Disaster Impact on Mental Health

1. Disaster Impact on Mental Health Adapted from: The Crisis Counseling Program Trainer’s Guide U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration Federal Emergency Management Agency

2. Everyone who experiences a disaster is affected by it in some way People pull together during an after a disaster Stress and grief are common reactions to uncommon situations People’s natural resilience will support individual and collective recovery Key Concepts

3. Poverty Race Age Ethnicity Unemployment Gender Vulnerability Factors

4. Category A-Injured survivors, bereaved family members Category B-Survivors with high exposure to disaster trauma or evacuated from disaster zones Category C-Bereaved extended family members and friends; first responders Category D-People who lost homes, jobs, and possessions; people with pre-existing trauma and dysfunction; at-risk groups; other disaster responders Category E-Affected people from the larger community Risk Factors Population Exposure Model

5. Some will have severe reactions Few will develop diagnosable conditions Most do not seek help or treatment Survivors often reject help Typical Outcomes of Disaster

6. Individual May cause stress and grief May cause fatigue, irritability, hopelessness and relationship conflicts Collective May damage community support May affect individual coping Two Reaction Types

7. Physical Emotional Cognitive Behavioral Types of Individual Reactions

8. As a small group, answer the following: • 1. What specific reactions have you seen in this category? • 2. What differences in reactions have you seen- or could you imagine- across age groups? Choose a spokesperson to report answers. Exercise

9. Gastrointestinal Eased startle Headaches, aches, and pains Chronic fatigue or sleep disturbance Weight change Immune system disorders Sweating or chills Sexual dysfunction Tremors or muscle twitching Positive response can include alertness Clumsiness, increased accidents Physical Reactions

10. Heroic, euphoric or invulnerable feeling Denial Anxiety or Fear Depression Guilt Apathy Grief Positive responses can include feeling challenged, involved and pressured to act Emotional Reactions

11. Disorientation and Confusion Preoccupation with Disaster • Poor Concentration Positive responses can include group • identification and sharpened perception • Difficulty Setting Priorities or Making Decisions • Loss of Objectivity • Recurring Dreams, Nightmares, or Flashbacks Cognitive Reactions

12. Change in activity level Irritability, anger, or frequent arguments Alcohol and drug use or abuse Frequent crying Increased use of over the counter Avoidance of triggering places or activities medications Difficulty communicating or listening Difficulty sleeping Behavioral Reactions

13. Unselfishness Helping Behavior Positive Behavioral Reactions

14. Spiritual beliefs influence how people make sense of the world • Survivors may seek the comfort that comes from spiritual beliefs • Spiritual beliefs will assist some survivors with coping and resilience • Survivors may question their beliefs and life structure Role of Spiritual Beliefs

15. Depressive Disorders Posttraumatic Stress Disorder (PTSD) Substance Abuse Dissociative Disorders Social Isolation Paranoia Acute Stress Disorder Suicidal Behavior Anxiety Disorders Severe Individual Reactions

16. Severity is affected by the type and level of exposure Casualties associated with the disaster Pre-existing trauma may increase the risk of severe reaction Pre-existing levels of support will affect the severity of reactions Severe Individual ReactionsFactors

17. Pre-disaster phase • Disasters with no warning can cause feelings of vulnerability, lack of security, loss of control, fear of future unpredicted tragedies, and inability to protect one’s self and family • Disasters with warning can cause guilt or self-blame for failure to heed warnings Collective Reactions

18. Reactions can range from shock to overt panic Initial confusion and disbelief are followed by a focus on self-preservation and family protection Impact Phase

19. Many survivors exhibit adrenaline-induced rescue behavior, as well as high activity with low productivity Risk assessment may be impaired There is a sense of altruism Heroic Phase

20. Disaster assistance is readily available Community bonding occurs Many are optimistic that everything will quickly return to normal Honeymoon Phase

21. Stress and fatigue take a toll Optimism turns into discouragement Need for substance abuse services may increase The larger community returns to business as normal Disillusionment Phase

22. Individuals and communities begin to accept responsibility for rebuilding their lives People begin adjusting to new circumstances, “new normal” There is a recognition of growth and opportunity Reconstruction Phase

23. How do you define resilience? What helps foster the resilience of individuals? Communities? What factors decrease resilience? Resilience

24. The ability to recover from or adjust easily to misfortune or change -Merriam-Webster Online Dictionary- Resilience

25. Life situation Perceived presence of control and hope Individual traits and coping styles Availability of accurate information Disaster and trauma experience Effective and caring emergency response Family and social support Spiritual beliefs Factors Affecting Resilience

26. Improved relationships (closer to loved ones) Increased confidence (ability to rebuild one’s life) Increased spirituality (finding deeper meaning and purpose in life) Increased inner strength (belief in one’s ability to endure) Resilience and Personal Growth

27. Questions?... Comments?...

28. Acquanetta Knight, Director Planning and Resource Development AL Dept of Mental Health 100 N. Union Street-Suite 554 Montgomery, AL 36130 Acquanetta.knight@mh.Alabama.gov 334-353-9168 Contact Information