Post on 03-Oct-2020
transcript
Petros Levounis, MD, MAProfessor and Chair, Department of Psychiatry
Rutgers New Jersey Medical School
Project ECHO
Rutgers New Jersey Medical School
Newark, New Jersey
Friday, May 15, 2020
Psychological
First Aid
1. Psychological First Aid
2. Leadership
APPENDIX: Resources
Outline for Today
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1Psychological First Aid
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Morganstein JC and Ursano RJ, Frontiers in Psychiatry, 2020.
Responses to Disasters
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The Five Major Principles
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Adapted from: Hobfoll, Psychiatry, 2007.
❖ Safety
❖ Calmness
❖ Self-Efficacy
❖ Connectedness
❖ Hope and Optimism
Psychological First Aid
Safety✓ Establish safe areas and behaviors.
✓ Get accurate and updated information.
✓ Be safe, feel safe.
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Adapted from: Uniformed Services University, Center for the Study of Traumatic Stress, CSTSonline.org, 2020.
Psychological First Aid
Calmness✓ Acknowledge/normalize distress reactions.
✓ Practice diaphragmatic breathing and
muscle relaxation techniques.
✓ Limit exposure to traditional and social
media as increased use enhances distress.
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Adapted from: Uniformed Services University, Center for the Study of Traumatic Stress, CSTSonline.org, 2020.
Psychological First Aid
Self-efficacy✓ Safeguard and develop routines.
✓ Maximize physical health:o Nutrition
o Sleep and rest
o Sex
o Exercise
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Adapted from: Uniformed Services University, Center for the Study of Traumatic Stress, CSTSonline.org, 2020.
Sleep Hygiene
1. Schedule: Stick to sleep time, even on weekends.
2. Ritual: Practice a relaxing bedtime ritual.
3. Exercise: Exercise daily.
4. Substances: Avoid sleep stealers (alcohol/caffeine).
5. Environment: Check temperature, sound, and light.
6. Bedding: Sleep on comfortable mattress & pillows.
7. Electronics: Turn off electronics before bed.
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Psychological First Aid
Connectedness✓ Promote collective self-efficacy.
✓ Use electronic media thoughtfully (and I
fully recognize how unsatisfying and
frustrating this recommendation is).
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Adapted from: Uniformed Services University, Center for the Study of Traumatic Stress, CSTSonline.org, 2020.
Psychological First Aid
Hope and Optimism✓ While not denying risk.
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Adapted from: Uniformed Services University, Center for the Study of Traumatic Stress, CSTSonline.org, 2020.
2Leadership
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Yerkes RM and Dodson JD, Journal of Comparative Neurology and Psychology, 1908.
The Yerkes-Dodson Law
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The Five Major Requests
❖ Hear me
❖ Protect me
❖ Prepare me
❖ Support me
❖ Care for me
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Shanafelt T, JAMA, 2020.
Qualities to Strive For
❖ Benign
❖ Kind
❖ Present
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Ursano RJ, Disaster psychiatry: from war and terrorism to earthquakes and corona virus, Boston VA GRs, 2020.
APPENDIX:
Resources
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Psychiatry.org
ASAM.org
Primary Resource
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1. Breslau N, Kessler RC, Chilcoat HD, Schultz LR, David GC, Andreski P: Trauma and Posttraumatic stress
disorder in the community. Archives of General Psychiatry 55:626-632, 1998
2. Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N: The psychological impact of
quarantine and how to reduce it: rapid review of the evidence. The Lancet 395(10227):912-920, March
14, 2020
3. Dobkin J, Diaz C: Coronavirus statistics: tracking the epidemic in New York. Gothamist. Published online
on April 19, 2020
4. Galea S, Merchant RM, Lurie N: The mental health consequences of COVID-19 and physical distancing:
the need for prevention and early intervention. JAMA Internal Medicine. Published online on April 10, 2020
5. Geller JL, Abi Zeid Daou M: Patients with serious mental illness in the age of COVID-19: what
psychiatrists need to know. Psychiatric News. Published online on April 7, 2020
6. Gruebner O, Lowe SR, Sykora M, Shankardass K, Subramanian SV, Galea S: A novel surveillance
approach for disaster mental health. PLoS ONE 12(7):e0181233, 2017
7. Hobfoll SE, Watson P, Bell CC, Bryant RA, Brymer MJ, Friedman MJ, Friedman M, Gersons BP, de Jong
JT, Layne CM, Maguen S, Neria Y, Norwood AE, Pynoos RS, Reissman D, Ruzek JI, Shalev AY, Solomon
Z, Steinberg AM, Ursano RJ: Five essential elements of immediate and mid-term mass trauma
intervention: empirical evidence. Psychiatry 70(4):283-315, discussion 316-69, 2007
8. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, Wu J, Du H, Chen T, Li R, Tan H, Kang L, Yao L, Huang M, Wang
H, Wang G, Liu Z, Hu S: Factors associated with mental health outcomes among health care workers
exposed to coronavirus disease 2019. JAMA Network Open 3(3):e203976, March 2, 2020
9. Levounis P: Addiction: not a hangnail, but not poverty either. Academic Psychiatry, 42:277-278, 2018
10. Morganstein JC, Fullerton CS, Ursano RJ, Donato D, Holloway HC: Pandemics: health care emergencies.
In Textbook of Disaster Psychiatry, 2nd Edition. Edited by Ursano RJ, Fullerton CS, Weisaeth L, Raphael B.
Cambridge, United Kingdom, Cambridge University Press, 270-284, 2017
References
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11. Morganstein JC, Ursano RJ: Ecological disasters and mental health: causes, consequences, and
interventions. Frontiers in Psychiatry. Published online on February 11, 2020
12. North CS, Nixon SJ, Shariat S, Mallonee S, McMillen JC, Spitznagel EL, Smith EM: Psychiatric disorders
among survivors of the Oklahoma City bombing. JAMA 282:755-762, 1999
13. Reger MA, Stanley IH, Joiner TE: Suicide mortality and coronavirus disease 2019—a perfect storm?
JAMA Psychiatry. Published online on April 10, 2020
14. Rosenberg AR: Cultivating deliberate resilience during the coronavirus disease 2019 pandemic. JAMA
Pediatrics. Published online on April 14, 2020
15. Shanafelt T, Ripp J, Trockel M: Understanding and addressing sources of anxiety among health care
professionals during the COVID-19 pandemic. JAMA. Published online on April 7, 2020
16. Shapiro J, Galowitz P: Peer support for clinicians: a programmatic approach. Academic Medicine
91(9):1200-1204, 2016
17. Stellman JM, Smith RP, Katz CL, Sharma V, Charney DS, Herbert R, Moline J, Luft BJ, Markowitz S, Udasin
I, Harrison D, Baron S, Landrigan PJ, Levin SM, Southwick S: Enduring mental health morbidity and social
function impairment in world trade center rescue, recovery, and cleanup workers: the psychological
dimension of an environmental health disaster. Environmental Health Perspectives 116(9):1248-53, 2008
18. Volkow ND: Collision of the COVID-19 and addiction epidemics. Annals of Internal Medicine, Published
online on April 2, 2020
19. Yerkes RM, Dodson JD: The relation of strength of stimulus to rapidity of habit-formation. Journal of
Comparative Neurology and Psychology 18(5):459–482, 1908
20. Zagury-Orly I, Schwartzstein RM: Covid-19 – a reminder to reason. The New England Journal of Medicine.
Published online on April 28, 2020
References (continued)
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Thank you
NJMS.Rutgers.edu/Psychiatry
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