Psychology Support International

1. Psychology Support International Psychological First Aid and Triage Preparedness for Critical Incident and Disaster Response www.psycorps.net Glenn T. Goodwin, PhD, DABFE, DABPS, FABMPPPresident/FounderJohn Thoburn, PhD, ABPPCo-Founder

2. Recent Historical Background • The tsunami was a major critical incident of epic proportions, unexpected (scientists discounted a tsunami in the Indian Ocean region of the world), and unprepared for as a result. • However, scientists now agree that another tsunami is likely, the only question is when. • Further, on average, natural and technological disasters kill 50,000 people each year. An additional 74,000 are seriously injured, 5million are displaced from their homes, and over 80 million are affected in some way by the effects of earthquakes, hurricanes/typhoons, floods, high winds, landslides, technological accidents, and urban fires (World Disaster Report, International Federation of Red Cross and Red Crescent Societies, 1999)

3. The Reason for PsyCorps • In the weeks and months following major disasters, long after the initial stabilization of medical and social relief efforts are in place, and the media attention tapers off, there exists an emerging, long-term effort in dealing with the psychosocial effects of death, injury, grief and loss.

4. The Reason for PsyCorps • However, the global provision of mental health care varies in its organization and effectiveness from region to region, often being reactive rather than proactive. • Furthermore, to be effective, psychological first aid must be culturally sensitive and relevant.

5. The Reason for PsyCorps • We realize that Western psychology must be locally interpreted to be relevant or appropriate in many regions of the world. • While other relief organizations seek to provide outside service to survivors of disaster, it is PsyCorps’ mission to help regions prone to natural or man made disaster create and develop their own teams to provide psychological first aid services directly to survivors, first responders and caregivers in the aftermath of critical incidents and disaster.

6. The Vision of PsyCorps • The vision of PsyCorps is to create a global community of culturally indigenous psychological support teams that are inter-connected and prepared beforehand to respond to the acute and long-term psychological effects of disaster survivors, first responders and caregivers.

7. Disaster Response: Acute Emergency Phase The Primary Echelon of Disaster Support Dealing with disaster induced deprived physical needs Food, shelter, physical security, water, sanitation Access to health care Management of communicable diseases The focus and mission of the well-recognized disaster relief organizations and NGO’s Bulletin of the World Health Organization, Jan 2005, 83 (1)

8. Disaster Response: Crisis and Post-Acute Emergency Phase The Secondary Echelon of Disaster Support Implementing culturally sensitive psychological first aid Having local, community-based psychological support teams (chapters) in place, trained and able to be mobilized to: Providing direct care to survivors Providing secondary care to first responders and care-givers Bulletin of the World Health Organization, Jan 2005, 83 (1)

9. Definitions: Critical Incident • Critical incidents (disaster) may be seen to reside along a continuum of scope from: • macro (disaster affecting the entire country such as war, terrorism or catastrophic natural disaster-volcano, tsunami) to, • meso (disaster affecting a region such as a airline crash, earthquake, flood, typhoon/hurricane, earthquake), to, • micro (discrete disasters affecting a locale such as an automobile accident or fire).

10. Definitions: Preparedness • Preparedness planning must address the psychosocial needs of both survivors and caregivers involved in critical incident and disaster. • A locale, region or country’s system of critical incident preparedness can only be as effective as the capacity for emergency, rescue and caregiver personnel to remain emotionally healthy and effective in dealing with their own stress and strain from interaction with the critical incident.

11. Needs Assessment • There is a general lack of organized psychological first aid provided to disaster responders. • Crisis workers and caregivers often feel the cumulative effects of stress, including burn-out or ‘compassion fatigue.’ • The international PsyCorps assessment suggests that there is a major need for additional resources and services dedicated to managing caregiver stress.

12. Needs Assessment • Humanitarian assistance programs are often uncoordinated, resulting in an adverse effect on service recipients. • Cross cultural issues of humanitarian assistance and applicability are often overlooked. • Culturally indigenous, psychological support teams are rarely trained, organized and coordinated beforea disaster strikes, affecting the timeliness of trauma response and quality of service.

13. Problem Statement • Many survivors, responders and caregivers of natural and man made critical incidents and disaster do not receive adequate attention to manage traumatic stress or compassion fatigue. The result has been • Survivors are more prone to developing PTSD • Caregivers are less effective than they might be • Caregivers are more easily burned out. • Civic, business and commerce suffers due to decreased employee productivity and mental health related absences and attrition.

14. Recommendations • That the government, civic and business community and NGOs should support posttraumatic stress reduction services to survivors, first responders and caregivers. • We recommend the development of Psychological Support Teams that are in place, trained and ready for effective and timely mobilization if and when major critical incidents occur. We suggest that these teams be comprised of locals to ensure culturally appropriate interventions. • We support the World Health Organization recommendation that ‘alleviating psychological distress and strengthen[ing] resiliency must be an integral part of humanitarian assistance,” (January 2005). By effectively integrating disaster mental health into broader humanitarian assistance programs, recipients will receive continuous care and greater service accessibility.

15. Why do we need Psychological Support Teams? • Mental health preparedness and aid has tended to be reactive and unorganized, rather than pre-planned and responsive. • Mental health preparedness and aid, in particular, needs to reflect the culture and values of the region. • Mental health resources need to be available to first responders and crisis workers as well as survivors.

16. Project Goals • The overall goal of PsyCorps is to ensure that culturally appropriate and accessible critical incident psychological support is available for the community at large. The following are the specific goals of the program. • Provide Development Consultation: a step-by-step framework for implementing regional psychological support teams experienced in emergency and disaster response • Provide team training and education in Flexible Psychological First Aid (FPFA) • Provide one-on-one FPFA support for survivors of critical incidents and disaster • Provide FPFA for responders and caregivers involved in critical incidents and disaster

17. Project Synopsis • PsyCorps International will establish PsyCorps Psychological Support Teams. • The Teams will be local volunteers, known as “befrienders”, trained in Flexible Psychological First Aid (FPFA) and Triage to provide trauma support services to survivors, first responders and caregivers involved in critical incidents and disaster. • Team development will include identifying an administrative core composed of project manager, clinical supervisor/director (licensed or certified mental health professional), liaison and administrative assistant.

18. Mission Statement • The mission of PsyCorps is to provide consultation and support in the development of international Psychological Support Teams that are: • Organized and prepared to respond to critical incidents and disaster • Trained in Flexible Psychological First Aid (FPFA) and Triage • Composed of nationals • Prepared to collaborate with civic and governmental agencies, emergency services, relevant health care services and other involved NGOs

19. The PsyCorps Paradigm: Flexible Psychological First Aid (FPFA) • The PsyCorps model offers a flexible, multimodal approach for the provision of psychological first aid and triage interventions. This model is called Flexible Psychological First Aid – FPFA

20. Flexible Psychological First Aid (FPFA) • Following disaster, there are numerous complex mental health issues and situations that emerge. We realize, based on clinical experience and accumulating research, that one model may be better suited than another for a given aspect of a critical incident. • The FPFA model draws from a spectrum of crisis intervention approaches to implement the most efficacious and appropriate strategy for a given situation. • Psychological support after disaster should emanate from a strengths based perspective with intervention and mental health assistance focusing on positive coping strategies.

21. Flexible Psychological First Aid (FPFA) • The FPFA model focuses on: • protection from future harm • current needs and concerns • practical assistance such as providing direction • assistance for connecting to loved ones • information resources and availability of additional support • acute care • psychological triage • death notification

22. PsyCorps | Psychology support international Addressing the Posttraumatic Consequences of Natural and Man-made Disasters Global network of Psychological Support Teams, organized, trained and prepared in advance, for response and management of the psychosocial aftermath of critical Incidents and disaster Indigenous to Each Culture Primary Mission: Providing Flexible Psychological First Aid (FPFA) and Triage for: Survivors First responders Caregivers