Psychological First Aid and Psychosocial Support

1. Psychological First Aid and Psychosocial Support Basic Introduction Module for PSS teamleaders 4 hrs

2. Introduction Tour de table: Eachpersonintroduceshim/herselfbriefly

3. Whatis a disaster? According to UNISDR (United Nations Office for Disaster Risk Reduction, 2009, p. 9): a disaster is a “serious disruption of the functioning of a community or a society involving widespread human, material, economic or environmental losses and impacts, which exceeds the ability of the affected community or society to cope using its own resources”.

4. (Mass)Emergency All typesofcrisesandincidents a localor regional jurisdictioncan handle mainlywithinitsusualmeans, althoughtheyareof larger scale, impactandcomplexitythanroutinedispatchproblems (e.g. a busaccident): Also situationswhenhelpfrom outside isneeded but infrastructureisintact.

5. Disaster The local/regional/affectedinstitutionsandorganisationsareoverchargedwiththesituationandneed substantial supportfrom outside. An exampleof “routinedisasters”isthe 2004 seriesofhurricanes in Florida. Destructionofinfrastructure versus intactinfrastructureas an importantaspectfordecidingreceptioncentreorevacuationcentre type ofintervention.

6. Catastrophe Local/regional/affectedinstitutionsandorganisationsarenonfunctional (anymore), mostactionshavetobeorganisedand/orcarried out fromoutside ofthedirectlyaffectedregion (e.g. the 2004 Tsunami). Massive destructionofinfrastructure, needoflongtermshelters.

7. Crisis • The term“crisis”maybeused in anyofthethreeeventcomplexitylevels. • Acrisisentailsundesirablecircumstances, whichappeartobecharacterizedbysignificantvalueconflict, greatuncertainty, and time pressure (Hermann, 1963;

8. Crisis The term “crisis”isusedtocover not onlytheobjectiveelementsoftheevents, butalso thesubjectiveperceptionofdecision-makersandaffectedpopulations. Eachoftheeventtypescanresult in a crisis.

9. Basic principles of social supportSphere social indicators – 1 • Access to information • Maintain normal cultural and religious events • Formal or informal schooling for children and recreational activities (safe places) • Participation in concrete, purposeful activities • Shelter for displaced, with the aim of keeping families and communities together

10. Case Example (Italy) • After a large earthquakeabout 500 peoplearewaiting in front ofthemorgue in ordertobeallowed in foridentificationprocedures • The PS teamsestablishplacesofworship, placeswherepeoplecansit down, eat, drink, placesforchildrenandaccompanythefamiliestotheviewings

11. Case Example (Italy) Sheltersfor 15000 peopleareestablished • The PS teamssuggesttovotefor a major in eachshelter, toestablishplacesofsocialreunion in theshelters, andschoolsandkindergartensforchildren…. • Funeralsareorganised in a culturallyappropriatemanner • Regular informationisgiventotheinhabitantsoftheshelter on thedangeroffurtherearthquakes, thefurtherproceduresofrecoveryaswellasinjurancequestions

12. Command structuresmayvaryextremely in different national contexts The same appliesforresponsibilitiesand legal background. • Psychosocialinterventionshavetobeembeddedintothegivenstructuresandadaptedaccordingly, thereisnoonefits all solution • In thefollowingoneexampleisgiven in ordertostart a discussion

14. Discuss different commandstructuresandresponsibilities in the different European countries (smallgroups)

15. Elements of (effective) psychosocialsupportHobfoll (2007) • Safety • Connectedness • Selfandcollectiveefficacy • Calm • Hope

16. Safety • Create a safeplace • Establish a trustfulrelationship • Staywiththem • Give open and honest information

17. Safety:Howtogiveinformation • Giveregularinformationaboutfacts, rescueandhowtoproceedaswellasanythingelsethatisneeded • Keep itshortand simple • Tell thetruth (you do not havetosayeverything but whatyousay must betrue) • Do not givetoodeatailledinformation in thebeginning but letyourselfbeguidedbythepersons´ questions

18. Self and collective efficacy: Regaining control Help peopletoregaincontrol, letthembeactivewhereverpossible-givethemtaskstheyareabletofulfill

19. Calm: Stress reduction • Help themtogaindistancetotheeventforsomemoments, re-establishroutinesandnormalcyassoonaspossible • Children: givethempossibilitiestoplayanddivertthemselves

20. Connectedness • Help themtoconnecttoeachother • Reunitefamiliesassoonaspossible • Strengthensocialnetworks • Try to bring in friends/relatives whocansupport

21. Hope • Help themtotakesmallstepsintothefuture • Plan littlesteps like howandwithwhomtoreturnintoone´shouse, whichmusictoplay at thefuneral etc.

22. usecaseexamples in thetrainerhandbooktoexplaintheelements

23. In ordertoprovidethe 5 Hobfollelementscertainstructureshaveproventobeuseful • Wenametheminterventionformatsor PSS modules

24. Event types and Intervention formats • Wedifferentiatemainlybetweentwoeventtypes • Massemergencieswithoutdamagetoinfrastructure • Disasterswithdamagetoinfrastructure

26. Intervention format: „Humanitarian Assistance Center“ A HAC is a focalpointfortheprovisionofinformationandassistanceto all thoseaffectedby anemergency, and also providessupporttosurvivorsof an emergency.

27. Intervention format: Humanitarian Assistance Center The survivorsincludethoseinjured – fromthosewithcriticalinjuriesrequiringlong-term hospitalisationtothewalkingwoundedwhomaybetoself-treatwithbasicmedicationandequipment at home – andthose not physicallyaffected, but traumatisedbytheemergency, includingthosedirectlyinvolved, aswellaswitnessesandlocalresponders, familiesandfriends.

28. Intervention format: Humanitarian Assistance Center A HAC isonlyonepartoftheemergencyresponse. Other, more immediate sourcesofinformationandhelpmaybeprovided in thefirst 24 hours (casualtybureau, restcentre, familyandsurvivors’ receptioncentre) (HAC guidance, 2009)

29. CasualtyBureau • Timeframe: Immediate • Tasks: Initial pointofcontactforreceiving/assessinginformationaboutvictims, to: – informtheinvestigation– traceandidentifypeople – reconcilemissingpersons – collateaccurateinformationfordisseminationtoappropriateparties. • Responsibility: Police.

30. Call Centre • Timeframe: Immediate • Tasks: a centerwherecallsarecollectedfrompeoplewhoaremissingsomebody. Personal dataofmissingandtheirfamilesarecollectedandgiventothecasualtybureau • Responsibility: Police

31. TelephoneHelpline • Timeframe: Immediate • Tasks: a telephonelinewhereeverybody in needrelatedtotheeventcancallandaskforinformationandadvice • Responsibility: Organisation in charge, authorities

32. SurvivorsReceptionCentre • Timeframe: Immediate • Tasks: A securearea in whichsurvivors not requiringacutehospitaltreatmentcanbetakenforshort-term shelterandfirstaid. Evidencemight also begatheredhere. • Responsibility: Organisation in Charge of Immediate response, Authorities.

33. Family and Friends Reception Centre • Timeframe: first 12 hours • Tasks: Tohelpreunitefamilyandfriendswithsurvivors – it will providethecapacitytoregister, interview andprovideshelterforfamilyandfriends. Responsibility: organisation in charge, authorities. • Responsibility: Organisation in Charge, Authorities.

34. Rest Centre • Timeframe: first 12 hours • Tasks: A buildingdesignatedortakenoverbythelocalauthorityfortemporaryaccommodationofevacuees/homelesssurvivorsor relatives andfriends, withovernightfacilities. • Responsibility: Organisation in Charge, Authorities.

35. Information Points • A spacewhereregularinformationcanbegiventotheaffectedgroup, canbepartof a receptioncenterorevacuationcenter, canbefacetofaceinformation, writteninformationand/or digital informationdepending on targetgroups, contextandresources. • Most important: Honest information, secureinformationandestablishmentof a dialoguewiththeaffectedgroup(s)

36. Mobile Teams • Mobile teamscanbeusedfor: needsassessment, vulnerabilityassessment, directpsychosocialsupporttofamilieswhohave lost someoneetc • Mobile teamsshouldbemultiprofessionalandputtogetherfromthoseprofessionsthataremostneeded at thegivenmoment

37. Discussotherformatsaccordingtoyourexperiences • Call Centres • Telephonehelplines • Support andInformationWebsite • Etc.

38. Simulation Exercise (half hour up to one hour) Exercise step 1 Translate the formats into your structures • Take a card for each of the formats you want to use • Write a “worksheet for each format including the “name” and structure of this format in your Country/organization, the responsibility in your country and organization, name main tasks

39. Simulation Exercise (half hour up to one hour) Exercise step 2 • Take two different event types, eg flooding in a village, , bus accident, terrorist attack in a city (Madrid film) and pandemic and develop a short image of an intervention plan including the relevant PSP module cards.

40. Makean Intervention Plan Plan whatactivitiesareneededimmediatelyandthosethatcancomelaterandwork out whichhelpers areneeded - membersofthecommunity/ communityleaders/volunteers/trained PSSpersonnel/mental health professionals. Make an initial estimate on howlongtheinterventionmightbeneeded. Involve all relevant groupsandstakeholders in planningforpsychosocial careandsupport.

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