Disaster And Mental Health Midterm PDF

DISASTER AND MENTAL HEALTH Midterm Objectives ◦ Understand the concept of Psychological First Aid ◦ Discuss and apply basic attitudes of that promotes helping ◦ Discuss the basic action principles in Psychological First Aid ◦ Learn ways of communicating with survivors PSYCHOLOGICAL FI...

DISASTER AND MENTAL HEALTH Midterm Objectives ◦ Understand the concept of Psychological First Aid ◦ Discuss and apply basic attitudes of that promotes helping ◦ Discuss the basic action principles in Psychological First Aid ◦ Learn ways of communicating with survivors PSYCHOLOGICAL FIRST AID FOR ALL Supporting People In the Aftermath of Crisis Event Raessel B. Gutoman Course Facilitator PFA AND FILIPINO CULTURE WHAT DOES FILIPINO DO FOR THEIR KAPWA IN TIMES OF CRISIS ? PFA AND FILIPINO CULTURE (Bautista, 2014) ◦ Pagsama (to accompany) ◦ Pagsabay (walk alongside with) ◦ Pagdamay (offer support) ◦ Pagdadala (carry the burden) ◦ Pakikiisa (be one with) Ordoñez, Psych Batch 2022  WHAT IS PSYCHOLOGICAL FIRST AID? MHPSS  PFA People in distress are provided with assistance to feel calm and supported in coping with P challenges Finding way to assist someone to manage their situation and make informed decision F Attending to person’s reactions, active listening, and providing practical assistance to address A basic needs  Specialized Services (Persons with mental disorder) Focused-Non Specialized Services (For moderately distressed people) Community & Family Support (normal reactions to crisis event) Basic Services & Security for Survival (For general population)  PFA: First-Line Psychosocial Support (Paunang Lunas) PFA is important, first-line psychosocial support for people affected by crisis events - PF , like medical “first aid”, is not enough on its own Immediately after a crisis event, those who assist are often family members, neighbors, teachers, community members and first responders of various kinds (emergency medical teams, police, firefighters) Term “PF ” was first coined in the 1940s but its use has increased in modern-day crisis events  Crisis Events Crisis events - both large-scale and individual - occur in every Personal Social community in the world Crises Challenges They have physical, social and emotional Health Natural consequences for those Challenges Disasters affected Man-made Violence disasters  What is PFA? Humane, supportive & practical assistance to fellow human beings who recently suffered a serious stressor: Non-intrusive, practical care and support Assessing needs and concerns Helping people to address BASIC needs Listening, but not pressuring people to talk Comforting people and helping them to feel calm Helping people connect to information, services and social supports Protecting people from further harm Hobfoll’s principles of psychosocial support in emergencies Ensuring Safety Promoting Calm Promoting Self and Collective Efficacy Promoting Connectedness Promoting Hope Have you done PFA? What are the needs of the survivor after a crisis event? Needs of survivors after Crisis Event Shelter, Food, Health Water, services or Sanitation help with Understandable chronic and correct information about medical the event, loved conditions ones, and available services Needs of survivors after Crisis Event Being able to Access to contact specific loved ones support related to Being consulted and involved in one’s culture important or religion decisions  To provide PFA in Crisis, what are your needs? PREPARE How to prepare? ◦ LEARN ABOUT THE CRISIS EVENT. (Who, When, Where, How?) ◦ LEARN ABOUT SERVICES AND SUPPORTS AVAILABLE ◦ Who are providing basic needs? ◦ Where and when can people access services and supports? ◦ Who are helping in the community? ◦ LEARN ABOUT SAFETY & SECURITY CONCERNS ◦ Is the crisis over or ongoing? ◦ What dangers are present in the environment? BASIC ATTITUDES THAT PROMOTES HELPING UNCONDITIONAL POSITIVE REGARD Accepting and supporting the person regardless of what the person says or does.  IMMEDIACY Using immediate situation to help survivor look into situation.  RESPECT Unconditional acceptance of survivors by being fully aware of any personal, cultural or religious differences, but it does not mean the acceptance of all their behaviors.  GENUINENESS Being authentic. No façade the quality of being real and exactly what it appears to be Able to experience the feelings and attitudes that are happening at the moment.  HOPE & OPTIMISM Able to help survivors gain insight and view the situation in a positive perspective  COMPASSION Feeling another person's pain and wanting to take steps to help relieve their suffering BASIC PRINCIPLES OF PFA WHO Guideline First Things First “Do No Harm”  Who can be provided with PFA? Can be provided to adults and children, adolescents, Very distressed people who parents/caretakers, families were recently exposed to a who have recently serious stressful event. experienced a crisis event and are distressed. Not everyone who experiences a crisis event will need or want PFA. Note: Don’t force help on those who don’t want it but make yourself available and easily accessible to those who may want support  Where to provide PFA? Privacy is essential for PFA can be provided confidentiality and to respect anywhere or place where it is the person’s dignity, for those safe and had some privacy who for you have been exposed to and affected people when certain types of crisis events appropriate. such as sexual violence. Note: Don’t force help on those who don’t want it but make yourself available and easily accessible to those who may want support  Role of Helpers when Delivering PFA Provides specific Applies psychosocial Provide PFA and compassionate support MHPSS services and respectful communication to the person by using his/her skills BASIC ACTIONS OF PFA WHO Guideline PFA AND FILIPINO CULTURE (Bautista, 2014) Prepare (Paghahanda) ------------------- Look (Tumingin at Magmasid) CONTACT AND ENGAGEMENT (Pakiki ugnay), SAFETY AND COMFORT (Kaligtasan at Ginhawa) Listen (Makinig) STABILIZATION (Pagkalma) PRACTICAL ASSISTANCE (Praktikal na tulong) Link (Pag-ugnay) CONNECTION WITH SOCIAL SUPPORTS (Pag uugnay) LINK TO SERVICES (Pag uugnay) INFORMATION ON COPING (Pagkaya) Basic Actions of PFA Look (Tumingin at Magmasid) CONTACT AND ENGAGEMENT To respond to contacts initiated by survivors, or to initiate I a non-intrusive, and helpful manner SAFETY AND COMFORT To enhance immediate and ongoing safety, and provide physical and emotional comfort  HOW DO YOU USUALLY START A CONVERSATION? How to Start the Conversation? ◦ You can start the conversation ◦ To elicit specific information: with… ◦ Can you give me a specific ◦ How are things going? example of…? ◦ Could you tell me about…? ◦ What happens when…? ◦ Could we talk about…? ◦ How do you feel when…? How to Start the Conversation? To focus attention: To clarify: ◦ ƒ What would you like to focus on ◦ What is the difference between first? the two situations? ◦ ƒ What happens when you try to…? ◦ When you said _________, can you tell me exactly what you ◦ ƒ Earlier, you were talking about meant? _________, could you tell me more about that? ◦ Could you tell me what you mean when you say…? How to Start the Conversation? To identify strengths: Open questions are used ◦ What are ways you have when starting conversation solved this problem in the past? ◦ Can you tell me more about ◦ Can you remember a time that? when this problem wasn’t a ◦ Can you give me a specific problem? What was going example about this? on in your life? What were ◦ Explain to me the you doing at that time? circumstances about that situation?  IS IT OKAY TO DOCUMENT YOUR CONVERSATION WITH THE PERSON YOU ARE PROVIDING PFA? Using Open and Closed Questions Closed: “How are you and your Closed: “What is the brother getting along?” name of the child’s teacher?” Open: Open: “Can you explain to me what the teacher ___________________________ has suggested in terms of her performance?” ___________________________ Basic Actions of PFA Listen (Makinig) STABILIZATION To calm and orient emotionally overwhelmed or disoriented survivors INFORMATION GATHERING ON CURRENT NEEDS & CONCERNS To identify immediate needs and concerns, gather additional information, and tailor PFA interventions PRACTICAL ASSISTANCE To offer practical help to survivors in addressing immediate needs and concerns  MHAT ELEMENTS MAKE A COMMUNICATION EFFECTIVE?  EMPATHY this means that trying to understand people’s emotions  POLITENESS always present yourself as a professional with good manner  EYE CONTACT not every culture values eye contact. Do not judge people who have no eye contact, but it is importance you have good eye contact when talking to person who need help.  NON- JUDGEMENTAL Never judge people from their outlook and treat them the way you want people to treat you  EMPOWERING never use negative words but always give them words of support and encouragement and believe in their strength and power to recover USE NON-VIOLENT THREATENING VOICE always use calm voice and no threatening words.  LISTENING SKILL Listen to keyword and try to picture what the speaker is saying, their tone of voice (anxious, sad, angry etc.), choice of words.  HAVE YOU EVER FELT THAT SOMEONE YOU ARE TALKING TO IS NOT REALLY LISTENING TO YOU? HOW DID YOU KNOW THAT SOMEONE IS REALLY LISTENING?  Listening (5 Levels of Listening) Covey, 1992 We are not attending to the conversation at all Ignoring We may mutter “Uh-oh” “uhh-hmm” “Yes”as if we are really Pretending listening We only hear certain parts of their talking Selective We pay attention to and focus on the words the other person is Attentive saying. Listening with the intent to understand. Understanding Emphatic someone on an intellectual and emotional level.  DO YOU ACTIVELY PARTICIPATE IN CONVERSATIONS THAT FEEL FULLY TWO-SIDED, ENGAGING, AND PRODUCTIVE? Active Listening Be aware of Listen first your own biases Look for feelings and values Eliminate barriers Understand to Do not interrupt communication Observe their Be clear, be Stop to think reactions to specific, be before what you’re aware answering saying What attitudes help in practicing emphatic listening? Practicing Non-Verbal Skills L Lean Forward O Open position LOVER V Voice modulation E Eye-contact R Relax HOW CAN WE BEST COMMUNICATE WITH YOUNG CHILDREN? HOW CAN WE BEST COMMUNICATE WITH ADOLESCENT? HOW CAN WE BEST COMMUNICATE WITH PWD? HOW CAN WE BEST COMMUNICATE WITH ELDERLY? Basic Actions of PFA Link (Pag-ugnay) CONNECTION WITH SOCIAL SUPPORTS To help establish brief or ongoing contacts with primary support persons and other resources of support INFORMATION ON COPING To provide information about stress reactions and coping to reduce distress & promote adaptive functioning. LINKAGE WITH COLLABORATIVE SERVICES To link survivors with available services needed at the time or in the future  LINK access information connect with loved ones and social support tackle practical problems access services and other help.  After crisis, what serious behaviors may warrant referral for further mental health care? ◦ Shows signs of depression ◦ they have not been able to sleep for the last week and are confused and disorientated ◦ they are so distressed that they are unable to function normally and care for themselves or their children by, for example, not eating or keeping clean despite food and washrooms available ◦ they lose control over their behavior and behave in an unpredictable or destructive manner ◦ they threaten harm to themselves or others  After crisis, what serious behaviors may warrant referral for further mental health care? ◦ They use drugs or alcohol excessively.Potential Threats to others (nakakasira ng gamit o nakakapanakit sa galit) ◦ Traumatic issues (e.g. death of a family member) ◦ For students, grades suddenly drop ◦ Drastic change in behavior (e.g. hirap bumalik sa pag-aaral, trabaho o dating Gawain) ◦ Often cries ◦ Often gets sick How to refer? Always prioritize the confidentiality and security of the person in distress Inform the person what the different options are, if relevant, and help the person make informed decisions about the way forward get their informed consent on the plan of action before proceeding Link (Pag-Ugnay) PFA PRACTICE FOR SCHOOL FOR TEACHERS: *Refer to School Psychologist/Guidance Counselor if -experiencing academic difficulties over a long period of time *If unaware of the process, check with administration, school counselor, or school psychologist *Document the specific incident Link (Pag-Ugnay) FOR COMMUNITY: Doctor Barangay Health Worker Social Worker (CSWDO) Teacher Organizations in the community that can help refer (ex. Barangay Officials/Church Link (Pag-Ugnay) FOR COMMUNITY: Doctor Barangay Health Worker Social Worker (CSWDO) Teacher Organizations in the community that can help refer (ex. Barangay Officials/Church) Other Referrals to Allied Professionals: Clinical/Counseling Clinical/Counseling Psychologist Psychologist Pays attention to Provide emotional, social, assessment and vocational, psychotherapy for educational, more serious development and concerns such as organizational clinical depression concerns and anxiety Other Referrals to Allied Professionals: Psychiatrist Psychiatrist Medical Doctor Can prescribe who diagnoses medication. and treats mental, emotional, and behavioral disorders Other Referrals to Allied Professionals: Social Workers Social Workers Focuses on both Cases of neglect, individual and their abuse, and likes. environment Can also refer assistance to DSWD burial, medical, or travel assistance for minors Other Referrals to Allied Professionals: Social Workers Social Workers Focuses on both Cases of neglect, individual and their abuse, and likes. environment Can also refer assistance to DSWD burial, medical, or travel assistance for minors  Do’s and don’ts when making referrals DO’s ◦ Stay calm. ◦ Listen and hear what the person is saying. ◦ Give time and space to the person so they can say what they need to say. ◦ Reassure the child (or other individual) that s/he has done the right thing to report this situation. ◦ Record the reported abuse in writing. ◦ Refer the case to the appropriate service provider. ◦ Follow up regularly.  Do’s and don’ts when making referrals DON’t’s ◦Do not panic. ◦Do not ask leading questions. ◦Do not give false promises. ◦Do not make a child repeat the story unnecessarily. ◦Do not try and remember everything to write it down later. Write it down as you are being told of the situation.  PFA AND FILIPINO CULTURE (Bautista, 2014) Closure (Pagsasara) HOPE: Pag-asa Malate & Sanidad (2022) GUIDE SCRIPTS FOR PFA “Hi, ako si ____________, taga ___________. Ano pong pangalan niyo? Establishing May kasama po ba Contact & kayo? Ano po yung Engagement maitutulong ko?” (Pakikiugnay) “Okay lang po ba akong lumapit? Naririnig Ensuring niyo po ba ako sa Safety & ganitong distansya Comfort natin? Okay lang po ba (Kaligtasan na dito tayo ma- usap? at Ginhawa) -Check for signs if person is overwhelmed or disoriented -Observe if persons to further calm down -Offer assistance on some strategies to help the survivor relax and feel calm Gentle inquiry “Pansin ko…” Stabilizing Acknowledge “Ah, (Pagkalma) pakiramdam niyo po…tama ba?” -Identify the nature & severity of experience, understand the concern of the person -access information Ex. Emergency “Ano pong nangyari Gather dito? Kumusta po Information kayo? Ano pong (Pagkalap ng pwede ko impormasyon) maitulong?” -tackle practical problems -where to access different resources -provide psycho-education Ex. Bagyo (Online PFA) “Anong Offer address mo at Practical sitwasyon? Itatawag Help (Praktikal ko sa rescue para na tulong) mapuntahan kayo” -help them understand the various support available for them Ex. Pandemic “Nabanggit mo kanina Connect with nawalan ka ng Social trabaho dahil sa Support(Pag- kalamidad, naka kuha uugnay) ka na ba ng Ayuda sa ___________?” -Connect them with people they know -Link them with services and other help Ex. Pandemic “Okay lang po ba Linking w/ hingin ko yung People & impormasyon nyo Services(Pag- para maipalista ko uugnay) kayo sa ayuda” -Obtain information on coping -Affirm positive coping -Positive self-help tips when appropriate “Ah maganda po iyang ginagawa Promoting niyo…” Coping (Pagkaya) “Pwede niyo rin po subukang…” -Inform the person that you are leaving -Make sure the survivor knows what to expect from you -Give only promises that you can fulfill “Bago po ako umalis, ipakilala ko lang po si Closure _________, taga (Pagsasara) ________ rin po siya, I update po niya kayo tungkol sa ________” Giving feedback ◦ Be sure the person is ready to receive feedback ◦ Describe observed behaviors and reactions ◦ Describe rather than interpret ◦ Focus on recent events ◦ Give sincere praise when due ◦ Reflective – examples: ◦ “tama ba ang binanggit mo ay….?” ◦ “Base sa nabanggit mo, parang _________ yung nararamdaman mo, tama ba?”  PFA Action Principles Prepare Learn about the crisis event. Learn about available services and supports. Learn about safety and security concerns. Look Observe for safety. Observe for people with obvious urgent basic needs. Observe for people with serious distress reactions. Listen Make contact with people who may need support. Ask about people’s needs and concerns. Listen to people and help them feel calm. Link Help people address basic needs and access services. Help people cope with problems. Give information. Connect people with loved ones and social support.  What PFA is NOT? NOT something only professionals can do NOT professional counselling NOT a clinical or psychiatric intervention (although can be part of good clinical care) NOT “psychological debriefing” NOT asking people to analyze what happened or put time and events in order NOT pressuring people to tell you their story, or asking details about how they feel or what happened Practice self-care and team-care Before: - Are you ready to help? - Are you connected with a group or organization for safety and coordination? During: - How can you stay physically and emotionally healthy? - How can you know your limits? - How can you and your colleagues support one another? After: - How can you take time to rest, recover and reflect? Practice self-care and team-care Before: - Are you ready to help? - Are you connected with a group or organization for safety and coordination? During: - How can you stay physically and emotionally healthy? - How can you know your limits? - How can you and your colleagues support one another? After: - How can you take time to rest, recover and reflect? Helping Responsibly: Ethical Guidelines Do’s Don’ts Be honest and trustworthy. Don’t exploit your relationship as a Respect a person’s right to make helper. their own decisions. Don’t ask the person for any money Be aware of and set aside your or favor for helping them. own biases and prejudices. Don’t make false promises or give Make it clear to people that even false information. if they refuse help now, they can Don’t exaggerate your skills. still access help in the future. Don’t force help on people, and Respect privacy and keep the don’t be intrusive or pushy. person’s story confidential, as Don’t pressure people to tell you appropriate. their story. Behave appropriately according to Don’t share the person’s story with the person’s culture, age and others. gender. Don’t judge the person for their actions or feelings.  TALK LESS, Good Communication: LISTEN MORE! Things to Say and Do Give information in a way the Try to find a quiet place to talk and person can understand - keep it minimize outside distractions. simple. Stay near the person but keep an Acknowledge how they are appropriate distance depending on feeling, and any losses or their age, gender and culture. important events they share with Let them know you hear what they you, such as loss of home or are saying, for example, nod your death of a loved one. “I’m so head and stay attentive sorry…” Be patient and calm. Respect privacy. Keep the Provide factual information IF you person’s story confidential, have it. Be honest about what you especially when they disclose know and what you don’t know. “I very private events. don’t know but I will try to find out Acknowledge the person’s about that for you.” strengths and how they have helped themselves.  Good Communication: Things NOT to Say and Do Don’t pressure someone to tell Don’t make up things you don’t their story. know. Don’t interrupt or rush Don’t use too technical terms. someone’s story. Don’t tell them someone else’s Don’t give your opinions of the story. person’s situation, just listen. Don’t talk about your own Don’t touch the person if you’re troubles. not sure it is appropriate to do Don’t give false promises or so. false reassurances. Don’t judge what they have or Don’t feel you have to try to haven’t done, or how they are solve all the person’s problems feeling. Don’t say…”You for them. shouldn't feel that way.” or Don’t take away the person’s “You should feel lucky you strength and sense of being survived.” able to care for themselves. People who Likely Need Special Attention (to be safe, to access services) Children and adolescents - Especially those separated from caregivers People with health conditions and disabilities - People who are non-mobile, or who have chronic illness, hearing/visual impairments (deaf or blind), or severe mental disorders - Frail elderly people, pregnant or nursing women People at risk of discrimination or violence - Women, people of certain ethnic or religious groups, people with mental disabilities  Okay lang malungkot/umiyak I’m here for you... Tell me about it… Tutulungan kita, subukan natin gawan ng paraan… Nakikinig ako... Nakakatakot/nakakalungkot nga iyon.. Self Care ◦Self-care is the ability to engage in helping others without sacrificing other important parts of one’s life. It’s taking responsibility for job functions you have control over, the ability to maintain a positive attitude towards the work despite challenges, and your right to be well, safe, and fulfilled. 3 Basic Aspects of Self-Care Awareness Balance Connection Things to remember: I am so loved I am valued My wants and needs are valid. I have family, I have friends It’s okay to ask for help I am important and I matter  OTHER RESOURCES QUESTIONS? Maaring ma access ang ilang digital copy ng psycho-educational materials dito… Maari rin I type sa Google ang… https://bit.ly/Psyc hoedMaterials Sakit according to UP Diksyonaryong Filipino (UP Department of Philippine Studies) hindi kanais-nais na pakiramdam bunga ng Ailment as both pagkasira ng metabolismo ng katawan, physical dysfunction sakuna and emotional strain tiisin, hirap, dusa, pighati SaKíT can be reduced by SĂkit (pagpapakasakit at pagmamalasakit ) - Pagsisikap at Pagsasakripisyo - Pagdamay sa damdamin ng kapwa Maraming Ordonez, 2022 Salamat References ◦ WHO PFA Guide for Field Workers ◦ PFA School Crisis ◦ Valderon, K. (2019). Integrating Mental Health in the School Culture ◦ Verzosa, L. (2020). Discernment for Community-Based MHPSS fro PUP ◦ Jomalesa, J. (2020). PFA Skill Building for PUP