In what ways might the application of psychological first aid differ for survivors of a natural versus a human-made disaster? Consider the perspectives of survivors or the first responders.
Psychological first aid should be administered with temporary relief in mind. Many will recover without needing further intervention. It is not meant to be a substitute for long-term counseling if that is deemed necessary. A first responder is intended to address immediate and basic needs (Snider, van Ommeren, & Schafer, 2011). A first responder should provide comfort and help people feel calm.
It is important to know that survivors of natural disasters are less likely to be at risk of long-term psychological distress from the event than those who experience an act of omission or commission (Jungersen, et al., 2013). The natural disaster survivor is likely to feel psychological and physiological symptoms due to a lack of control as an act of God or nature is unpreventable. Natural disaster survivors are typically more resilient and determined to return to normal. The restoration process holds a sense of catharsis. There is a parallel to be made between the rebuilding of the town with their own recovery (Shallcross, 2012).
In the aftermath of a human-caused disaster, it is important to distinguish that an act of omission, an accident, is less likely to cause long-term symptoms of a stress disorder than an act of commission, a premeditated event that is meant to cause harm. Acts of terrorism have the highest likelihood that they will cause long-term stress disorders. These types of events often leave survivors feeling traumatized of vulnerable, no longer able to trust in the safety of one’s surroundings (Shallcross, 2012). There are often feelings of anger and retaliation mixed in with the shock and sadness. Survivors will need their faith in safety and control.
What are the pros and cons of non-professionals providing psychological first aid to survivors?
Professional psychologists are familiar with the events of trauma. That familiarity can be good in helping them to remain calm and professional during a crisis. They are less likely to break under the pressure of being surrounded by the chaos. However, if not trained specifically in trauma care, they could be tempted to administer counseling, which the survivor is not mentally prepared to do in their state of shock. They need time to process what has happened before they are aware of how it has affected them emotionally (Shallcross, 2012).
A non-professional would be more likely to only do what they were trained to do and not attempt to administer therapy. They may also be more likely to be able to follow orders from the team in charge of handling the response to the event.
I agree that rapid mental “first aid” after a natural disaster is a great way to mitigate some of the trauma that could cause PTSD. I personally have not partiipated in one, but the military executes HA/DR (Humanitarian Aid / Disaster Relief) operations so frequently we actually have doctrinal methodologies for it. I think a natural disaster often has a broad impact on daily human necessities that can itself magnify the initial trauma of an event. Relieving human suffering is a great start, but I feel we may forget that PTSD symptoms don’t necessarily manifest rapidly. The instinct to move on to the next crisis may remove the focus needed on their long term mental health to adequatly address the impacts of the disaster. We, as Americans, seem particularly fond of moving on quickly and often neglecting those that continue to suffer after the news cycle passes (Hurricane Katrina, maybe?). Do you think the military should include other services, like the Public Health Service, into HA/DR operations?
How would you challenge someone just learning about psychological first aid to critically think about its impact on the health care field? I appreciate your reflections!
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