This document provides guidance on remote psychological first aid (R-PFA) during the COVID-19 outbreak. It discusses what R-PFA is, who it can be provided to, and how to conduct R-PFA using remote communication methods. The key steps of R-PFA - look, listen, link - are explained in detail. It is emphasized that R-PFA should focus on actively listening, accepting feelings, addressing needs and concerns, and referring to specialized services if needed. Special considerations for vulnerable groups and potential issues like stigma, domestic violence, and economic hardship are also covered.

1. MHPSS and
Remote Psychological First Aid
during the CoVid-19 Outbreak
D A N P A O L O R . Y E M A , R P S Y
A S S T . P R O F E S S O R , U N I V E R S I T Y O F T H E P H I L I P P I N E S L O S B A Ñ O S
C H A I R , M H P S S S P E C I A L I N T E R E S T G R O U P - P A P

2. MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT
(MHPSS) is used to describe any type of local support
that aims to protect or promote psychosocial well-
being and/or prevent or treat mental disorder.
MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT
Revisiting the Framework

3. HUMAN RIGHTS AND EQUITY
Core Principles
MHPSS
PARTICIPATION
DO NO HARM
BUILDING ON AVAILABLE RESOURCES AND CAPACITIES
INTEGRATED SUPPORT SYSTEMS
MULTILAYERED SUPPORTS

5. MHPSS should be a core component in public health and psychosocial response. And it should be integrated to the
following activities:
1. Assessment of community needs and feedback to supervisors on developments in the community
2. Continuous risk assessment
3. Support for other sectors surveillance including contact monitoring and tracing, health, logistics
4. Peer support activities
5. Basic training in psychological first aid and supportive communication for volunteers, health and community workers
6. Supervise, support and monitor volunteers and other stakeholders by training in CoVid-19 sensitization messages to
provide correct information to increase calm, sense of safety, and trust in epidemic responders and their efficacy
7. Regular supervision and case management support
8. Collecting data on the number of affected people receiving services
9. Assessing the impact of psychosocial activities
10. Following up on activities
11. Develop, adapt and distribute information, education and communication materials
MHPSS ACTIVITIES
What can we do?

6. Remote Psychological
First Aid (R-PFA)
What is it?

7. WHAT IS PFA?
Psychological first aid (PFA) is a method of helping people in
distress so they feel calm and supported to cope better with
their challenges. PFA helps normalize worry and other
emotions. It also promotes healthy coping and provides
feelings of safety, calming, and hope.
PFA is based on the principles of care and empathy which
are actualized by paying attention to reactions, active
listening, and practical assistance (if needed).
The current guidelines on remote PFA during the CoVid-19
oubreak are specific for adults.

8. Keeping a physical distance to others is required
during the outbreak. But physical distance can
be bridged by keeping socially connected with
others.
Modes of communication may include phone or
internet calls, Apps and other social media.
REMOTE PSYCHOLOGICAL
FIRST AID
What are the options?

9. WHO IS PFA FOR?
Self-quarantined persons in homes, hotels or appointed facilities·
The general population who may call to seek information and
support.·
Health workers and social welfare responders providing care and
treatment to patients·
People who have recovered from COVID-19·
Families and friends of deceased·
Caregivers with children at homes due to closure of schools·
Older adults and other groups who may find themselves isolated and
appreciate a daily well-being and care call·
Other groups with previous vulnerabilities such as mental health or
substance abuse problems, that may be in need of support
PFA, though offered to the general population experiencing a crisis, can
be specifically offered to the following: ·

10. ACTION PRINCIPLES OF PFA
begin the conversation
introduce the helper
pay attention and listen
actively
accept feelings
calming someone in
distress
ask about needs and
concerns
help find solutions to
needs and problems
refers to how to:
accessing information
connecting with loved
ones and social support
tackling practical
problems
accessing services and
other help.
refers to how to assist
with:
the current situation
who seeks support
what the risks are
the needs of the affected
expected emotional
reactions.
refers to how to assess:
Look Listen Link

11. LOOK
Assessing needs and Planning
considerations

12. What are the practical and
emotional support they might need?
What is their current situation?
What are the risks that they are
experiencing?
Assessment
Questions for consideration

13. Posts in social media.
Social exclusion.
No longer responds to correspondences (calls, messages, etc.)
Low work productivity (poor work output, does not submit on
time, does not attend meetings, etc.)
1.
2.
3.
4.
Physical signs are easy to determine, how could we do it remotely?
How to tell if a colleague is in
distress?
What are the signs?

14. Monitor reactions.
Ask, don't assume.
Approach respectfully. Do not push yourself.
Emphatize.
Re-assure as best as you can. (Cue: Reactions
are normal responses to an abnormal situation.)
Understand.
Offer support. Help in accessing reliable
resources. (Self-care.)
Refer if necessary.
1.
2.
3.
4.
5.
6.
7.
8.
How to approach/help a
colleague in distress?
What can I do?

15. Regularly and supportively monitor your staff for their
wellbeing and promote and environment which promotes
conversation.
Ensure good quality communication and accurate information
updates provided to all staff.
Ensure that your staff get the rest and recuperation they need.
Provide a brief and regular forum to allow workers to express
their concerns and ask questions.
Encourage peer support amongst colleagues.
Facilitate access to, and ensure staff are aware of where they
can access mental health and psychosocial support services.
Provisions and strategies are in place for both workers and
managers, and that supervisors are able to role-model self-
care strategies to mitigate stress.
1.
2.
3.
4.
5.
6.
7.
What can supervisors
/team leaders do?

16. Planning
for the right tasks.
Communication channel
1. 2. Operating hours. 3. Information dissemination. 4. Safety and privacy of both
caller and responder.
5. Ease of communication channels. 7. Volunteer Recruitment.
6. Referral pathway.

17. Establishing Protocols
What to do?

18. Set guidelines for
answering calls.
(If needed only.)
Monitoring of
callers.

19. Literacy and
Information drive
Referral system

20. Psychoeducation Care of carers

21. LISTEN
Responding to Calls

22. PFA can be in the form of audio-visual or only
auditive contact. Here are some considerations in
responding to calls:
1. Empathy and warmth.
2. Attention and affirmation:
3. Acceptance
4. Safety
5. Asking the right questions.
6. Be aware that its normal to react
with anger, frustration or confusion when
experiencing adversity.

23. HOW DO WE ANSWER
CALLS/QUERIES?
Step by Step Guide

24. Introduce yourself.
Ask how you can
be of help.
Agree on the
duration of the call

25. Listen to the practical and
emotional needs of the caller.
Help the caller in:
Exploring emotions.
Normalizing reactions.
Learning about CoVid-19.
Accepting emotions.
Setting limits.

26. Ask what the caller will chose
to do and assist the caller to
find out things they can do or
suggest they write a list for
inspiration.
Ask about coping, self-care
and stress management.

27. LINK
Referring and Ending Call

28. Help people address basic needs
and cope with their problems.
If the caller needs some practical or emotional
assistance, the PFA provider should refer the
caller to specialized services.
There are different agencies and organization
offering aid with food and shelter needs, or
medical and professional mental health support.

29. The caller has not been able to sleep for the last week and is confused and
disorientatedb.
The caller is so distressed that they are unable to function normally and
care for themselves or their children by, for example, not eating or keeping
clean.
The caller loses control over their behavior and behaves in an
unpredictable or destructive manner.
The caller threatens harm to themselves or others.
The caller starts excessive and out-of-the-ordinary use of drugs or
alcohol.
The caller are living with a psychological disorder and/or were taking
medication prior to the situation of distress may also need continued
mental health support.
The caller presents chronic health conditions and need more supports.
The caller presents symptoms of severe mental health conditions.
The caller is experiencing violence or is being sexually abused in any way.
When to Refer?
Some Considerations

30. Give information.
Ask what they know and believe about the
virus and where and how they get updated
information.
Connect to social support.
Ask how they stay in touch with their loved ones, friends;
access their religion, etc.

31. End the conversation.
Summarize the conversation by highlighting key issues discussed and
the action points identified. Agree on a follow up if possible and enf
the call by thanking for the conversation.
Refer.
Ask if there any practical problem or
challenges. Refer to other services, if
needed.

32. ACTION PRINCIPLES OF PFA
begin the conversation
introduce the helper
pay attention and listen
actively
accept feelings
calming someone in
distress
ask about needs and
concerns
help find solutions to
needs and problems
refers to how to:
accessing information
connecting with loved
ones and social support
tackling practical
problems
accessing services and
other help.
refers to how to assist
with:
the current situation
who seeks support
what the risks are
the needs of the affected
expected emotional
reactions.
refers to how to assess:
Look Listen Link

33. They are vulnerable and marginalized because of their:
a. Dependence of the informal economy
b. Proneness to shock
c. Inadequacy of access to social services or political
influence
d. Limitation of capacity and opportunity to cope and
adaptLimitation or inaccessibility to technology
Some Issues
Inclusion of the marginalized and
vulnerable people in risk communication,
community engagement and psychosocial
support initiatives.
(Women, the elderly, adolescents, youth, and children,
persons with disabilities, indigenous populations,
refugees, migrants, and other minorities.)

34. A potential increase in child abuse.
Domestic or intimate partner violence.
Substance abuse.
Anxiety related to facing severe economic
hardship.
Some Issues
Aside from common reactions associated
with CoVid-19, there are other issues that
are related to an outbreak:

35. Don’t attach locations or ethnicity to the disease, this is not a “Wuhan Virus”, “Chinese
Virus” or “Asian Virus”.
Don’t refer to people with the disease as “COVID-19 cases” or “victims”
Don’t talk about “COVID-19 suspects” or “suspected cases”.
Don’t talk about people “transmitting COVID-19” “infecting others” or “spreading the
virus” as it implies intentional transmission and assigns blame.
Don’t repeat or share unconfirmed rumours, and avoid using hyperbolic
language designed to generate fear like “plague”, “apocalypse” etc.
Don’t emphasise or dwell on the negative, or messages of threat.
Some Issues
Social Stigma: Be careful with your language.

36. Materials/resources (psychosocial responses of
different groups and ages to CoVid-19; self-care and
coping; updates on CoVid-19)
List of groups/organizations/agencies for referral
with their contact details
Special considerations for frontline workers, people
who are being treated for CoVid-19, isolated and
quarantined individuals
Important Considerations
Important things you have to prepare:

37. What technology will I use?
What if there is a problem with my signal/internet
provider?
I don't have the technology (gadget) to be able to
participate, what can I do in order to help?
I don't know how to use advanced applications,
what will I do?
What if my communication channel fails?
Important Considerations
Some important questions that
you can answer in advance:

38. We can actively do our part by focusing on things we can control, i.e. keeping
safe, taking care of ourselves, and preventing the spread of the virus.
ALways Remember!
Our negative responses to CoVid-19 are but
normal reactions to an abnormal situation.

39. You may reach me through e-mail at dryema@up.edu.ph.
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