Psychosocial Support in Disasters

Foundations & Phases - Disaster's Mental Echoes

• Psychosocial Support (PSS): Interventions to protect/promote mental well-being & prevent/treat mental disorders in disaster-affected populations.
• Core Goals:
  • Mitigate distress, bolster coping mechanisms.
  • Foster individual & community resilience.
  • Aid return to normal functioning.
• Psychological Phases & Reactions:
  • Pre-disaster/Warning: Fear, anxiety.
  • Impact: Shock, confusion, survival focus.
  • Heroic: ↑Altruism, community cohesion.
  • Honeymoon: Optimism, support influx (lasts weeks-months).
  • Disillusionment: Frustration, anger as aid wanes, reality sets in (can last 1-2 years).

    ⭐ Disillusionment phase: Critical period. External support wanes; PTSD, depression risk ↑.

  • Reconstruction: Gradual recovery, adjustment, rebuilding (years).

Core Principles & PFA - Healing Hands, Calming Hearts

• Core Principles of Psychosocial Support:
  • Promote Safety: Physical, emotional security.
  • Promote Calming: Reduce physiological arousal, foster tranquility.
  • Promote Self & Community Efficacy: Empower survivors' ability to cope.
  • Promote Connectedness: Strengthen social bonds, reduce isolation.
  • Promote Hope: Instill belief in recovery and a positive future.
• Psychological First Aid (PFA): Evidence-informed modular approach for immediate support. Not professional counselling or debriefing.
  • 📌 LLL Action Principles (WHO):
    • Look: Assess for safety, obvious urgent basic needs (food, water, shelter), and individuals with serious distress reactions.
    • Listen: Approach respectfully, ask about needs/concerns, listen actively, help them feel calm.
    • Link: Help access basic needs, connect with loved ones/social support, share accurate information, link with services.

⭐ PFA emphasizes respecting safety, dignity, and rights; it's about providing practical care and support.

Vulnerable Groups & Needs - Shielding the Susceptible

• Children: PTSD, anxiety, regression, sleep/appetite changes.
  • Needs: Child-friendly spaces, play therapy, routine, family reunification, parental psychoeducation.
• Elderly: Isolation, neglect, exacerbation of chronic illness, cognitive decline.
  • Needs: Medical access, social support, mobility assistance, clear communication.
• Pregnant/Lactating Women: ↑Risk of adverse birth outcomes, malnutrition.
  • Needs: Prioritized nutrition, ANC/PNC, safe delivery, infant feeding support.
• Persons with Disabilities: Loss of assistive devices, access barriers, communication difficulties.
  • Needs: Replacement devices, accessible shelters/services, specialized care.
• Individuals with Pre-existing Mental Illness: Relapse, symptom worsening, medication disruption.
  • Needs: Medication continuity, crisis support, stigma reduction.

⭐ Children often manifest disaster trauma through regressive behaviors (e.g., thumb-sucking, bedwetting), nightmares, and heightened startle responses.

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Interventions & Community - Pathways to Resilience

• Community Interventions:
  • Psychoeducation: Normalize stress, promote help-seeking.
  • Support Groups: Peer support, reduce isolation.
  • Skill-Building: Coping strategies, problem-solving.
  • Strengthen social cohesion & community efficacy.
• HCP Role:
  • Screening: Distress, high-risk individuals.
  • Brief, culturally-adapted interventions.
  • Train & supervise CHWs/volunteers.
  • Coordinate with specialized MH services.
• Referral & Stepped Care:
  • Referral criteria: Severity, impairment, risk.
  • Linkages: PHC → DH → Specialized Care.
  • Accessible, equitable, culturally sensitive services.

⭐ Community participation is crucial for the success and sustainability of psychosocial interventions in disaster settings (Sphere Standards).

High‑Yield Points - ⚡ Biggest Takeaways

• Psychological First Aid (PFA): primary intervention emphasizing safety, calming, connection.
• PFA: Look, Listen, Link - assess, support, connect to services.
• Vulnerable groups (children, elderly, women) need special attention.
• CISD is controversial; PFA is preferred for immediate response.
• Strengthen community coping mechanisms and social support.
• Screening and referral for severe issues (PTSD, depression) is vital.
• Avoid medicalizing distress; normalize initial stress reactions.