Post on 21-Dec-2015
transcript
Mental Health Preparedness
Agenda Review how people react
psychologically to a crisis
Discuss relationship of mental health in public health emergency
Discuss compassion fatigue related to public health responders
What Is Meant By “Crisis?”
Some type of turning point
An emotionally significant event or radical change in one’s life
An unstable or crucial time when decisive change is impending
What Is A Crisis? A “crisis” is a situation in which a
person’s ability to cope is exceeded. “Nothing will ever be the same.” Triggering event within the last 24 – 48
hours. Response emotionally driven (not rational). Situation perceived as either physically or
psychologically threatening. If the subject feels he is in crisis he is.
Characteristics Of People In Crisis Thinking is constricted, emotions are
expansive. Lowered attention spans. Inability to discern between small and
large problems. Often do not see way out of the
situation. Try out different behaviors to reduce
stress.
During A Crisis What Do People Feel?
Wide range of emotions Fear Anxiety Anger Hopelessness Helplessness
What About Panic? Vast majority of
people Do not panic in
times of crisis Do not act
unreasonably Do not engage in
extreme behavior
What Do We Know About Stress Reactions?
Impacted by loss of control
Impacted by unpredictability
Can lead to experience/reaction called “learned helplessness”
Stress Is Evaluated By: Perceived danger/threat value
Irrelevant/harmless? Threat/challenge?
Coping mechanisms available Cognitive Behavior Neurophysiological Emotional
Why Do People Respond Differently to Stress?
Family/Genetic Influences History of physical/psychological
conditions Personality and temperament Cultural background Gender
Why Do People Respond Differently to Stress?
Past Experiences – “wisdom” Learned coping patterns Previous exposure to similar stress Lifestyle patterns
Why Do People Respond Differently to Stress?
Existing vulnerabilities/strengths Health Motivation Support at work/home Relationships with spouse/friends Financial situation Other’s health (i.e. child, parent) Other?
Why Do People Respond Differently to Stress?
Existing Beliefs and Skills Spiritual or religious influence Open communication style Moral Values Accepts help (from pastor/counselor/other) Self-Concept
Troublesome Behaviors In A Crisis
What you can count on: Those who try to bypass official
channels Vicarious rehearsal MUPS: Multiple Unexplained Physical
Symptoms Stigmatization
Mental Health And Emergencies/Disasters Responding to emotional and
psychological impact of event is critical part of response strategy
General agreement that all people involved in event are impacted some way
Mental Health And Emergencies/Disasters
Emotional reactions to the event may vary person to person
Some people may exhibit symptoms of mental illness immediately after event but few develop long-term mental health problems
Mental Health And Emergencies/Disasters
However, recent experience with catastrophic events have challenged this thinking Large scale loss of life, property and
disruption in community life reveals more serious patterns of psychological impact.
Particularly true when event is intentionally caused by human action
Directed Mental Health Interventions
A. Seriously injured victims and bereaved family members
B. Victims with high exposure to trauma, victims evacuated from disaster area
Priority Setting In Crisis Counseling
C. Bereaved extended family members, emergency workers, medical officers’ staff, service providers providing death notification or working with bereaved families
Priority Setting In Crisis Counseling
D. People who lost homes, jobs, pets, mental health providers, chaplains, emergency health care providers, school personnel working with survivors, media personnel
Priority Setting In Crisis Counseling
E. Government officials, groups that identify with target victims group, businesses with financial impact
F. Community at large
At-Risk Persons
Those with preexisting mental health problems
Children Those displaced by event particularly
if they have little support Those with preexisting medical
problems Those with disabilities
Preparedness: Developing Resiliency
Resiliency The process of adapting well in the
face of adversity, trauma, tragedy, threats, or even significant sources of stress (e.g. family problems, serious health problems, financial stressors)
“Bouncing Back” from some type of adversity
Preparedness: Developing Resiliency
Research has shown that resiliency is ordinary, not extraordinary; people demonstrate resiliency each day
Being resilient doesn’t mean that a person doesn’t experience difficulty or distress
It involves thoughts, behaviors, and actions that anyone can learn and develop
Factors Associated With Resiliency
Having caring and supportive relationships
Relationships that create love and trust Capacity to make realistic plans and
take action A positive view of yourself Skills in communication and problem
solving Capacity to manage strong feelings
Steps To Build Resiliency
Make connections Avoid seeing crises as insurmountable Accept that change is part of life Take decisive action and move toward
life goals Look for opportunities of self-discovery Keep things in perspective
Steps To Build Resiliency
Take care of yourself Learn from your past experiences
and make positive changes Stay flexible Let yourself experience strong
emotions Learn to rely on others and let
others rely on you
Examples Of Preparedness Activities
Educational campaign
Establish mental health response network with local providers
Target at-risk populations Assist in development of safety plan Assist in development of emergency kit Assign liaisons to identify specific
concerns in your community
Secondary Trauma
Defined as the emotional residue of exposure to working with the suffering, particularly those suffering from the consequences of traumatic events
Secondary Trauma
Professionals who listen to the stories of fear, pain, and suffering are especially vulnerable to secondary traumatization
Emergency care workers, police officers, mental health professionals, medical professionals, clergy, and human services workers are vulnerable to secondary trauma
Secondary Trauma
• Is a state of tension and preoccupation with the individual or cumulative trauma of clients
• Can be thought of as secondary post-traumatic stress• avoidance/numbing of reminders of the
event• persistent arousal
• Secondary trauma is not “burnout”
Consequences of Secondary Trauma
• Job performance declines• Mistakes increase• Morale drops• Personal relationships are affected• Deterioration of home lives• Personality deterioration• Decline in general health
Critical Incident Stress
A “critical incident” is any event that has a significant amount of emotional reactions which have the potential to interfere with their ability to function either at the scene or at a later time
Key Ideas
Normal reactions to an abnormal event
Reactions include cognitive, behavioral, psychological
Examples of Critical Incidents
Line of duty death Serious line of duty injury Suicide of co-worker Disasters Law enforcement shooting
CIS Interventions
Demobilizations Defusings Debriefings One-on-One meetings
Self-care and Stress Management
Prior to assignment Personal Preparedness Team and Organizational Preparedness Safety of Family Members Social and Organizational Support
Self Care and Stress Management
During an Assignment Work with a partner Limit length of shifts Use stress management techniques Keep a notebook Defuse regularly Call home regularly Closures
Self-Care and Stress Management
Following an Assignment Returning home
Express gratitude to those who have covered your normal responsibilities
Expect an adjustment period of a week or two
Mild depression Physical let-down
Expect a lot of questions from others
Summary Mental health preparedness/response
must be part of all emergency management plans
Individuals respond differently to events
Promote resiliency to minimize impact of life changing events
Taking care of oneself is just as important as caring for victims