Post on 16-Dec-2015
What Constitutes Crisis?
Naturally occurring Earthquake Tornado Flood Wildfire Pandemic Disease
Manmade Hazardous Material Release Terrorism Other Criminal Activity
Traumatic Events
Sudden and unexpected Children more vulnerable – less experience in
coping with life Adults may be overwhelmed by events that
occur suddenly and are beyond their control – may produce psychological reactions including Post Traumatic Stress Disorder (PTSD)
Public Perspectives
61% fear terrorism more than natural disaster 77% believe information to cope with fear and
distress are needed 57% do not think the health system is
meeting the mental health needs resulting from the threat of terrorism
Information received after a crisis significantly shapes reactions over the weeks and years following
Immediate Reactions to a Crisis
Disbelief Disorientation Dislocation Fear Feeling time is slowed down Feeling numb or disconnected Feeling helpless Feeling responsible (should be doing more)
Response to 9/11 Attacks
First week 44% of adults & 35% of children – 1 or more
substantial stress symptoms Intrusive thoughts Very upset when reminded Nightmares, sleep disturbance Poor concentration Anger outbursts
Response to 9/11 Attacks
20% of Americans know someone who was missing, hurt or killed
64% had a shaken sense of safety & security 43% less willing to travel by airplane
Within 2 months in Manhattan 7.5% increase in PTSD (67,000 new cases) 9.7% increase in Depression (87,000 new cases)
Secondary trauma via TV and other media correlate to PTSD symptoms – 60% witnessed via live TV
General Psychological Effects
Emotional Effects Grief, anger, despair, sadness, hopelessness,
numbness, denial, flashbacks, generalized Anxiety Disorder, Panic Disorder, Post Traumatic Stress Disorder (PTSD)
Cognitive Effects Impaired concentration & decision-making,
impaired memory, disbelief, worry, tunnel vision
General Psychological Effects
Physical Effects Fatigue, insomnia, cardiovascular strain, hyper-
arousal, health problems/concerns headaches, decreased appetite, nonspecific distress, MUPS – Medically Unexplained Physical Symptoms (worried well)
Interpersonal Effects Increased relational conflict, social withdrawal,
impaired performance, over-protectiveness, feeling abandoned and rejected
Who’s At Risk?
Those with severe exposure, injury, threat to life, extreme loss, disrupted community, and high secondary stress
Females age 40 -60 with no experience in coping techniques
Young & middle aged adults (vs. older adults) Prior exposure to violence and trauma Ethnic minorities Persons with prior psychiatric history Adults with children School children First responders
Protecting the Public’s Psychological Health Provide basic resources – food, shelter,
communication, transportation, and medical services
Programs to promote individual and community resilience
Surveillance for psychological consequences Treatment for acute and long-term effects of
the trauma
Protecting the Public’s Psychological Health Human Services – reuniting families, child
care, housing, job assistance Risk Communication – dissemination of
information Training service providers to respond,
protected against psychological trauma Surge capacity Identifying the underserved, marginalized
persons needing psychological services
Traumatic Stress
Traumatic stress may affect: Cognitive functioning. Physical health. Interpersonal relations.
Mediating Factors
Prior experience with a similar event The intensity of the disruption in the survivors’
lives The emotional strength of the individual The length of time that has elapsed between
the event occurrence and the present
Physiologic Response
Stress Increases Heart rate increases Motor skill ability decreases Perceptual narrowing occurs – tunnel-vision Response programming is delayed until threat
identified
Actions to Perform Under Stress
Take a deep breath Look around during size up, view the BIG
picture Think before acting – develop a plan
Remember: IT’S NOT MY EMERGENCY!
Phases of a Crisis
Impact: stunned, shock
Inventory: confusion, then assessment
Rescue: inclined to act, compliant
Recovery: relief, anger
Reconstruction: grief, long term resolution
Possible Psychological Symptoms
Acting differently than normal for this person Performing activities that do not make sense for the time Irritability, anger Self-blame, blaming others Isolation, withdrawal Fear of recurrence Feeling stunned, numb, or overwhelmed Feeling helpless Mood swings Sadness, depression, grief Denial Concentration, memory problems Relationship conflicts/marital discord
Possible Physiological Symptoms
Loss of appetite Headaches, chest pain Diarrhea, stomach pain, nausea Hyperactivity Increase in alcohol or drug consumption Nightmares Inability to sleep Fatigue, low energy
Team Well-Being
Team leaders should: Provide pre-disaster stress management training. Brief personnel before response. Emphasize teamwork. Encourage breaks. Provide for proper nutrition. Rotate personnel. Phase out workers gradually. Conduct a debrief discussion. Arrange for a post-event debriefing later.
Critical Incident Stress Debriefing
Six phases: Introduction and a description Review of the factual material Sharing of initial thoughts/feelings Sharing of emotional reactions to the incident Instruction about normal stress reactions Review of the symptoms Closing and further needs assessment
Risk Communications - EPA
Accept & involve the public as a legitimate partner
Listen to the audience Be honest, frank and open Coordinate and collaborate with other
credible sources Meet the needs of the media Speak clearly and with compassion Plan carefully and evaluate performance