • Community plans
  • Procedures and Protocols developed
  • Simulations

23
Definition of Psychological First Aid
  • Psychological First Aid is a first order
    response, of short duration, to a person who is
    experiencing distress as a result of a disaster,
    an emergency or a crisis to foster coping in the
    current situation.

24
PSYCHOLOGICAL FIRST AID
  • Who require PFA ?
  • Any person who is in crisis requires PFA. After a
    major stressful event (a disaster) it is not just
    the survivors who requires Psychological First
    Aid but also their relatives and the people who
    come to assist the survivors.

25
Five steps of Psychological First Aid
  • Meet the immediate needs.
  • Providing a safer place without further threat.
  • Providing physical First Aid, if needed.
  • Offer something to drink or eat.
  • Make the survivor feel comfortable.
  • Be aware of people who are having self harming
    ideas or intentions to cause harm on others.

26
  • 2. Listen, listen and listen
  • Share the reality of the person.
  • Use appropriate body language.
  • Provide key words to facilitate survivors
    expression.
  • Use gentle touch, if appropriate.
  • Acceptance and taking time to listen.

27
  • 3. Accept the feeling expressed by the survivor.
  • Empathize and validate feelings expressed by the
    survivor.
  • Accept the normal reactions after a major
    stressful event like feeling of fear, grief,
    guilt and anger.
  • Listen non-judgmentally and without interruption.
  • No advice no false assurance.

28
  • 4. Assist with next step
  • Provide factual information where they could find
    specific recourses.
  • Encourage the survivor to plan a personal action
    plan for the immediate situation.
  • Help the survivor to develop sense of place.

29
  • 5. Refer and follow-up.
  • Identify persons who need counseling and
    intervention.
  • Refer persons who does not respond to your
    intervention.
  • Link the person to a system of support.
  • Follow-up next day.

30
Table for sustainability of Sense of Place
  Objective 4 Assist Community Members to
establish a sense of place   This objective
will be accomplished through the creation of
community centers or community gatherings in
each of the programs target areas and by
providing assistance to tsunami survivors in
locating official identification document and
family photos.   Objective 5 Enhance National
capacity to disseminate best practices and
lessons learned   This objective will be
accomplished through the active involvement of
the SLRCS and local government counterparts in
systematic program monitoring and evaluation. The
program will sponsor annual psychosocial seminars
in Sri Lanka during which the program results and
lessons learned will be shared.
Ecological
Cultural
Problem Solving
SENSE OF PLACE
Solution Oriented
Human Capital
 
31
Indicators for a Sense of Place
  • Attachment to the place where a person lives.
  • Spending a lot of time and effort into making a
    place my own.
  • Feeling more relaxed when at home in the
    community.
  • Community has things that highlight your
    personality.
  • Community is a secure place to live.
  • Personal touches to the ecology of the place
    where I live.
  • I take pride in the community where I live.
  • I work with others at making our community a
    place my own.

32
Defining Sense of Place
  • Sense of Place is related to the perceived
    relationship between the survivor and the
    environment.
  • Sense of Place represents a dynamic process by
    which a survivor manipulates the environment to
    reflect his/her self identity.
  • Sense of Place is related with autonomy, acting
    on the environment, making space for meaning,
    creates a place, and gives the person a sense of
    autonomy.

33
Impact on Sense of PlaceOnce a sense of place
is established life is relatively stable and
resilient.
  • When a traumatic life event disrupts the life of
    the survivor, the feeling of security,
    attachment, identity, familiarity, and
    resilience, the survivors self-identity is
    disrupted.
  • To reestablish the sense of place the survivor
    may require more work and energy output. This
    requires building networks with family, peers,
    and significant persons in the survivor life.
  • Sense of place has a strong familial,
    community, and environmental contributions to its
    development.

34
Stress Reactions
35
Physical Reactions of STRESS
  • Fatigue, exhaustion
  • Appetite change
  • Tightening in throat, chest or stomach
  • Worsening of chronic conditions
  • Somatic complains

36
Emotional Reactions of STRESS
  • Depression
  • Irritability, anger
  • Anxiety, fear
  • Despair, hopelessness
  • Guilt, self-doubt
  • Unpredictable mood swings

37
Cognitive Reactions of STRESS
  • Confusion, disorientation
  • Recurring dreams or nightmares
  • Preoccupation with disaster
  • Trouble concentrating or remembering things
  • Difficulty making decisions
  • Questioning spiritual beliefs

38
Self Care
39
What is Self Care ?
  • Self Care is a method of reducing stress, which
    the individual himself / herself can apply on
    self.

40
Who can do Self Care ?
  • Self-care activities are for people who have some
    degree of control on themselves and are aware
    that they are under stress.

41
Build your energy levels  
  • Walk, swim, play sport on a regular basis, jog.
    Eat a balanced meal      
  • Alternate work with pleasure activities.
  • Sleep sufficient time to feel rested.
  • Take time off when sick.
  • Get enough sleep.
  • Wear clothes you like.
  • Take vacations.

42
Keep your emotional reserves
  • - Develop gratifying personal relations.
  • - Seek emotional support.
  • - Formulate realistic goals for yourself.
  • - Prepare yourself for frustrating moments,
    allow yourself not to be perfect.
  • -  Give yourself affirmations, praise yourself.
  • -  Allow yourself to cry.
  • - Find things to make you laugh.

43
Psychological Self-care
  • Make time for self-reflection
  • Say no to extra responsibilities sometimes.
  • Let others know different aspects of you.
  • Notice your inner experiences listen to your
    thoughts, judgments, beliefs, attitude and
    feelings.

44
Psychological Self-care
  • Do something at which you are an expert or in
    charge.
  • Engage in activities, which you enjoy. (For
    example, play some games, go to the cinema, take
    part in song and dance activities.)
  • Be curious about learning and absorbing new
    things.

45
Spiritual Self-care
  • Be aware of the non-material aspects of life.
  • Identify the meaningful aspects of your life and
    value its importance.
  • Contribute to causes that you believe in.
  • Meditate.
  • Pray,
  • Participate in spiritual communes.

46
Techniques to Reduce STRESS
  • Relaxation
  • Deep breathing
  • Visualization
  • Affirmation

47
Identification of a Crisis
  1. Verbal cues
  2. Non verbal cues from the person
  3. Surroundings
  4. People in immediate contact

48
Common reactions to Crisis
  • Tiredness and exhaustion
  • Sleeplessness
  • Helplessness
  • Disorganization, affects functioning within
    family, at work and in social relationships.
  • Anxiety expressed by headaches, stomach aches,
    palpitations and muscular tension.
  • Irritability towards social network
  • Depression.
  • Confusion

49
Conditions of Referral
  • Behaviour out of context.
  • Behaviour crossed the limits of context demands.
  • Behaviour harmful to self or others.
  • Evidence of suicidal talk or low self care.
  • Overdose or withdrawal of substances of abuse.

50
The common causes of stress in children are
  • Death of a dear one. E.g. Parent, sibling,
    relative or friend
  • If a child suffers from physical injury or
    handicap
  • Memories and thoughts of a crisis or disaster
  • Dear one injured or physically disabled
  • Loss of a favorite toy or any other object
  • Displacement from the house
  • Fights between parents, violence at home
  • Poverty
  • Examination
  • Corporal punishment by the teachers

51
COMMON STRESS REACTIONS IN CHILDREN
  1. Inactive. Not able to follow daily routine.
  2. Fear of the dark, fear of being alone.
  3. Not able to speak.
  4. Disturbed sleep (nightmares, fear of going to
    sleep, fear of being alone at night)
  5. Clinging, not wanting to be away from parent or
    teacher, bed-wetting.
  6. Anxieties about the dead person that s/he will
    return.
  7. Fears triggered by the event.

52
FACT TEAM
  • Should assess the individual and social capacity
    of resilience of the Disaster population.
  • Should look in to whether the Sence of Place of
    the population has been disturbed
  • Coordinate the referral system.
  • Look in to relief and recovery
  • Please read Page 291-293 of SPHERE.(non
    communicable Diseases)

53
Thank You!
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