Psychological first aid (pfa) in disaster
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Weekly journal club topic presentatio of department of Psychiatry. Bangladesh is disaster prone country. Disaster psychiatry is very relevant here. Hope this ppt will provide mental health professional a little idea about PFA , disaster psychiatry and disaster management.
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Psychological first aid (pfa) in disaster
- 1. Psychological First Aid (PFA) in disaster Dr Md Saleh Uddin Resident, Phase B Department of Psychiatry BSMMU, Dhaka 20.05.2014
- 2. Contents • Disaster • Disaster Psychiatry • Psychological First Aid (PFA) • Mental Health First Aid (MHFA) • Conclusion • References
- 3. Disaster
- 4. Disaster • is a severe destruction that greatly exceeds the coping capacity of the affected community Disaster Response RecoveryMitigation Preparedness
- 5. Local Scenario • Major Cyclones: 75 cyclones and floods/100 years
- 6. Natural disaster 1980-2010(CRED report 2012) • No of events:234 • No of people killed:191,836 • Average killed per year:6,188 • No of people affected:323,480,264 • Average affected per year:10,434,847 • Economic Damage (US$ X 1,000):17,072,500 • Economic Damage per year (US$ X 1,000):550,726
- 8. Killed by disaster Affected by disaster
- 9. • A report published in 1996 states that 66% of the tornado affected people were psychologically traumatized in the costal area • Another study found 31.3% war injured freedom fighters suffering from post traumatic stress disorder even after 27 years of liberation war
- 10. • 2007 - Super cyclone ‘Sidr’ changed the views regarding post disaster mental health service • Technical and financial support came from World Psychiatric Association (WPA) • Multiple teams rushed to the affected area to provide mental health services
- 11. Training Manuals
- 12. Plan Act
- 13. • District Disaster Management Plan(DDMP)
- 14. Global scenario
- 17. • Victim • Psychological responses • Psychosocial intervention
- 19. Psychological responses Psychological responses Within 24hrs Within days to weeks After 3 weeks
- 20. Psychological responses Don’t need intervention May need only minimal intervention Need help from mental health professional
- 21. Normal reactive process • Most recovers within 6 to 16 months • Common stress reactions Emotional , Cognitive, Physical, Interpersonal • Post traumatic growth/benefited response
- 22. Within 24 hrs • Tension, anxiety, panic • Stunned, dazed, shocked, disbelief • Restlessness, confusion • Agitation, crying and withdrawal • Survivor’s guilt
- 23. Within days to weeks • Being fearful , vigilant, hyper alert • Irritable, angry, unable to sleep • Worried, despondent • Flashback • Weeping, guilt feeling • Sadness • Positive thinking(hope for future, rescue work) • Acceptance of disaster as nature’s doing
- 24. After 3 weeks • Restlessness, panic feeling • Continued deep sadness, unrealistic, pessimistic thoughts • Outward inactivity, isolated and wihtdrawn behavior • Anxiety
- 25. Psychiatric response • Acute stress disorder • PTSD • MDD • Substance abuse • Psychological disorder • Organic • Adjustment disorder • Bereavement • Family violence • Child and spouse abuse
- 26. Psychosocial intervention • Psychosocial first aid (PFA) • Trauma counseling • Greif counseling • Anticipatory guidance • Crisis counseling • Problem solving counseling
- 27. Psychological First Aid (PFA)
- 28. • Understanding PFA • How to help responsibly • Providing PFA • Caring self and colleague
- 29. PFA “A human supportive response to a fellow human being who is suffering and who may need support” (Sphere2011, IASC WHO-2007)
- 30. PFA Elements • Care and support • Needs and concerns • Address basic needs • Listening to people, not pressuring • Comforting people and helping them to feel calm • Helping people connect to information, service and social support • Protecting from further harm
- 31. PFA What PFA is not • Not only professionals do • Not a professional counseling • Not “Psychological debriefing” or ”CISD” • Not asking, analyzing, put in order • Available to listen but not pressuring to talk
- 32. PFA Who need immediately • Serious life threatening injuries • So upset, cant care themselves and family • May hurt self/others
- 33. PFA When and where • Recently affected • Sometimes days or weeks after • Scene of accident/disaster • Health center, shelter/camps etc
- 34. PFA Providing PFA • Preparation • Good communication • PFA action principal • Ending help • Who likely need special attention
- 35. Providing PFA Preparation • Learn about crisis • Learn about available service and support • Learn about safety and security concern
- 36. Providing PFA Good communication • Basics of communication skill • Don’t pressure • Don’t think you must solve all problems • Don’t give false promise
- 38. Providing PFA Ending help Depends on the context of crisis Individual’s role and situation Needs of the people
- 39. Providing PFA Special attention group • Child adolescent group • People with health conditions/disabilities • People at risk/discrimination/violence
- 40. Caring for self and colleague • Getting ready to help • Managing stress • Rest and reflection
- 41. • Safe effective feasible? • 58 citations • Insufficient evidence • Objective observation and expert opinion(Class iii, iv)
- 42. Mental Health First Aid (MHFA)
- 43. MHFA • Person developing a mental health problem or experiencing a mental health crisis • Until treatment /Support received • Not a substitute of counseling, medical care, peer support/ treatment.
- 44. MHFA People can learn • Overview of mental health problems • First aid for crisis situations • First aid for non crisis situations
- 45. MHFA Spectrum of mental health intervention
- 46. MHFA • Created in Australia (2001) • Currently in 18 countries • Piloted in USA (2008)
- 47. MHFA Why MHFA? • Problems are common • Stigma • Professional unavailability • Do not seek help • Awareness
- 48. Conclusion • Basics Disaster management Disaster Psychiatry Psychological first aid (LOOK LISTEN LINK) • Local research and system innovation
- 49. References • Disaster mental health response Handbook, The NSW institute of Psychiatry, Australia, 2000 • Role of psychiatry in disaster management: a brief review, H U Ahmed et al, NIMH, Dhaka. Journal of Psychiatry, Vol 20, December 2006 • Psychosocial care of Disaster affected population: Physicians manual, WHO, 2007 • NIMH Dhaka, Bangladesh, 2008 • Psychological first aid: guide for field worker, WHO, 2011 • Mental health service after disaster: Current scenario and future prospect of Bangladesh, H U Ahmed et al, WPA regional meeting, Indonesia, 2012 • National plan for disaster management 2010-2015, Disaster management and relief division, Govt republic of Bangladesh. • Annual disaster Statistical Review2012, Center for research on the Epidemiology of disasters (CRED), Belgium • www.google.com: Images
- 50. 1971 2013 2014
- 51. Disaster Vs Healthy Body & Mind “ SOCIAL WEAPON ”
- 52. Resilience
- 53. THANK YOU