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Report on the work conducted under task C of the Community Resilience in Urban Areas (CRUA) project

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CRUA Report

Report on the work conducted under task C of the Community Resilience in Urban Areas (CRUA) project 1

1. This publication has been produced with the assistance of the European Union. The contents of this publication are the sole responsibility the IFRC Reference Centre for Psychosocial Support as involved in the CRUA project and can in no way be taken to reflect the views of the European Union.

Martha Bird, Cecilie Dinesen, Louise Juul Hansen, Louise Vinther-Larsen, Ea Suzanne Akasha, Camila Perera and Nana Wiedemann, all of the IFRC Reference Centre for Psychosocial Support.

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Executive summaryThis document reports on the work conducted under task C of the Community Resilience in Urban Areas (CRUA) project.

The CRUA project task descriptions as approved by the EC are comparatively wide. As the IFRC Reference Centre for Psychosocial Support (PSC) started to build working relations with the other CRUA partners and produce first work, it became clear that it was necessary to reshuffle task descriptions and order of workflow to obtain the best possible results for CRUA. This reshuffling was aligned with British Red Cross as project lead as well as with the other project partners.

The main outputs of task C are:

The material "Key actions for psychosocial support in flooding situations" containing the Final emotional resilience model with recommendations

The Toolbox supporting the key actions for psychosocial support in flooding situations

Local action plans per CRUA partners integrated in task B emergency planning and template for planning

To support the development of these materials, task C also included three tasks:

Good practices interviews with non-CRUA Red Cross National Societies working with psychosocial support and flooding in urban contexts

A literature review of academic and grey literature on emotional resilience

An analysis of interviews and workshops with flood affected community members in all three partner countries

As shown by both the CRUA case studies, interviews, workshops and the literature review, psychosocial issues permeate the lives of those affected by crisis including flooding. This knowledge is broadly accepted in the crisis management sector and evident in the efforts to mainstream psychosocial support (and mental health) in key standard setting, such as the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings2 and the Sphere project3. At European level, this is further reflected in the NATO TENTS Guidance for responding to the psychosocial and mental health needs of people affected by disasters or major incidents4 and the Comprehensive Guidelines for Mental Health and Psychosocial Support in Crisis5.

To address this, the key actions for psychosocial support in flooding situations and the toolbox supporting the key actions for psychosocial support in flooding situations aim to support implementing organisations and authorities to achieve

2. www.who.int/mental_health/emergencies/IASC_guidelines.pdf3. www.sphereproject.org4. Available here: www.coe.int5. Available here: www.compass-crisis.org


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a practical, step-by-step yet flexible and scalable material to plan and implement psychosocial support interventions using community-based approaches that would lend themselves to multi-agency partnerships addressing urban flooding, thus contributing to long term community resilience.

In the acknowledgment that each crisis and response is unique and that crisis implies impossible time constraints, extreme demands on resources and imperfect choices and the fact that it will very rarely be relevant or possible to implement all key actions for every crisis, the concept for the CRUA key actions material encompasses the following component:

Brief reasoning behind the importance of each key action

Brief examples of what the implementation of the key action would look like on the ground for each key action

For each key action, a box signposting to the tool in the toolbox that would most likely be the most important tool to use first

An introduction to the issues specific to flooding in terms of psychosocial support

A one-page starting point to guide in situations where no preparedness is in place but the importance of addressing psychosocial support issues is acknowledged

Definitions of key psychosocial support terminology

The key actions are supported by the toolbox. The value of a toolbox is that the main document – the key actions – can be kept relatively short and less complicated to pick up and use. Further, signposting thought the toolbox avoids duplication. The concept of the toolbox was further developed towards description of each tool covers the following points (if applicable):

Introduction to tool

Introduction to target group’s needs in flooding

Languages

Training needs

Adaptation to context

Tool location

Each description was purposefully brief and limited to approximately one page, allowing reader to assess the applicability of the tools and estimating efforts needed to use the tool very quickly.

ContentsExecutive Summary 2

Introduction 6

Report on interviews and workshops with flood affected community members in all three partner countries (D-C1) 9

Good practices interviews with non-CRUA Red Cross national societies working with psychological support and flooding in urban contexts (D-C2A) 10

Austria: Central European Floods, May-June 2013 11Croatia: Flooding in the Balkans, May 2014 16New Zealand: Christchurch Earthquakes 18United States of America: Hurricane Sandy, October 2012 20United States of America: Texas flooding, 2015 21

Literature review of academic and grey literature on psychosocial support and flooding in urban contexts (D-C2B) 25

Introduction 26Research question 27Definitions 27

Methodology 29Findings from academic literature review 30

Coping mechanisms and emotional resilience 30Psychoeducation, information and emotional resilience 30Disaster management and emotional resilience 31Social and family network and emotional resilience 31Other findings 32

Conclusions 33Bibliography 34

© This document and the related toolkits are copyright of British Red Cross – please do not distribute or copy without consent.

Analysis of findings from C-D1 (D-C2C) 37

Methodology 38Analysis and findings from interviews and workshops 43

Belief that the flood caused eventual death/onset of (severe) physical illness 44Community 44Family 46Housing type 46Information 47Insurance 47Loss 47

Mental reaction (fear, anxiety, hypervigilance, worry, feelings of abandonment) 48

Not prepared for future flooding or other disaster 49Recommendation 50Role of authorities 54Stress 55Vulnerable group 56

Conclusion 56

Development of the key actions for psychosocial support in flooding situations, toolbox and local action plans (D-C3) 57

The rationale 58The process 60

Annexes 62

Generic interview guide for good practices interviews with non-CRUA Red Cross societies working with psychosocial support and flooding in urban contexts 63

Guide to Community Workshops on Emotional Resilience (Task C.1) 65

Key actions for psychosocial support in flooding 76

Toolbox for psychosocial support in flooding 76

Local action plans per CRUA partners integrated in task B emergency planning and template for planning 76

© This document and the related toolkits are copyright of British Red Cross – please do not distribute or copy without consent.

Introduction

The document reports on the activities under task C of the Community Resilience in Urban Areas (CRUA) project as defined in project’s form T. The document reports the processes and work undertaken in task C and also includes the three deliverables of that task.

The CRUA project task descriptions as approved by the EC are comparatively wide. As the IFRC Reference Centre for Psychosocial Support (PSC) started to build working relations with the other CRUA partners and produce first work, it became clear that it was necessary to reshuffle task descriptions and order of workflow to obtain the best possible results for CRUA. This reshuffling was aligned with British Red Cross as project lead as well as with the other project partners.

Rawpixel.com / Adobe Stock


Introduction // 7

The table below outlines the deliverables as described in the project task description in form T. The reshuffled tasks and the reasoning behind are mapped against the original deliverables. Overall, the output of the work has not changed, but the order of tasks has. In addition, as T form descriptions of the expected output were unclear, they were defined more clearly to allow for more constructive work. The remainder of this report follows the new structure of task C sub-tasks and deliverables.

Original deliverables in form T Flooding

Reshuffled tasks and order of tasks

No. Original title Amended title Amended task content Reasoning for reshuffle

C-D1 Report on national and local knowledge and procedures across the range of partner countries and identify gaps where we can bring in innovative practices that have been developed globally in response to the impact of climate change.

Report on national and local knowledge

A: Report on interviews and workshops with flood affected community members in all three partner countries

Task C data collection was embedded in task B activities that allowed access to community members and their experiences of psychosocial support and flooding in urban areas

C-D2 Guidance and toolkit on good practice and innovation

Report with an analysis of findings from C-D1 and international knowledge

A: Good practices interviews with non-CRUA Red Cross societies working with psychosocial support and flooding in urban contexts

B: Literature review of academic and grey literature on emotional resilience

C: Analysis of findings from C-D1

To situate CRUA experiences and knowledge in a broader context and to allow the identification of ways to overcome the challenges identified within CRUA a literature review and good practices interviews were conducted. This international knowledge and the community level knowledge gained for D-C1 were analysed to identify the most useful content and format for the overall output of task C, the Emotional Resilience Model

C-D3 Recommendation report for European, national and local models of good practice in well-being and emotional resilience of vulnerable urban communities

Final emotional resilience model with recommendations and actions plans

A: The material “Key actions for psychosocial support in flooding situations” containing the Final emotional resilience model with recommendations

B: Toolbox supporting the key actions for psychosocial support in flooding situations

C: Local action plans per CRUA partners integrated in task B emergency planning and template for planning

The identified need and international knowledge pointed towards the development of a practical, almost step-by-step material to support NGOs, CSO, the red cross and other non-statutory agencies in carrying out psychosocial support activities that are integrated in all phases of the crisis management without duplicating existing products. The solution was to write the key actions and link key actions closely to already existing tools for implementation. The overall message of the key actions material is to integrate psychosocial support in all other actions. For this reason the local action plans identified as a separate sub-deliverable under task C were integrated in task B.

Table 2: Overview of respondents and case floodings for case study


Introduction // 8

The work on the three deliverables in task C was organised to run in parallel in order to ensure hermeneutic learning and cross-fertilisation between processes and findings. This approach also meant that if needed the work towards each of the three deliverables could run on separate time schedules as it was less dependent in time on results of other processes. A notable exception was the interviews and workshops conducted for D-C1 Report on national and local knowledge. Here delays at national level under task B had

repercussions in terms of delay to work toward deliverable D-C1. To compensate and avoid overall delays to the project, work toward D-C2 and D-C3 continued as planned.

Preliminary findings, early concepts for the emotional resilience model (eventually the key actions for psychosocial support in flooding) and draft deliverables were presented to CRUA partners at partner meetings and discussed with partners in physical and virtual meeting throughout the project period.

Report on interviews and workshops with flood affected community members in all

three partner countries (D-C1)

The workshops and interviews with flood affected community members in all three partner countries were carried out to shed light on how members of urban communities that experienced severe flooding experienced this on a psychosocial level. The interviews and workshops and results of the data analysis (reported below) influenced the content and structure of the key actions directly and indirectly by identifying emergent themes to address in the key actions.

A total of 6 datasets were collected:

• Interview reports of 5 interviews from Northern Ireland covering 2 locations

• 1 Workshop report from a community workshop held in Hungary

• 1 Workshop report from a community workshop held in Denmark

EugeneF / Adobe Stock

Good practices interviews with non-CRUA Red Cross National Societies working with

psychosocial support and flooding in urban contexts (D-C2A)

IFRC on www.flickr.com


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The good practices interviews with non-CRUA Red Cross societies working with psychosocial support and flooding in urban contexts were carried out to identify and understand gaps and needs in real-life psychosocial responses to flooding.

Using semi-structured telephone interviews the PSC staff used the centre’s global network with in the Red Cross Red Crescent Movement to collect information from five different floodings globally. The selection was designed to deliver a rich feedback from a manageable number of respondents, who were both very experienced psychosocial crisis managers and responders in their national contexts and who had the technical insights to extract lessons from the concrete floodings they had responded to and from their overall professional practice that could benefit the CRUA project. Finally, the respondents were selected to give information that would not overlap too closely on parameters such as geography, institutional and national/legal set-up, scale of intervention, funding sources and sizes, and types of response activities. The overview of respondents and case floodings that were selected for case study is outlined in table 2 below.

A generic interview guide was developed and shared with all respondents in advance of the interview. However, as intended, the guide was followed loosely to allow the respondents

themselves to draw out their own most important conclusions. In addition, not all respondents had been part of the total duration of the flood response due to e.g. specialisation or contractual terms and were therefore not able to address all elements of the interview guide. The generic interview guide is available in Annex 1, Generic interview guide for good practices interviews with non-CRUA Red Cross societies working with psychosocial support and flooding in urban contexts.

The findings informed the development of the early conceptualization of the key actions material and supporting toolbox. This conceptualization was presented and further developed in a workshop together with CRUA partners at a partner meeting in Budapest in 2015. As more mature drafts developed, the author and contributors referred back to the case interviews at regular intervals to glean lessons, examples and recommendations to inform the final product.

Below, the findings from the case studies are reported. The sub-headers follow a designed to function as headers of the content of the individual case studies to allow for easy cross-comparison and contrasting.

Good practices interviews with non-CRUA Red Cross National Societies working with psychosocial support and flooding in urban contexts (D-C2A)


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Event CharacteristicsThe provinces of Salzburg, Vorarlberg, Tirol, Upper Austria and Lower Austria were reported affected by floods due to heavy rainfalls. The municipalities along Inn, Salzach, Traun, Enns, Steyr, Danube rivers were reported affected by floods and landslides. A state of emergency was announced in parts of Salzburg, Upper and Lower Austria. As of 3 June, one person was reported killed and another three were still missing. Heavy rainfall and associated flooding have triggered landslides in the north-western provinces of Austria, including Vorarlberg, Tyrol and Salzburg, forcing hundreds of people to evacuate. Several long-distance trains on 3 June were cancelled on the country’s western route due to flooding.6

When more than one province is involved in an emergency, the federal level emergency response is activated. This is often the case during floods

Emergency ResponseThe role of the Austrian Red Cross in the response:

• Austrian Red Cross is responsible for the medical response as the ambulance providers in Austria. Psychosocial support is integrated into the medical response. This means the Austrian Red Cross coordinates other actors in the medical and PSS response if it is a federal level response. If it is a local response, other actors may provide support in medical/PSS

Psychosocial ResponsePsychosocial support is integrated in the medical response in Austria.

During flooding, there is a medical check point at the evacuation centres where medical checks are performed. As a part of this, there are also psychological checks performed by psychologists.

The crisis intervention teams are built into the overall teams. They are involved in general activities such as the water distribution and needs assessments during the first days. This means that they are going to families and asking for their needs. They are used to taking that role of going and talking to families from other activities that they do. After a few days they start doing more PSS specific activities.

Normally, the psychosocial support teams in Austria wear a green jacket over their uniform. Everyone in Austria knows this because they are part of the ambulance services. But they usually take this off during the first days because they don’t want to signal that they only do PSS. After 3 days they wear the jackets again and they can respond to the PSS needs.

At the evacuation centres the Crisis Intervention teams mainly do case management for families. This is possible because there is a very large team of more than 200 trained volunteers and it may not be possible for other National Societies. The teams also do activities for the children such as schooling and play activities.

6. IFRC: 5 June 2013, Information bulletin, Central European Floods: http://www.ifrc.org/docs/Appeals/13/IB%20FL-2013-000068-CZEDEU-CHEAUT.pdf (accessed 07/09/2016)

Austria – Central European floods, May-June 2013Source: Dr Barbara Juen, Austrian Red Cross, federal level coordinator for psychosocial support. IFRC on www.flickr.com


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Building community resilience in urban areasResilience building activities (by Austrian Red Cross):

We do a lot of the normal resilience building activities.

If schools are not able to operate for one reason or another, we facilitate the schooling and kindergarten activities so that parents can focus on rebuilding their homes.

We work a lot with the teachers and train them to deal with the experience of the children and to involve them in the rebuilding of the schools. There was an example where the children helped the rebuilding of the school and pained a wall with their experiences. We also work with the parents.

Coordination and involvement in the command structureIt is very important that the psychosocial support coordinator is involved in the command structure and try to shape the ways in which they communicate with people and shape the dialogue. Because we do the needs assessments we are the advocates of the beneficiaries, we collect their problems through consultation. In that way we can facilitate communication, shape dialogue and minimize conflict and anger.

It is very important to continuously work with the authorities and ensure that psychosocial support is involved at all levels. We are usually seen as the ones that play with children, but the mayors and the command structure should accept our role and accept that we can contribute with shaping the information and dialogue with beneficiaries and also the structure of the evacuation centres.

Training of staff and volunteersThe volunteers in the crisis intervention teams have received basic training in Red Cross First Aid and additionally more than 500 hours of PSS training.

Their PSS training includes:

• Psychotraumatology (related to Community-based Psychosocial Support: stress and coping, loss and grief, but a bit more in depth because they also deal with suicide and other issues).

• Hobfoll principles and how to put them into action, to build resilience

• How to deal with viewing dead bodies (not so relevant in floodings but relevant for their other work).

• Community building

• Children

• Suicide (part of their other roles).

Recommendation for others: provide basic community-based psychosocial support training, using the IFRC Community-based Psychosocial Support Training Kit, supplement with 1-2 flooding specific case studies.


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This is not always easy, it is a continuous struggle, it is easier some places than others, it is about making clear what we can do. We are doing advocacy for the beneficiaries, we are the link between them and the operation level, and this is closely linked to having PSS people in the command structure. But is has to be someone with a strong background in both PSS and disaster management.

Urban areasWorking in urban areas is more difficult because many don’t see themselves as a single community. There are many different sub-communities; there may be migrants, young people etc. but there is also a large group of isolated people who do not belong to any sub-community.

Evacuation centres play an important role, because here we can build communities. It is a place to bring people together, and in this respect they are even more important in urban areas than in rural areas because people may not naturally meet at other places.

The evacuees usually don’t live at the evacuation centres but with families and friends, but they come there to get the things they need: food and donation. It is also serves an information centre.

Recommendations for urban areas• Send out mobile teams after a few days. In

Austria there is TeamAustria, which consists of pre-organised volunteers who support the response.

• Use the two approaches all the time: bringing people together and sending out mobile teams.

• The evacuation centre is very important, and if it works well it can sometimes be changed into a community centre after the disaster response is over.

• If the community is very segregated or some groups are not well integrated, you

may need to think about having separate evacuation centres, at least in the beginning, maybe they can be merged later on.

• Have a place and a plan for organizing spontaneous volunteers who want to help.

• People in cities are more passive, they expect more from the authorities. You need to involve them in the evacuation centre and actively take them in.

Also it is a factor that they don’t know the responders or the politicians directly. This means that conflicts are more likely to arise. People get more aggressive to people they don’t know. We have to use the disaster to build up this feeling that they have in rural areas.

Crisis communicationIn urban areas the media is even more important than in the rural areas. It is very important that we use them and make them play the game with us: they can help us show that people help each other. In a rural area it is more visible what we do to support each other, people can see it with their own eyes – in urban areas we need the media to show it instead of showing conflicts and disagreements.

This can be done through media, social media and IEC (information, education and communication) materials. You have to be creative to build community awareness in urban areas. You may want to use a neighbourhood that they identify with, rather than the whole city if it is a big city. In smaller cities it may be enough to just use the city as the reference point.

Use the guidelines on crisis communication in the OPSIC Action sheets. Very good, also training component.

Crisis communication is important: banks, insurances and authorities should speak with one voice. They should be accountable and not give promises they can’t keep.


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Banks and insurance

The big problem is that all insurances and banks have their own regulation, and this causes confusion in the communities. We have done advocacy to bring them together and standardize their regulations so that they speak with one voice.

We have not done PFA training for the insurance people but this is something that should be recommended.

Both should be done: advocacy and PFA training.

Needs assessmentContinuous needs assessment is important as needs change on a daily basis especially in the first phase of an emergency. Psychosocial support staff and volunteers need to be part of the teams performing both assessments and planning to ensure that people get what they need, or are adequately informed if and why they cannot get it. This is also in line with the Inter-Agency Standing Committee guidelines on mental health and psychosocial support in emergency settings, IASC, 2007.

Long-termThis depends on the community resilience building activities: does it work? Does the evacuation centre work? If we manage to build a community centre we can use it for building resilience in the future. It is important to remember that these events are repeated over and over again, there are cycles. So next time we should be better prepared.

Recommendations for guidelines:• Flooding in Europe is so important.

We need the guidelines. The literature focuses on rebuilding physical structures.

• European Network for Psychosocial Support (ENPS): there is a lot of experience there already, maybe we could collect a booklet with best practice.

• Expand the OPSIC Comprehensive Guideline with crisis communication, continuous needs assessments.

Casey E Martin / Adobe Stock


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Event characteristics

Continuous, heavy rainfall in mid-May 2014 resulted in extensive flooding in Serbia, Bosnia and Herzegovina and Croatia.

In Croatia, the floods caused widespread power outages, water shortages, damage to the infrastructure, livestock and livelihoods, and displacement. Three people were killed, and, out of the estimated 15,000 people evacuated, more than 7,000 were registered and looked after by the Croatian Red Cross. (IFRC, 30 May 2014).7

Croatia was the least affected compared to Bosnia and Serbia, but the village that was worst affected was very severely affected. It was a rural area village of 5,000 people, poor, low level of development and a lot of the people were refugees from the war. This means that there were a lot of vulnerable groups: separated families, high unemployment.

Psychosocial responseThe first psychosocial support teams came from other areas of Croatia because there were no trained PSS volunteers in the areas. In October, two local teams were established. The teams were still supported from outside until January were they worked on their own.

The displaced persons were living in reception

centres for 1-2 days, then they leaf the reception centres and stayed with relatives.

The first level of the psychosocial response was home visits to identify vulnerable groups and provide PFA and PSS if needed.

The second level was after the people had returned to their houses – community activities. Children as a group were quite well covered by other organisations so the Red Cross focused on older people and other vulnerable groups.

ActivitiesEvent on Women’s International Day (8 March) for women who still lived in containers: Workshop, socializing, make-up course etc.

Activities for older people:

• Home care visits

• Traditional crafts

• Poems

• Arts

• Costumes cultural events

• Practical support to administrative work.

Regional workshop

• Brought together 46 people – experience from other countries

Regional statement

7. From www.reliefweb.org ”Balkan Floods 2014” http://reliefweb.int/disaster/ff-2014-000059-srb (accessed 07.09.2016

Croatia – Flooding in the Balkans, May 2014Source: Sanja Pupacic, psychologist, Croatian Red Cross



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Staff and volunteersThere was also focus on needs of staff and volunteers who suffered from work related stress and burn-out from distribution of aid. The population has high expectation of receiving aid and staff and volunteers were very stretched and felt a high amount of pressure.

At the same time, a negative media campaign against the Red Cross was launched involving fundraising issues and allegations of fraud. This put staff and volunteers in a vulnerable position and had serious effects on staff health.

CoordinationCoordination was a big problem. The division of roles were unclear and local mayors turned against the Red Cross making it difficult to implement response in the local areas – but we still managed to do a lot.

Local teams worked with youth and older people and arranged public events, sports events and cultural events.

It was a very traditional community which was ethnically mixed of Muslims and Christians.

• issued as advocacy towards governments on how to improve in the future.

• 20 recommendations

InsuranceInsurance was not a big issue in Croatia because people in the region do generally not insure their houses. The government paid for reconstruction. There was a scheme for this where the government invested a lot of money. People could decide if they wanted to get the money and do the reconstruction themselves or let the government do it.

The psychosocial support programme finished end of June because of lack of funds but there is still a great need. The national society is still building their capacity and will conduct trainings later.

Training of staff and volunteersVolunteers were trained in Community-based psychosocial support in the beginning of June. A training was also held for local authorities. In September there was a two-day training and in November there was a 3 days training.



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Event CharacteristicsFrom 4 September 2010 to June 2011 the town of Christchurch and surrounding Canterbury region of New Zealand experienced three major earthquakes and thousands of aftershocks. The second big quake in February killed 181 people. The disaster was the second most deadly and by far the costliest disaster in New Zealand history. The earthquakes caused liquefaction of the soil, which in turn lead to flooding.

Psychosocial responseThis was the first time New Zealand Red Cross provided psychosocial support in an emergency. The term was new in the organisation and it was a process of learning for the organization. There was a need to educate the organization and to connect to other Red Cross Red Crescent partners around the world. There was a lot of innovation involved in the process.

In the response phase there were no specific psychosocial support activities, but volunteers providing other services in the response phase supported the affected population by providing active listening and supporting communication.

During the recovery phase, there was a much stronger focus on providing psychosocial support. Activities were scaled up and there was a need for more intensive support. NZRC did not have the capacity to do that, so it was

decided to focus more on the general support for the general population.

• Website for younger persons.

• Support to bereaved families

• “Alright?” Campaign with other organisations

Alright? CampaignNot focus on clinical needs but realizing that the problems are not going to go away. Public messaging using the language of the people instead of expert language, no logos from participating organizations, only the campaign logo.

The campaign had three phases:

1) Normalizing phase

2) 5 ways to well-being, but messaging still locally based: what do people do and need to be alright? Different colours etc. -contrast to the grey and dusty city.

3) Community-phase – let them run with it. Different initiatives:

a. Public stunts: local orchestra, well-being game, cooperates picking people up in limousines, competition on work places, dance-offs etc.

b. Poster generator on website

Call for action integrated in the campaign: do something little.

New Zealand – Christchurch EarthquakeSource: Jolie Wills, psychosocial support advisor, New Zealand Red Cross

New Zealand Red Cross on www.flickr.com


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Leadership manualTwo Winston Churchill reports on leadership and one on support to supporters – the leadership publication is a result of this, but in a more key message and everyday language.

It has been used in recovery trainings in Australia and Kathmandu – people don’t see themselves as leaders but there is a lot of leadership involved.

It is also used in preparedness trainings.

Training The training of the insurance people came about a little later on. First we trained the volunteers in psychosocial support based on IFRC Reference Centre for Psychosocial Support manuals and some input from the Australian Red Cross who had a lot of experience with bushfires and floods. We needed to contextualize the training a lot, and we had to focus on the secondary stressors.

The training was peer reviewed and the people said that you had to train others who are working on social recovery. So first we trained our own people, then people from the social sector and then insurance people. If we were to do this differently, we would have trained them earlier on.

Focus on that it is a challenge job for people in the insurance companies and banks, they meet angry and frustrated people and they are at same time also part of the community.

For people working with road construction, consulting people has been very integrated in their work. It is not just a road project, it is a people project. They consult people.

For insurance companies we worked on advocacy to have an insurance advisory service and a dispute service where disputes could be handled. NZRC also gave cash grants to independent advice to people, from experts.

New Zealand Red Cross on www.flickr.com


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Event characteristicsHurricane Sandy was the deadliest and most destructive hurricane of the 2012 Atlantic hurricane season, and the second-costliest hurricane in United States history. At least 233 people were killed along the path of the storm in eight countries.

In the United States, Hurricane Sandy affected 24 states, including the entire eastern seaboard from Florida to Maine and west across the Appalachian Mountains to Michigan and Wisconsin, with particularly severe damage in New Jersey and New York. Its storm surge hit New York City on October 29, flooding streets, tunnels and subway lines and cutting power in and around the city.8

Recovery workDirect services were provided to hurricane affected people in terms of financial assistance in the form of grants of up 10,000 USD per household. This could be used for reconstruction, relocation or even relocation to another state if necessary. 5,200 households in four states were supported with grants.

In terms of community recovery, the focus was on establishing broad partnerships.

Voluntary organizations active in disasters (VOADS) focus on facilitating communication between spontaneous volunteers and

established organisations such as the Red Cross.

The focus is on building a cohesive community understanding perspective because we know from a resilience perspective how important this is. Generally experience shows that communities with a strong pre-disaster network recover better from disasters.

Long-term recovery groupsThe recovery work therefore focuses on working with other partners to form “long term recovery groups” using loose strategic planning with goal setting and strategic planning. Some of these groups are very strong and continue working for several years.

In the first phase, these groups focus on addressing the immediate needs in the community. In the next phase, the focus is on fun and recreational activities but with an integrated core message of preparedness. There are examples of communities that have become more fun and colourful through the work of the long-term recovery group.

After the Hurricane Katrina (2005) there has been a lot more clarity about the different roles in disaster response and recovery. There was a National Disaster Reduction Framework. The role of the Red Cross is also clearer after the framework.

8. From Wikipedia: https://en.wikipedia.org/wiki/Hurricane_Sandy, (accessed 07.09.2016)

United States of America: Hurricane Sandy, October 2012Source: Anjana Dayal de Prewitt, senior advisor, community resilience, American Red Cross. Ms. Prewitt functioned as recovery manager for American Red Cross, training and recruiting staff and ensuring programmatic consistency in the different states along the Atlantic Coast. She started the work five months into the response to manage recovery – thus this cases focuses mainly on recovery.

Leonard Zhukovsky / Adobe Stock


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American Red Cross staff attended meetings, but it was very difficult to attend all meetings due to the densely populated metropolitan areas –getting around could be very challenging. Especially the early days were characterized by frustration, confusion and dislocation making it difficult to support forming the groups.

Social media were used more and more but it would be something we would do differently next time: more proactive focus on social media in the formation of the groups.

Diverse communitiesThere was some outlier examples were the communities were so diverse that it was impossible to form one long term recovery group even though efforts were put into trying to encourage the formation of one group. There were different historical and cultural reasons for this. The result was two separate groups and a duplication of the efforts from the organisations’ side.

Another example was the Staten Island where community groups and authorities worked well together – they worked until the two-year mark and then fell apart.

For example, some funding were provided to Staten Island to improve their preparedness – they realized that they had not had their own supplies and that because they were an island, support had come too late to them.

The length of how long the LTRGs are supported depends on the severity of the disaster and the level of funding. In the case of Hurricane Sandy the groups were active up to three years, while in the case of the Texas floods (2015) they were probably only active for one year.

In the ideal world, each state should have a VOAD structure at the city and county level and each community should have community organizations active in disasters (COAD), and the VOADs should train and support

the COADS and the COADs should actively engage with the VOADs and create awareness and mobilize effectively.

Psychosocial responseIn terms of the psychosocial response, there was more psychosocial support in the response phase than in recovery, and in general less mental health than after the Hurricane Katrina in the Red Cross response.

Part of the reason for this a clearer role in funding, and the high funding level in general, a lot of mental health services were funded through federal funding. There was a crisis counselling programme connected to the initial assessment (not Red Cross).

Another reason may also be that Hurricane Sandy affected a wealthier area than Hurricane Katrina – however there are still pockets of poverty and massive needs – the strategy was to have roving outreach people to identify people with needs (undocumented migrants, older seniors, people who are dislocated etc. etc.).

Another reflection is that the level of funding was coloured by the high level of public concern. Also there has been a great deal of work at governmental level after Katrina to make the response more organized and focus more on mental health needs in general.

During the response phase, disaster mental health works identified individuals with needs and addressed their needs but this was kept in a different system than the financial support system because the information was confidential.

The case management staff in recovery (financial assistance) also attended to mental health needs if they arose and referred people for help and active social support - for example an 72-year old lady who presented for financial assistance but it become clear that she had some complex physical and mental challenges was referred for help.


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Emergency responseThe American Red Cross tested a new model for service delivery during the response to the Texas floods called “Mini Community Recovery Centre (MCRC)”. The MCRC brought together a multi-sector team consisting of case workers, health services, public affairs, disaster mental health, and IT/computer services.

The idea was to identify neighbourhoods with needs, identify a location for the MCRC and then quickly set up the services and advertise in the local neighbourhood. The MCRC would be running for 1-3 intense days and the MCRC would be rapidly scalable depending on the needs in the community. The logic was that the short time-frame would enable the Red Cross to meet the most urgent needs without creating dependency and without the focus on people just lining up for “stuff”, which is often the result in other disasters.

This model was designed for this disaster but based on experiences from Hurricane Sandy where they used the emergency vehicles as the “centre” and where available and visible on the streets. The physical “centre” was a new thing that was tested in the Texas floods.

United States of America: Texas Flooding, 2015Source: William Marting, clinical psychologist. The interviewee is a clinical psychologist and had two roles during the response to the Texas floods. He started off at the Disaster HQ level and later on he became the Disaster Mental Health team leader responsible for supervision, outreach response and DMH workers and shelters etc. The interviewee had previously worked with Hurricane Katrina and Hurricane Sandy.

Event characteristicsIn late May 2015 heavy rainfall was the cause of very severe flooding in Texas and Oklahoma, claiming at least 31 lives and causing widespread destruction of property and infrastructure.

apirati333 / Adobe Stock

Bernd Leitner / Adobe Stock


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Emergency response continuedEven large cities are made up of neighbourhoods. This model allows you to go out and be visible in the local area and to canvas the needs and mobilise support that meet the needs. The idea is that 1-3 days are enough and then you move onto a new neighbourhood.

The main challenge is the targeting of the right communities and neighbourhood to provide the service. Too often the focus becomes on identifying the right location – i.e. physical location for the CMRC - before targeting of communities. Targeting is a complex task that involved close collaboration with the damage assessment team and the government liaison team. They need to work closely with the government to identify the neighbourhood and negotiate with the community leaders (unofficial and official). This requires practice and skills. The challenge is that if this work is not done properly, you end up going to the communities that may not have the greatest need. If you just ask around, everybody will have a need.

A bad example of this was a Minister that wanted his people served. He said that they were being neglected, manipulated the municipality. Red Cross ended up putting up a MCRC there but in the end, they served only 9 people. An outreach team to the area would have been enough.

The announcements were done very local and very low-tech. No TV, no radio. The centre would typically be open from 10 am to 5-6 pm. Arrive at 9 am, set-up the teams, ensure snacks and water. One time there was no good visibility from the highway so we set up a sign saying “Red Cross Disaster Assistance”.

Some teams would go to the neighbourhood with 1-page hand-outs. Preferred outreach team of mental health, health, and case worker: 3 people. They go and communicate with the community and announce that the centre is there.

The experience is that the physical location means that it is more efficient compared to going from door to door. The teams manage to see more people in shorter time. During Sandy we probably saw the same people but it took more time because we had to go from door to door and climb all the stairs.

The limitation is that those with physical limitations can’t go but we try to ask people if they know of someone in need of help.

The idea is that the centres are scalable – but if you stick around for much longer than one to three days it may encourage dependency. Our feeling was that it worked pretty well with that time frame. In parallel to this structure there was a general Red Cross number that everyone could call for assistance so it is not like we abandon the community after the MCRC closes.

The system was only set up 3 weeks into the disaster. It was challenging because it was a state-wide disaster and we were struggling with the traditional disaster response with outreach teams because there was a lot of displacement and it was difficult to find the clients.

We ran the centres for around 2 weeks and then transited into traditional recovery with community groups linking up to government agencies and the course: Coping in todays’ world.

The best thing is if we could identify a “host group” within the community that identified the community and were already credible. Ideally the MCRC should be established at a facility provided by the host group and they could engage their constituency in the work. So if we become better in identifying this host group, the MCRC could be used in longer term. Everything is better if it is local.

We have also done MARCs (Multiple Agency Resource Centres) for very large groups. They can be pretty efficient but people have to go to them.


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Psychosocial responseIn order to integrate mental health in services, there needs to be commitment from the disaster response leadership. A committed project lead in charge of the operation and the resources allocated from the different teams: Mental health, health services, logistics, case work teams, IT-set up.

Another new thing about the MCRC is that the focus is really on the human contact. Not about giving away stuff (everything from clean-up kits, to diapers etc.). Previously there has been too much focus on stuff, not on engaging people at the human level.

The people were briefed in the morning about the focus on the human contact. They were told to slow down, meet people and let them tell their story. This means that Red Cross

volunteers were able to meet the needs better and target the services much more. Instead of just giving them a lot of stuff they could take the people to the “stuff area” and give them exactly what they needed.

In the reception area, clients were met by disaster mental health workers. Clients were offered snacks and something to drink and could explain their story and wait for services (if health, case work etc.) In that sense the DMH workers were really important players.

The triage model that we use for Mental Health is a quick assessment of people’s need. We don’t provide ourselves but facilitate referral to local services if we see that there is a need, also based on their previous history of support. In that sense our interventions are one-shot interventions and then we refer to systems in the community.


Literature review of academic and grey literature on psychosocial support and

flooding in urban contexts (D-C2B)



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IntroductionFlooding is the most recurring natural disaster in worldwide and in Europe [2][4]. According to the WHO, river and coastal flooding have affected9 3.4 million persons in the WHO European Region in the last 10 years and has led to large socioeconomic costs [1]. Flooding events are predicted to increase in both frequency and intensity as a result of climate change [2]. Urbanization also presents a risk, as infrastructures such as the buildings, roads and cemented spaces present in urban areas prevent rainfall and river or coastal floods from infiltrating the soil and thus increasing the risk of flooding [5].

Seventy-five percent of Europe’s citizens live in urban areas and this number is expected to rise [3][4]. Accordingly, the increase in the frequency and intensity of flooding as well as in the number of people living in urban areas can results in a higher number of individuals vulnerable to the consequences of flooding.

In addition to the socioeconomic consequences of flooding such material damage and loss of social network, flooding affects the physical health and the psychosocial wellbeing of individuals [1]. Although there is limited evidence, various studies have explored the implications of floods in human’s physical health [6][9]. Injuries, which occur when individuals try to move their family, their goods or themselves from danger, are one of the most common physical health hazards of flooding, along with infections which result from accumulation of water, leakages, unsanitary conditions or altered patterns of contact [6].

Evidence on floods and their impact on mental health is also limited [6]. This has been attributed to the methodological challenges of conducting qualitative research in these contexts [13]. Evidence gathered by Ahern and colleagues in a systematic review showed that the most common mental health consequences of flooding are anxiety and depression [6]. Although the authors acknowledge that diagnosis of Post-traumatic stress disorder (PTSD) after flooding may be subjected to cultural and social differences, they document that 5 studies from Europe and North America have reported an increase in PTSD after flooding [6]. Moreover, the physical consequences listed previously often affect the individual’s mental health and psychosocial wellbeing.

According to the World Health Organization, the mental health consequences of floods ‘‘have not been fully addressed by those in the field of disaster preparedness or service delivery’’ [31]. As this type of disaster becomes more recurrent and intensifies in Europe it becomes important to revise those interventions of strategies that have been shown to contribute to individual emotional resilience in the event of these emergencies. This literature reviews uses the salutogenic approach to identify interventions and strategies that utilize people’s actions, attitudes and thoughts as the means to flood preparedness, response and recovery.

9. A person affected is defined as people who require immediate assistance during a period of emergency, including displaced or evacuated people.


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Research questionWhat do we know about psychosocial support interventions or strategies that promote emotional resilience and psychosocial wellbeing in urban communities affected by flooding?

Definitions

Flood:10

means the temporary covering by water of land not normally covered by water. This includes floods from rivers, mountain torrents, ephemeral water courses, floods from the sea in coastal areas, and floods from sewerage systems.

Emotional resilience:

is defined as the ability to react or adapt positively to a difficult and challenging event or experience. It is the ability to bounce back after something difficult has happened, or to get through difficult experiences in a positive way [14].

Psychosocial well-being:

describes the positive state of being when an individual thrives. It is influenced by the interplay of both psychological and social factors [14][15]. The three domains of skills and knowledge, emotional well-being, and social well-being provide a good framework for understanding how psychosocial programmes and activities can impact well-being, for example:

Skills and knowledge Emotional well-being Social well-being

• learning how to resolve conflicts

• hope for the future • ability to interact

• improved peer communication

• sense of control • solve problems with others

• making good choices

• self-worth • sense of belonging to a community

10. Based on art 1 and 2 of the DIR 200//60/EC on the assessment and management of flood risk


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Mental health and psychosocial support:

is any type of local or outside support that aims to protect or promote psychosocial well-being and/ or prevent or treat mental disorder [19].

Disaster preparedness:

refers to measures taken to prepare for and reduce the effects of disasters. That is, to predict and, where possible, prevent disasters, mitigate their impact on vulnerable populations, and respond to and effectively cope with their consequences.

The primary aims of disaster response are rescue from immediate danger and stabilization of the physical and emotional condition of survivors. These go hand in hand with the recovery of the dead and the restoration of essential services such as water and power. How long this takes varies according to the scale, type and context of the disaster but typically takes between one and six months and is composed of a search and rescue phase in the immediate aftermath of a disaster followed by a medium-term phase devoted to stabilizing the survivors’ physical and emotional condition[17].

Disaster recovery:

refers to those programmes which go beyond the provision of immediate relief to assist those who have suffered the full impact of a disaster to rebuild their homes, lives and services and to strengthen their capacity to cope with future disasters [18].

luxorphoto / Adobe Stock


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MethodologyThe present literature review was conducted in order to gain an overview of the academic literature pertaining to psychosocial support interventions that promote emotional resilience and psychosocial wellbeing in urban communities affected by flooding. For this purpose, a search of relevant databases was conducted.

The following databases were searched:

• Pubmed

• Psychinfo

• Jstor

The following key words were used in systematic combination:

The search returned 111 results relevant for the literature review.

Literature identified through the database search was subjected to a two-step selection process:

• First literature was included or excluded based on title and abstract

• Second the full text was reviewed

Grey literature deemed relevant by PSC staff and CRUA project members but not captured by the database search was added to the results and the full texts reviewed.

Finally, 75 counts of literature were identified during the review of the initially identified literature and added to the number of full texts reviewed, bringing the total to 47 publications included in the review.

• Community

• Urban community

• Neighbourhood

• Flood

• Disaster

• Psychosocial support

• Psychosocial intervention

• Psychological intervention

• Psychotherapy

• Social support

• Resilience

• Mental health

• Flooding-affected

• Tsunami

• Hurricanes

• Earthquake

• Voluntary delivery

• Professional delivery


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Coping mechanisms and emotional resilience

A longitudinal study by Bei and colleagues published in 2013 titled A prospective study of the impact of floods on the mental and physical health of older adults found that the use of maladaptive coping, such as venting and distraction, was associated with greater deterioration in mental health in older adults affected by flooding, while emotion-focused coping such as acceptance, positive reframing, and humour, was protective against such deterioration [7]. Additionally, the study indicates that participants that reported having poor mental health prior to the flooding event and used emotion-focus coping strategies did not experience greater deterioration in their well-being [7].

Conversely, a systematic review by Norris and colleagues published in 2002 and titled 60,000 Disaster Victims Speak: Part I. An Empirical Review of the Empirical Literature, 1981—2001 suggests that the individuals’ perceptions of their own capacity to cope and control outcomes might be more important than the coping strategy they use [34]. For example, a study with children affected by flooding found that those who use coping

strategies that were viewed by their peers as efficacious were less depressed five months after the event than the ones that used strategies viewed as less efficacious [34]. As explained by the authors, perceived control, self-esteem and optimism were found to be linked to lower distress [34].

Psychoeducation, information and emotional resilience

A qualitative study conducted by van Kessel and others and published in 2014 titled Strategies to enhance resilience post-natural disaster: a qualitative study of experiences with Australian floods and fires mapped the strategies and interventions that contributed to the strengthening of emotional resilience of a population repeatedly affected by flooding [20]. The study showed that discourses of rebuilding damaged houses after a flooding event was important the individual’s emotional resilience [20][47]. Although attendance to psychoeducation sessions on the aftermath of a flooding was low, those attending the sessions expressed using this knowledge when making decisions [20]. The study showed that internet-based sessions were not considered useful by participants [20].

Findings from academic literature review.Emotional resilience is defined as the ability to react or adapt positively to a difficult and challenging event or experience [14]. This ability is not rare and promoting it has important implications for mental health. The effectiveness of interventions or strategies that promote emotional resilience has been identified in different groups and contexts: soldiers and veterans, children and youth, across various disaster events, political violence, among others [26][27][28][29][30]. This review has identified, following the process outlined in the Methodology section, those interventions or strategies that promote emotional resilience in urban communities affected by flooding.communities affected by flooding?


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Access to information was found by van Kessel and colleagues to contribute to emotional resilience [20]. A similar finding was also reported in a cross-country comparison of vulnerability and resilience to flood risks in three European countries (Germany, Italy and the United Kingdom) conducted as part of the FLOODsite project titled Vulnerability, resilience and social constructions of flood risks in exposed communities which identified that groups with lack of information during the different phases of the disaster reported more symptoms of stress in the aftermath of a major flood [22]. The OPSIC project’s Comprehensive Guide on Mental Health and Psychosocial Support in Disaster Settings advises on the importance of setting information points and organizing meetings where individuals can ask questions and input into the decisions [37]. According to the guide the meetings also represent an opportunity to provide MHPSS services [37].

A study conducted by Teun Terpstra published in 2011 and titled Emotions, Trust, and Perceived Risk: Affective and Cognitive Routes to Flood Preparedness Behavior indicates that risk communication about flooding in the Netherlands influences citizen’s perceptions of the flooding events [21]. As Dutch citizens do not have a clear perception of floods, the last flood took place in 1953, Terpstra recommends authorities to include both perceptions of emotions in flood risk communications [21]. Common negative emotions to flooding are fear and powerlessness and positive emotions are solidarity and compassion [21]. Perception is also presented as influential by other authors as shown in van Kessel and colleagues’ systematic review Resilience–Rhetoric to Reality: A Systematic Review of Intervention Studies After Disasters [40].

Disaster management and emotional resilience

In 2006, Tunstall and colleagues published a study titled The health effects of flooding: social research results from England and Wales which found that the how a disaster is handled significantly impacts the mental health of those affected by the disaster [24]. According to the authors, strategies that minimize displacement and individuals’ return to their home have a positive impact over the individual’s mental health [24]. Conversely, if displacement or time spent in shelters is prolonged, it is recommended to increase psychosocial support services.

Lessons learned from a 2002 flood in Lower Austria showed that psychologists and social workers need to work jointly in supporting those affected by the flooding [23]. The experience indicates that said collaboration is important to the affected population, so they perceive cooperation which in turn establishes a sense of normalcy in their relations with the responders [23].

Social and family network and emotional resilience

Various studies have identified those individuals with strong family networks fare better in the different phases of the disaster [32]. It has been identified that communities that have an informal but organized social network are able to provide more emotional assistance to its members [32]. In a compilation of available evidence Sue Tapsell highlights in her chapter Socio-Psychological Dimensions of Flood Risk Management that increasing individuals’ understanding of the importance of protecting their emotional security


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contributes to resilience [46]. Similarly, Tapsell recommends making individuals aware of their strong attachment to their home and normalizing the threats of flooding [46].

A survey measuring social cohesion in urban communities in England affected by flooding showed that higher social cohesion in communities contributes to the psychological health of individuals and is strongly associated with a reduction in psychological distress [35]. According to Green and others’ article titled Resilience and Vulnerability to the Psychological Harm of Flooding: The Role of Social Cohesion to be effective, social cohesion interventions must encourage positive social values as well as the creation of informal ties [35].

Van Kessel and other’s study showed that public meetings in the recovery centres were important for making new friends and increasing community involvement and social

sharing [20][47]. Similarly, social events created specifically to boost emotional support were effective in encouraging individuals to connect, grieve and celebrate [20]. The article published by Rob Gordon, titled The social system as site of disaster impact and resource for recovery presents similar conclusions [47]

The article Social capital and post-disaster mental health adds that social involvement might lead to “contagion of stress” and increased feelings of anxiety in communities with low perceptions of trust [38]. Therefore, a previously established high perception of trust and mutual help among individuals affected by flooding rather than sudden social interaction in the aftermath of the disaster has a more positive impact in emotional resilience [38].The authors found that individuals benefit from a combination of individual stress reducing interventions and psychosocial interventions that foster cognitive social capital [38].

Other FindingsAccording to Prewitt Diaz & Dayal’s article Sense of Place: A Model for Community Based Psychosocial Support Programs, re-establishing ‘sense of place’ is an important process which improved the individual’s psychosocial wellbeing [36]. As explained by the authors, the American Red Cross engages in different community approached that contribute to re-establishing sense of place [36]. The approaches are designed by the community through discussions, interviews and mappings and, as explained by the authors, although the programme has not been rigorously tested yet, it is a promising first step towards addressing this need [36].

Finally, two articles reviewed by van Kessel and colleagues in the review demonstrated that dance, drumming and other recreational groups created a positive emotional climate among the affected and promoted social interaction [40].


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ConclusionsResearch on populations affected by flooding is usually carried out under difficult conditions and accordingly evidence on emotional resilience strategies and interventions is limited. The large majority of research identified during the first revision focuses on identifying vulnerable populations -previous history of mental illness, low socioeconomic status, children and adolescents and the uninsured- and identifying strategies to mitigate vulnerabilities [7][8][10][11][12]. Although vulnerabilities are crucial in disaster management so are those conditions and attributes that help individuals to more effectively deal with disasters and, as commonly agreed in resilience research, risk factors are not the opposite of protective factors [25]. Future research should identify and test interventions and strategies that enable emotional resilience in urban communities affected by flooding.

However, it is important to highlight that “What works in one situation many not work in another, what works for one individual many not for another, and what works at one point in time may not at another”

[33]. Therefore, although some of the interventions or strategies presented in this review might contribute to emotional resilience it is important to first assess the target community’s resources are by using tools such as the Communities Advancing Resilience Toolkit (CART) [39]. CART can be used by community members to identify their capacities, ability to cope and create change in the event of a flooding [39]. Similarly, IFRC’s Rapid Assessment Guide for Psychosocial Support and Violence Prevention in Emergencies and Recovery provides standards and directions for carrying out rapid needs assessment which identify the needs and capacities and enables practitioners to integrate the to their initiatives [45].

This literature review identified strategies and interventions that contribute to the emotional resilience of individuals affected by flooding living in urban areas. Although further research is needed on this topic the findings of the review contribute to the Emotional Resilience Model developed by the IFRC Reference Centre for Psychosocial Support as part of the EU funded project Community Resilience in Urban Areas, or CRUA.

scherbinator / Adobe Stock


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[18] International Federation of Red Cross and Red Crescent Societies (August 30, 2016). Responding to disasters. Available at: http://www.ifrc.org/en/what-we-do/disaster-management/responding/

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[24] Tunstall S, Tapsell S, Green C, et al. (2006). The health effects of flooding: social research results from England and Wales. J Water and Health, 4, 365–80.

[25] Höfler, M. (2014). Strengthening psychosocial resilience in humanitarian practice: resource-centred and risk-centred approaches. Resilience, 2(1), 32-46.

[26] Macedo, T., Wilheim, L., Gonçalves, R., Freire Coutinho, E.S., Vilete, L., et al. (2014). Building resilience for future adversity: a systematic review of interventions in non-clinical samples of adults. BMC Psych, 14(227).

[27] Meredith, L., Sherbourne, C.D., Gaillot, S., Hansell, L., Ritschard, A., Parker, A., et al. (2011). Promoting Psychological Resilience in the U.S. Military. Available at: http://www.rand.org/content/dam/rand/pubs/monographs/2011/RAND_MG996.pdf

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[33] Crabtree, A. (2013). Questioning Psychosocial Resilience After Flooding and the Consequences for Disaster Risk Reduction. Soc Indic Res, 113, 711-28.


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[34] Norris, F.H., Friedman, M.J., Watson, P.J., Byrne, C.M., Diaz, E. & Kaniasty, K. (2002). 60,000 Disaster Victims Speak: Part I. An Empirical Review of the Empirical Literature, 1981—2001. Psychiatry, 65(3), 207-239.

[35] Green, G., Paranjothy, S. & Palmer, S.R. (2015). Resilience and Vulnerability to the Psychological Harm of Flooding: The Role of Social Cohesion. Am J Public Health, 105(9), 1792-95.

[36] Prewitt Diaz, J.O. & Dayal, A. (2008). Sense of Place: A Model for Community Based Psychosocial Support Programs. AJDTS, 2008-1.

[37] Operationalising Psychosocial Support in Crisis (OPSIC). (2016). The Comprehensive Guide on Mental Health and Psychosocial Support in Disaster Settings. Available at: http://opsic.eu/wp-content/uploads/2015/06/OPSIC-Comprehensive-guideline-FINAL-June-2015.pdf

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[39] Pfefferbaum, R.L., Pfefferbaum, B., & Van Horn, R.L. (2011). Communities Advancing Resilience Toolkit (CART): The CART Integrated System. Oklahoma City, OK: Terrorism and Disaster Center at the University of Oklahoma Health Sciences Center.

[40] van Kessel, G., MacDougall, C. & Gibbs, L. (2014). Resilience–Rhetoric to Reality: A Systematic Review of Intervention Studies After Disasters. Disaster Med Public Health Preparedness, 8, 452-60.

[41] Priest, S.J., Clark, M.J. & Treby, E.J. (2005). Flood insurance: the challenge of the uninsured. Area, 37.3, 295-302.

[42] Paranjothy, S., Gallancher, J., Amlot, R., Rubin, J.G., Page, L., Baxter, T. et al. (2011). Psychosocial impact of the summer 2007 floods in England. BMC Public Health, 11(145).

[43] Ferraro, R.F. (2008). Psychological Resilience in Older Adults Following the 1997 Flood. Clin Gerontol, 26(3-4), 139-43.

[44] Crabtree, A. (2012). Climate change and mental health following flood disasters in developing countries, A review of the epidemiological literature: What do we know, what is being recommended?. AJDTS, 2012-1, 21-9.

[45] International Federation of the Red Cross and Canadian Red Cross (2015). Rapid Assessment Guide for Psychosocial Support and Violence Prevention in Emergencies and Recovery. Available at: http://pscentre.org/wp-content/uploads/PSS-and-VP-Rapid-Assessment-Tool-Emergencies-and-Recovery-2015.pdf

[46] Tapsell, S. (2010). Socio-Psychological Dimensions of Flood Risk Management. In Pender, G . & Faulkner, H. (Eds.). Flood Risk Science and Management. Wiley-Blackwell.

[47] Gordon, R. (2004). The social system as site of disaster impact and resource for recovery. AJEM, 19(4), 16-22.

Analysis of findings from C-D1 (D-C2C)

Bernd Leitner / Adobe Stock


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MethodologyData was collected using the Guide to Community Workshops on Emotional Resilience developed by the PSC for the purpose and found in THE annex. The guide was produced to guide CRUA colleagues not specialized in psychosocial support to collect data from the community engagement workshops in urban areas that had been flooded carried out as part of task B. It was therefore designed to be flexible enough to be adapted to local implementations of task B while maintaining the integrity of the data produced. For instance, the envisaged format for the data collection was workshops. However, this proved very difficult to implement in the Northern Irish context. After consultation with the PSC the Northern Irish team shifted the data collection strategy to face-to-face interviews but maintained the interview guide.

The data collection was carried out in local languages and findings translated into English by CRUA partners for reporting and analysis purposes. The intention with the data collection was not to produce 1:1 transcripts of the sessions (workshops, interviews) that would then be translated and analyzed. This is beyond the scope of CRUA. Both the abridgment and translation process reduced the density and volume of the data. This had the advantage of producing concise and manageable data, but also meant that data to some extent was secondary already before it reached analysis.

However, no significant losses were identified during analysis. Had this been the case, the CRUA partners responsible for data collecting and reporting were available to the PSC throughout the project and the PSC would have requested further information from them had this been deemed relevant.

The qualitative methodology used was that of thematic analysis (Skovdal and Cornish, 201511) through tagging data in the form of written reports from the workshops and interviews.

The coding strategy for thematic analysis prescribes that tags for emergent themes are identified by reading through the data. Emergent themes are drawn from the wording and thinking of respondents and identified until exhausted.

Tags were listed as they emerged and later collated at two levels. During the identification, emergent themes suggestions for potential analytical coding and potential thematic coding were captured. The analytical coding themes were derived from literature on psychosocial support in general and the literature review of academic and grey literature on psychosocial support and flooding in urban contexts (D-C2B, found below) in particular. The analytical coding themes were subordinate to one another on two levels and listed separately.

11. Qualitative research for development. A guide for practitioners, Morten Skovdal and Flora Cornish (2015), Save the Children Fund.


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Table 3: Overview of emergent themes tags (exhausted) and subsequent ordering at two levels

Emergent theme tags, level one Emergent theme tags, level two

Vulnerable group DisabledChildrenElderlyForeign nationals

Family N/A

Information Lack of informationLack of communicationUnclear communicationBad communication

Loss Of sense of placePossessionsPrized/personal possessionsCertaintySupport/support systemCommunity coherence

Insurance N/A

Community Strong WeakOldNewSmallLargePreparedUnprepared

Housing type RentalOwnerTemporary

Stress Managing rebuilding processFinancial stressLack of support from authoritiesWaitingUncertaintyHomelessnessGeneral mental stress

Belief that the flood caused eventual death/onset of severe physical illness N/A


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Emergent theme tags, level one Emergent theme tags, level two

Role of authorities PassiveActiveGood Bad

Practical reaction N/A

Mental reaction ShockDisbeliefWorryAttention to weather forecastsFear

Recommendation To authoritiesTo organizationsTo members of the public

Not prepared for future flooding or other disaster

N/A

Table 4: Analytical coding themes and tags stemming from literature

Analytical coding tags, level one Analytical coding tags, level two

Coping mechanism N/A

Hobfoll principles12 a sense of safety (positive)calming (positive)a sense of self- and community efficacy (positive)connectedness (positive)hope (positive)a sense of safety (negative)calming (negative)a sense of self- and community efficacy (negative) connectedness (negative)hope (negative)

Volunteers N/A

Positive outcome of flooding N/A

Negative outcomes of the flooding N/A

PSS effect of workshop/interview Positive Negative

12. Hobfoll Five Essential Elements of Immediate and Mid-Term Mass Trauma Intervention: Empirical Evidence, Stevan E. Hobfoll, Patricia Watson, Carl C. Bell, Richard A. Bryant, Melissa J. Brymer, Matthew J. Friedman, Merle Friedman, Berthold P.R. Gersons, Joop T.V.M de Jong, Christopher M. Layne, Shira Maguen, Yuval Neria, Ann E. Norwood, Robert S. Pynoos, Dori Reissman, Josef I. Ruzek, Arieh Y. Shalev, Zahava Solomon, Alan M. Steinberg, and Robert J. Ursano, Psychiatry Interpersonal & Biological Processes 70(4):283-315; discussion 316-69, February 2007


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However, once the draft tagging strategy was identified, it became clear that the level of detail in the tagging structure was higher than the data could carry. In other words, using the detailed tags would lead to a level of deconstruction of the data that would in essence prevent rather than promote analysis. For instance, tags were specific to the country of origin of the data meaning that the analysis could not capture similarities between countries. In keeping with the thematic analysis methodology, the first version of tags and the corresponding tagging strategy were therefore simplified by choosing level one of the emergent themes tag to become the single-level set of tags which was used for coding the data.

The final single-level tag set is presented in the table (right) in alphabetical order.

Based on the emergent and analytical coding themes, a draft tagging strategy was planned for three rounds.

1. Round one: tag all text according to level one of the collated emergent themes.

2. Round two: subdivide data by level two tags if the data is extensive or divergent.

3. Round three: tag data according to analytical codes for negative and positive inflections of the 5 Hobfoll principles for intervention to discern if the data suggests that one of more of the 5 principles are of particular importance in relation to flooding and therefore require further investigation in the literature review.

Table 5: The final single-level tag set

Final single-level tag set

Belief that the flood caused eventual death/onset of (severe) physical illness

Community

Family

Housing type

Information

Insurance

Loss

Mental reaction (emotional reactions other than loss, and belief flood caused eventual death/ill health)

Not prepared for future flooding or other disaster

Practical reaction

Recommendation

Role of authorities

Stress

Vulnerable group


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To assist the data analysis and ensure that it was thorough, transparent, efficient and consistent, the data analysis software CATMA 5.013 was used. CATMA 5.0 is freely available, open source software developed and maintained by the University of Hamburg, Germany.

After the tagging was complete the emergent theme “Practical reaction” contained only 2 text bites, which carried no analytical value. The theme has therefore been excluded in the remainder of this report.

It should be noted that the data used is partly interviews with 1 or 2 community members each, partly workshops with approximately 15 community members in each. The style of reporting is different for the types of data, with the data for the interviews being more

detailed and transcript-like while data from workshops naturally leans towards a minutes-type style. The intention with the workshops was not to reach consensus, nor was the purpose of the reporting to capture the level of agreement between participants. Rather, both the interviews and workshops were designed to elicit a diversified and rich array of experiences to inform the development of the overall product of task C, the key actions for psychosocial support in flooding and supporting toolbox. While basic quantitative analysis on these experiences are given below in order to introduce the nature of the data more closely, it is important to recall that value of this qualitative data lies in the richness of the experiences and, most importantly, the conclusions that the respondents themselves and the present analysis draws from these experiences.

13. www.catma.de

The final tagging strategy was simplified accordingly and took place in two rounds:

1. Round one tagged data sections using the single-level set of tags

2. Round two crossed checked tagging between data set to ensure consistency.


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Analysis and findings from interviews and workshopsIn this section the findings from the interviews and workshops with flood affected community members in all three partner countries is presented.

Table 6: Overview of tagging instances per tag and presence in partner country data

Final single-level tag set Count of tagging instances for all data

Countries represented (Yes/No)

DK HU UK

Community 24 Y Y Y

Family 4 Y Y Y

Loss 19 Y Y Y

Recommendation 13 Y Y Y

Role of authorities 18 Y Y Y

Vulnerable group 16 Y Y Y

Belief that the flood caused eventual death/onset of (severe) physical illness

6 Y N Y

Insurance 13 Y N Y

Mental reaction (emotional reactions other than loss, stress and belief that flood caused eventual death/ill health)

6 N Y Y

Not prepared for future flooding or other disasters

7 Y N Y

Stress 18 Y N Y

Housing type 17 N N Y

Information 6 N N Y

Overall, the themes of community, family, loss, recommendations, role of authorities and vulnerable groups are presented data from in all three partner countries and also represent the highest count of tagging instances. Given the focus of the workshops and interviews this distribution this is expected. Notable exceptions to this are the themes stress, housing type and insurance, neither of which was found in the Hungarian data. This is in

part explained by the fact that community members reported a high degree of community coherence before, during and after the flooding of their town. The theme family is also atypical in its broad representation across countries, yet low count of instances. This is likely to be a result of the data collection focusing on eliciting community rather than household level information.


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In the following the data from each of the 13 themes is presented in alphabetical order and annotated.

Belief that the flood caused eventual death/onset of (severe) physical illnessThe theme reflects that respondents identified a relation between experiences of flooding and physical illness and/or death. In no instances was a causal relation verified by health professionals. Present in Danish and Northern Irish data, the theme suggests a long term effect of flooding on physical and emotional ill-health. From a psychosocial point of view whether or not the causal relation is verifiable or not is less important as the subjective experience is seen as a loss by respondents. One report noted that a respondent was:

“utterly convinced that the stress of this time contributed to the onset of dementia in her mother”.

CommunityRespondents were asked that they understood by community and how the flood affected their community. Overall, the data on community draws a complex picture of communities that are part stable but also shifting constructs that change over time in both positive and negative ways. Often the data also alludes to close community (neighbours, friends, local shops) as the most important source of practical and emotional support.

Often respondents were able to define their community very precisely. For instance, it was noted that a respondent defined her community as one side of the street her home is on; others stated that the community they were part of consisted of the long-term inhabitants, while new-comers were not included. Respondents also identified changes to their community that were results of the flood. For instance:

“…after the flood, people tried to move away. Many have been successful in this and so many residents who knew the area, who were good neighbours and active in the community left. This changed our community.”

Others described the flooding event as the real impetus for the community coming together more and working on their problems as a group. Some recall the memories of unity and cooperation between actors. This helped them not just in the moments of the flooding but they can rely on these memories for long term and find power in them.

Several respondents juxtaposed time and community. Many reported a sense of camaraderie during the immediate flooding that was not there before. In some case this enhanced sense of community continued in the long term, in others it waned quickly leaving people to feel that they were on their own. A respondent recall the


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night her community was flooded like this:

“we helped each other out… moving from one house to another; cleaning, shifting water, sorting things out… helping people no matter who they were”.

In some of the cases were the sense of community persisted, respondents were asked why they thought this was the case. Answers point to pre-exiting bonds between community members. In one case trust between community members in general and between community members and municipal employees in particular was highlighted as the positive reason for the communities ability to overcome the flooding, in other past experiences of coming together as a community to solve issues contributed positively to the respondents view of the community as fairly engaged and active in recovery. In cases were sense of community was affected negatively this was attributed not only to community members moving away, but also to a lack of physical structures, such as a community hub, and organisational structures. An example of a failure of organisation was given by one respondent:

“We did try to create a flood group in the area, but people didn’t get on board in significant numbers because they all wanted to move away after the flood. People who did get involved in these groups became tired of being the ones who were trying to do everything for the community”.

In relation to this several respondents who were struggling to recover had not received the support from authorities that they had expected. A report described the situation like this:

“they were alone; no one to help them clean up, no one to inform and advise, no one to listen to them and no one to provide any emotional support”.

The sense of community cohesion has an impact on future preparedness, and respondents linked low cohesion with low levels of preparedness:

“We do know some of their neighbours, but mostly just their names and to say hello to, there is no real community structures or shared activities…the community will not come together to prepare for flooding; those who do flood will be too busy looking after their own homes, and those who do not flood don’t see it as their issue.”


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FamilyThe focus of the workshops and interviews was on community, and although families are key to communities, surprisingly little mention was made of this in the data. One mentioned the difficulty of arranging child care during recovery and rebuilding and the stress this entailed. Another mentioned difficulties in handling children’s emotional reactions to the flooding due to lack of knowledge.

Housing typeThis tag was created to investigate whether a connection would be made between housing type (rental, ownership, house, apartment etc.) and experiences of flooding. Some respondents allude to tenants as outsiders to community, often this is perceived as an active choice. Others state that home owners experienced a decrease in value for their property; many had also invested heavily in flood prevention measures. However, the tag uncovered interesting data on “home” and the feelings connected to home (as opposed to housing or property. Several respondents had lived in temporary housing or with friends and family for several months while their homes were rebuilt. This was reported to being both stressful, expensive and a negative impact on emotional and physical health. Even when housing was once again liveable, the negative emotions respondents linked to their houses meant that they were not able to regard them as homes. Two quotes illustrate this nexus well:

One reported:

“They moved around from hotels to family members houses, to other hotels and B&B’s. This meant that they had to live out of bags, they had to do all their laundry in others houses, or more often in expensive laundrettes. They could not do their own cooking and so had to eat out two or three times a day for months and this was a financial burden and may have impacted their health. They felt their home was a base they returned to each day, and during this time they literally felt baseless: like they were constantly travelling. Beyond this their home was their sanctuary; and without it they felt less secure. When the interviewees did return home, this was not the end of their difficulties. Their home was still not fully functional, and they basically lived only in the upstairs rooms for another month or two. Their water service was intermittent and work progressed and cooking was still difficult. These daily disturbances mounted up and contributed to the interviewee’s stress levels. In our conversation they seemed to take stress; the degree to which they felt it and the impact it had, as read.”

Another interviewer noted:

“She describes how she can’t sleep any nights that it rains, she lays awake worried about her mother’s house and often goes down to check on it. The interviewee wants to move into this house and live in the home she grew up in, but she feels that the flood has left a “real mental scar” on her and she doesn’t think she can cope with the anxiety and panic she feels about flooding happening again. She believes she will sell her family home.”


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InformationRespondents mentioned the importance of timely, relevant and accurate information in order to prepare for and overcome flooding and noted that navigating information in the response and recovery phases of flooding is difficult. Some mentioned increase attention to weather forecasts and information related to being and feeling safe and protected from future floods as important. However, most of the data pertaining to information is closely related to the recommendation that the community members were asked to give, please see below.

InsuranceAll respondents who addressed the theme of insurance agreed it was a central topic for flooding. Those without insurance or who could not claim insurance suffered financially and worried more than who did have coverage. The role of insurance companies was important for recovery. Positive stories includes assessors who were able to settle the claim quickly and who took charge of the rebuilding process by managing builders, plasters, plumbers etc. easing the practical and emotional hardships of being flooded. Negative stories include changes in premiums following a flood making in too expensive to pay insurance and companies delaying the rebuilding process while assessment of the claim was carried out.

LossLoss is a common theme for many respondents. They reported losses of many different kinds, often experiences several losses at once. Below a list of some of the losses described by participants and some quotes to illustrate them.

Loss Quote/Comment

Loss of personal items of emotional value

“She described the terrible toll the flood had on her mother, who lost all of her most prized and personal possessions. Additionally moving out of her house was very difficult for her mother as she had lived there a long time with her husband, whom had died not so long before. The interviewee is utterly convinced that the stress of this time contributed to the onset of dementia in her mother”

Another respondent said:“I lost the photos of the children when they were young”

Loss of sense of control and loss of expected support

“No one had given us any warning, and we had no experience of flooding, we had made no preparations whatsoever… no property defence measures and no plan for flooding. They also felt left alone during the flood. We realised that the flooding was widespread and that emergency services had to attend the most serious situations…”


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Loss Quote/Comment

Loss of hope, loss of control, loss of meaning

“During the flood event the interviewees described the feeling among the residents as shock, hopelessness and described people as “falling apart”. They themselves did not know what to do, or who to ask for help. This was the hardest aspect for them during the actual flood, the hopelessness.”

Loss of physical health“The interviewee is utterly convinced that the stress of this time contributed to the onset of dementia in her mother”

Loss of support, of feeling connected

“Their response to this was characterised by a feeling of abandonment… they felt absolutely alone and that response and recovery was completely up to themselves.”

Financial loss and the emotional effect of financial loss (loss of connectedness between generations)

“A great many of the residents feel that they have lost significant value off their homes after the flood. On top of this they have spent a quite a bit of money on property protection devices to make their homes more resilient to flood water.”

Loss of sense of safety

“He noticed that after the flood some residents had lost confidence in the safety and security of their homes. So much in fact that he described them as having “mentally lost their homes”. Indeed many people wanted to move, and some did; changing the makeup of the community.”

Mental reaction (fear, anxiety, hypervigilance, worry, feelings of abandonment)Several of the respondents identified mental reactions of fear, anxiety, worry, hypervigilance and feelings of abandonment in themselves or others. Some examples to illustrate include:

A respondent remarked on others in his community:

“Since the flood, he depicts the affected residents as “hyper-vigilant and anxious”. He has noted that every time it rains many residents have reported feelings of acute anxiety. Generally people in the area are paying a lot of attention to weather forecasts and to the maintenance of drainage infrastructure. The implication here was that residents are worrying about rainfall events that have little to no chance of causing any flood issues, and that this may not be entirely healthy. Indeed he reports that some residents have put off going on holidays for fear of the rain”.


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Another stated that

“…those who are “left behind”, those who cannot or do not want to move away, are constantly in fear of future flooding… [Others] cannot cope with the stress waiting for another flood.”

Not prepared for future flooding or other disaster Almost all respondents from all Denmark and Northern Ireland reported that they had not expected or been prepared for a flooding. The workshop facilitators/interviewers that were part of the CRUA team independently summarised this in their feedback to the PSC.

For Denmark the facilitators noted:

“In general all experienced a major lack of preparedness for a situation, where the households were out of electricity, communication, heat, water e.g. many did not actually believe, that they were at risk of being flooded despite early warnings. This made many think that they were safe and did not need to take any actions. In some situations a few sandbags were handed out by local agencies, but lack of knowledge on how to use them and insufficient amounts of bags made the effect more or less non-existing. It was a chock to be flooded mainly due to the fact, that many underestimated the safety of the family and experienced panic situations, where they did not know what to do and found themselves unable to take actions which could mitigate the consequences of the flooding.”

The Northern Irish interviewers noted:

“These residents have only experienced one flooding incident; they live very near a river but felt confident they wouldn’t flood. One rainy afternoon changed that. The rain had been coming down hard for a couple of hours, but it had actually stopped raining, which only added to the shock. The residents had seen the water coming down the road but could not believe it.”

By contrast the Hungarian team reported:

“The town was affected by floods many times but the 2013 Danube Flood was the biggest event ever. The town was prepared and prepositioned 5000 pcs sand bags (usually enough). The flood caused many unprecedented situations: more than 150K sandbags were filled, approx. 60 houses were flooded.”

This preparedness corresponds well with the overall assessment that the town coped well with the recovery after the flood.


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RecommendationRespondents in all three countries were asked for recommendations. The recommendations are not assigned value or relevance in this analysis. Instead, representative examples are listed below.

The practice of combining practical and emotional support with needs assessment was endorsed: Speaking about the Hungarian Red Cross Danube flood response, respondents noted:

“Their anxiety and stress levels need to be addressed, this is the greatest need of the residents, they are still struggling. Continue to assesses and improve the local drainage infrastructure. A sandbag store nearby would definitely help with getting houses protected in time, but also make people feel more secure and calm[…the respondent was] sceptical about public awareness campaigns and felt they do little to change attitudes or behaviours. He felt that community workshops would work better. However he also felt that one to one communication works best: individual work/visits with those who have experienced flooding, listening to them with an empathetic ear, giving them advice”

An example from Northern Ireland

Another Northern Irish respondent recommended that:

“help came in multiple waves: cleaning and NFI [non-food items] parcels, food parcels, kitchen-garden seed parcels, assessment of building damages, monitoring of reconstruction, etc.) and this was a good thing as the volunteers of Hungarian Red Cross got in touch with us regularly and had time to speak with us. This was good, and not just because we were in need of cleaning stuff, but it meant an opportunity to speak about our problems.”

“[The respondents] feel that residents of the area know the flood risk best and want to be listened to when they tell council and others that they are in imminent danger of flooding. They want to have more say in their flooding preparations; what their community needs and how it should respond (e.g. they asked to be able to put out road closed signs when their street is dangerously flooded). They want an emergency plan for their community and ideally would like to be central in creating this. They would also like access to household flooding protection devices, which many feel are too expensive at the moment. Finally they want to identify a local building that can act as an emergency support centre”.


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“a physical presence from authorities during and after a flood. Would like a person who is a central point of contact for information and advice. Ideally this person would be training in empathetic listening skills. The combination of the practical knowledge and emotional support would greatly help reduce stress.

The Danish facilitators listed the recommendations that the workshop attendees identified specifically for psychosocial support:

• Creating as much “normality” as possible in the not normal situation

• Telling your flooding story repeatedly to others in different settings

• Session with school – explaining what some of the children had been through, focusing on continuing children’s network and relations

• Engaging in advocacy activities on national and local policy levels

• Participating in local social events and social networks. E.g. “commemoration of anniversary” of the flooding, focusing on things one could be grateful for, which evolved from the flooding consequences

• Establishing networks on social media for seeking and providing help, non-food items etc.

• Helping others – not holding back and being afraid to interfere

• Ensuring follow up/long term social activities for vulnerable – giving affected families a break from daily stress

• Putting up guards entering flooded community

• Ensuring some kind of indication, that you/your family is present in your house during the flood

A third Northern Irish respondent recommended:


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• Support and facilitate communities to engage in preparedness planning and support developing of good manuals or information for people to use such as Basic information materials on "preparedness kits".

• Locally follow up with meetings, workshops, door-to-door activities to transform information distributed into actions. By taking a needs and local capacity based approach to promote resilient community behaviour. Respecting authority sector responsibilities.

• Continuous dialogue with authorities/statutory agencies before, during and after flooding.

• Agreements with agencies on specific RC role and responsibilities in emergency situations before an actual flooding situation.

• RC volunteers having capacity to "listen". Being a "listening-corps". Providing psychosocial support and psychological first aid during and after flooding situations.

• Red Cross Psychosocial cafe or safe zone.

• Door-to-door follow up on individual households.

• Basic psychosocial support training for volunteers and community members in risk areas.

• Establishing or contributing to local information centre. Red Cross "sign-posting" to information to and from authorities and between community members.

• Establishing or supporting both manual/physical and virtual platforms for information exchange in close coordination with authorities.

• Providing or supporting provision of practical help and non-food items.

• Red Cross coordination of local needs/held capacities of community members.

• Red Cross using networks of recycle/used clothes shops.

• Creating social events for flood hit communities: Come together, dinners, cafés, commemoration of anniversaries, children's or activities.

• Just show up! Ensuring that someone will react on needs or be an advocate/information provider for the flood hit communities and support coordination with authorities.

The workshop attendees further developed a wish list for possible future actions and activities by Danish Red Cross in relation to flooding:


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Before: • Be prepared.

– Make sure your insurance coverage is satisfactory.

– Seek information on how to prepare yourself and your household and how to respond in a flooding situation

During/After:• Create virtual and physical platforms for exchange of information

and community support

• Ensure and organise local access to practical help

• Create activities facilitating psychosocial networking and room for exchanging experiences as well as providing community self-support

• Remember to listen to each other’s stories and don’t be afraid to offer your help and support to anyone who might need it

• Remember to look out for the most vulnerable near you and in your community. Especially for the children, remember to create special activities and seek alternative ways to maintain normal relations and networks

The Danish workshop participants were also asked to develop advice for a fictional community similar to themselves, but which had never been flooded. The advice reads as follows:


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Role of authoritiesThe roles, types, and interconnectedness of authorities were overall accepted as complex by respondents but their experiences with authorities differed markedly. Some had experienced lack of support, uncoordinated responses and lack of preparedness (e.g. no warnings or insufficient maintenance of drainage systems). Others experienced confusing or unclear delineations of responsibility and communication from authorities. Other experienced that authorities were responsive and able to learn from one flooding to the next, thereby improving preparedness and response. Finally some were satisfied with the overall response by authorities and gave only praise. When respondents reported negative experiences with authorities, in general they also took time to identify the specific authorities that had functioned well and explained why. Authorities that were perceived as unresponsive or not living up to their responsibilities were a worry and source of stress to respondents.

Some also found that the actions of authorities not responsible for flood prevention might be undermining mitigation efforts undertaken by other agencies, e.g. permissions given to build in new areas in ways that would increase flood risk. This also caused worry. When authorities were seen to improve their practices and take action to mitigate or prevent future flood risk this was viewed positively and defined as a source of support, comfort and feeling of safety.

In addition to the civil protection agencies and other public entities with legal responsibilities towards flood affected communities, the respondents also identified churches, civil society and non-governmental agencies as authorities that they turned to for support and perceived as relevant and positive actors in flooding situations.

hcast / Adobe Stock


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StressRespondents reported a plethora of stressors and feelings of stress. Several of these have already been reported under the other themes above. Here a number of additional examples of stress are given:

• physical separation of family members (during rescue and due to rehousing)

• the stress of racing against time to secure possessions from flood damage

• the stress of being physically unable to respond to flood threat

• coping with a disabled family member

• organising safe place for children to stay in the immediate aftermath of the flood

• not knowing if things would turn out well

• mental exhaustion following the shock of flood

• prolonged building work

• the absence of help during recovery

• builders making mistakes

• living in temporary and cramped housing

• moving back during rebuilding

• living in damp housing

• financial worry

• worry about ill health

• not having routines

• loss of prized possessions

• rain

• fear of new flood and not wanting to leave home for e.g. holidays due to this

• fearing not being prepared

• not trusting authorities to support and mitigate future flood

• the constant low-level stress of worrying about a future flood

• not knowing what to do

• receiving wrong/false advice from insurance companies

• feeling rootless

• Seeing children and family members worry. Not knowing how to handle this

• not being able to handle your own situation

• poor communication of important information from authorities

• dealing with no electricity, no internet

• Realising that the acute situation actually is not the worse part – but the stress and uncertainties during recovery phase are even worse

• schools and other institutions for children not paying attention to after-reactions

• worry about pets and small animals

• supporting stressed neighbours, when you are stressed yourself


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Vulnerable groupRespondents were asked to identify vulnerable groups in their communities and local areas. Reports indicate that this was not the main focus of discussion and the following should not be seen as exhaustive. The vulnerable groups identifies by respondents include:

Older people, who were most often considered vulnerable due to lower physical strength which made them less able to cope in the immediate flood. Respondent also reported that older people seemed to feel the stressors of recovery more heavily and tended to cope by moving away. Older people were conversely also reported to be a source of social cohesion and their moving was perceived as a loss.

Foreigners and tenants, who were less connected to the surrounding community and there perceived as less able to access community support

Un-insured people or those who were not able to claim insurance faced significantly higher financials burdens and ensuring stress

Children, who were more susceptible to stressors and less able to cope.

People with a disability and families of people with a disability due to the additional efforts needed to create tolerable living conditions for disable people affected by flooding

ConclusionTaken together it is evident that flooding is a source of significant stress for the affected. This can lead to psychosocial ill-being as reported by several of the respondents. Many respondents were not prepared for flooding and their emotional reactions to the flooding, yet found the practical and emotional support of their closest community, such as neighbours, family, friends to be of high value to their recovery, indicating that the social fabric of communities to an important degree determine how well communities react to flood risk. Respondents were also able to offer a rich and varied range of recommendations a several levels of response, indicating clearly that community members (or inhabitants of a flood prone or affected area) can play a constructive role in preparedness, response and recovery.

Hunor Kristo / Adobe Stock

Development of the key actions for psychosocial support in flooding situations,

toolbox and local action plans (D-C3)

Lisa F. Young / Adobe Stock


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The rationaleAs presented in the Key actions for psychosocial support in flooding, flooding is the most recurring natural disaster worldwide and in Europe. According to the World Health Organization (WHO), river and coastal flooding have affected 3.4 million people in the WHO European Region in the last 10 years and has had large socioeconomic costs. Flooding events are predicted to increase in both frequency and intensity as a result of climate change.

Urbanization presents a risk, as infrastructures such as buildings, roads and cemented spaces present in urban areas prevent rainfall and river or coastal floods from infiltrating the soil and thus increasing the risk of flooding. In addition, poorly maintained and insufficiently dimensioned sewage systems significantly compound risk.

Seventy-five percent of Europe’s citizens live in urban areas and this number is expected to rise. The increase in the frequency and intensity of flooding as well as in the number of people living in urban areas can results in a higher number of people vulnerable to the consequences of flooding.

In the aftermath of crisis most people (80%) are able to recover with the support of family, friends, social networks and their communities alone and so need less or no support from the Red Cross Red Crescent or similar organisations. The remaining 20% will benefit from community-based psychosocial support and a small proportion will need referral to specialised care. With flooding in particular, psychosocial issues tend to materialise long after the water has gone, so it is important to maintain psychosocial activities as long as the continued needs assessments say this.

As shown by both the CRUA case studies, interviews, workshops and the literature review, psychosocial issues permeate the lives of those affected by crisis including flooding. This knowledge is broadly accepted in the crisis management sector and evident in the efforts to mainstream psychosocial support (and mental health) in key standard setting, such as the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings14 and the Sphere project15. At European level, this is further reflected in the NATO TENTS Guidance for responding

The good practices interviews with non-CRUA Red Cross societies, the literature review and the interviews and workshops with flood affected community members served a preparation and support to the development of the main outputs of task C, namely:

• The material "Key actions for psychosocial support in flooding situations" containing the Final emotional resilience model with recommendations

• The Toolbox supporting the key actions for psychosocial support in flooding situations

• Local action plans per CRUA partners integrated in task B emergency planning and template for planning

This section provides a brief overview of the rationale for and processes behind the development of these three outputs. The outputs are annexed below.

14. www.who.int/mental_health/emergencies/IASC_guidelines.pdf15. www.sphereproject.org


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to the psychosocial and mental health needs of people affected by disasters or major incidents16 and the Comprehensive Guidelines for Mental Health and Psychosocial Support in Crisis17.

While research remains to be commenced to investigate further the similarities and differences between European countries with regards to crisis vulnerability and planning and delivery systems, early indications are that key drivers for differences are highly localised. A 2015 study18 showed that:

• Planning and delivery systems and disaster vulnerability differ between regions in Europe

• Planning and delivery systems in more vulnerable regions are less evolved.

• North, west and central regions have more developed systems and are less vulnerable

• Variance in vulnerability is primarily located at the regional level (in other words: what we consider country characteristics are in fact regional entities)

• System variance is primarily located at the individual level

These indications relate well with the finding on multiagency partnerships developed in CRUA task D, which showed variances between countries with regard to multi-agency partnership in the context of urban community resilience with a focus on flooding. Findings from CRUA task D also indicate that psychosocial support is an underserved element of crisis management19 despite the need and prominence in international crisis management guidelines.

This situation confirmed knowledge collected and developed by PSC showing that civil society and non-governmental organisations, public health systems and civil protection agencies a challenged by how to address these issues, by knowing what to do, how and when.

The starting point for developing what eventually became the material "Key actions for psychosocial support in flooding situations" and the toolbox supporting the key actions for psychosocial support in flooding situations was therefore to achieve a practical, step-by-step yet flexible and scalable material to plan and implement psychosocial support interventions using community-based approaches that would lend themselves to multi-agency partnerships addressing urban flooding, thus contributing to long term community resilience.

16. Available here: www.coe.int17. Available here: www.compass-crisis.org18. Dückers, Michel (2015) referenced in the Operationalising Psychosocial Support in Crisis (OPSIC). (2016). The Comprehensive Guide on

Mental Health and Psychosocial Support in Disaster Settings., p 41. Available at www.compass-crisis.org 19. Report on sharing good practice and multi-agency partnership Framework. Community Resilience with focus on flooding: An overview of

institutional structure and good practices in Ireland, Hungary and Denmark based on multi-agency workshops in the three countries and supplementary information from Nordic countries,, Peter van der Keur, Lisa Staugaard, Anne Mette Meyer, Tim McInerny, Hans Jakob Hausmann, Susanne Berendt, Atte Harjanne• and Hans Jørgen Henriksen (2016)


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The processThe work in task C was organised to run in parallel in order to ensure hermeneutic learning and cross-fertilisation between processes and findings. This approach also meant that if needed the work towards each of the three deliverables could run on separate time schedules as it was less dependent in time on results of other processes. A notable exception was the interviews and workshops conducted for D-C1 Report on national and local knowledge. Here delays at national level under task B had repercussions in terms of delay to work toward deliverable D-C1. To compensate and avoid overall delays to the project, work toward D-C2 and D-C3 continued as planned.

The PSC has published a number of guides, manuals, handbook and trainings on psychosocial support over the years. The materials are aimed at a global Red Cross and Red Crescent audiences and purposely generic so they can be adapted to local circumstances. The PSC centre also makes use of selected materials developed by other leading authorities on psychosocial support and crisis management. A key function of the PSC is to advise on how implement psychosocial interventions. This meant that a natural starting point towards building a material to support psychosocial interventions in flooding was to identify the most useful tools to use for guiding flood interventions. A draft toolbox was therefore developed. The value of a toolbox is that the main document – the key actions – can be kept relatively short and less complicated to pick up and use. Further, signposting thought the toolbox avoids duplication.

The concept of the toolbox was further developed towards description of each tool covers the following points (if applicable):

• Introduction to tool

• Introduction to target group’s needs in flooding

• Languages

• Training needs

• Adaptation to context

• Tool location

Each description was purposefully brief and limited to approximately one page, allowing reader to assess the applicability of the tools and estimating efforts needed to use the tool very quickly.

In parallel with the development of the concept and draft of the toolbox, the good practice interviews were conducted, yielding insights into what would be helpful in the field for practitioners responding and preparing for flooding. Based on these insights an outline of the components for what should be included in the eventual Key actions for psychosocial support in flooding was drawn up. This draft and the draft toolbox were presented to CRUA partners at a partner meeting in the fall of 2015. During the meeting the partners also assessed, commented and advised on the further development of the material through an internal CRUA workshop facilitated by the PSC. The output of the workshop was a high-level endorsement of the drafts by the CRUA partners.


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Following this process, the results of the analysis of the workshops and interviews with community members in the three partner countries as well as the draft of the literature review became mature enough to support the development of the key actions.

To support the ability of implementing agencies and organization to deliver interventions that adhere to international and European standards the psychosocial support in crises, the nuclear key actions for flooding developed by the EU FP7 funded project Operationalising Psychosocial Support in Crisis20 were adopted to from the structure and deliver the most essential actions. Based on this more key actions were added.

In the acknowledgment that each crisis and response is unique and that crisis implies impossible time constraints, extreme demands on resources and imperfect choices and the fact that it will very rarely be relevant or possible to implement all key actions for every crisis, the concept for the CRUA key actions material was refined to include to following component:

• Brief reasoning behind the importance of each key action

• Brief examples of what the implementation of the key action would look like on the ground for each key action

• For each key action, a box signposting to the tool in the toolbox that would most likely be the most important tool to use first

• An introduction to the issues specific to flooding in terms of psychosocial support

• A one-page starting point to guide in situations where no preparedness is in place but the importance of addressing psychosocial support issues is acknowledged

• Definitions of key psychosocial support terminology

The development of further drafts was conducted in a series of OSC internal write-shops and writing sessions over the course of 2016.

A draft of the key actions and a mature draft literature review were presented to the CRUA partners together with an overview of first findings from the workshops and interviews with community members in the three partner countries at a partner meeting in late summer of 2016 and comments to in particular the key actions collected and integrated.

Following this, an in depth review process was conducted with reviewers from both inside and outside the CRUA team. Based on these inputs the final versions of the key actions and toolbox were developed.

As the overall message of the key actions material is to integrate psychosocial support in all other actions the local action plans originally identified as a stand-alone sub-deliverables under task C were integrated in task B and a generic template to guide the development of future local action plans inclusive of psychosocial support developed in collaboration with task B leaders, please see the report of task B for details of this work.

20. The Comprehensive Guide on Mental Health and Psychosocial Support in Disaster Settings (2016), p. 215. Available at www.compass-crisis.org

Annexes

Rico Löb / Adobe Stock


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Annex 1: Generic interview guide for good practices interviews with non-CRUA Red Cross societies working with psychosocial support and flooding in urban contexts

Theme Questions

Introduction to CRUA and the interview

The CRUA project is an EU-funded project with involvement of the British Red Cross, Hungarian Red Cross and the Danish Red Cross, as well as the PS Centre and the Climate Change Centre hosted by the Dutch Red Cross.

The purpose of the CRUA project is to improve community resilience in urban areas in situations of flooding. The role of the PS Centre in this project is collect information and best practice about emotional resilience in flooding and to provide recommendations for psychosocial support interventions.

This interview is an important source of information in this regard. We have selected a number of case-studies where we would like to understand more about the gaps and needs with regards to the psychosocial support response in particular. Together with a literature review and workshops in the three partner countries – Hungary, Denmark and Northern Ireland – this will inform our recommendations for future flood responses.

We are particular interested in how psychosocial responses or activities can contribute to building resilience within the communities affected by flooding, especially in urban areas.

Event characteristics We are interested to hear more about the XX event, where I understand that you were involved as a part of the Red Cross response.

Is that correctly understood?

What was your role?


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Theme Questions

Emergency response

How was the overall emergency response organized?

• What was the RCRC role/mandate in the emergency response?

• Evacuation centres?

• Logistic centres?

• Were people hosted in emergency shelters or with friends and family?

• Other general characteristics?

Psychosocial response

How was the psychosocial response organized?

• Acute / medium term / long-term?

• How was it linked and/or integrated into other services?

• PSS Information centres?

• Integrated into other structures (evacuation centres, logistics centres?`)

• PSS/mental health mobile teams?

• Referral systems?

Did Red Cross produce any IEC materials?

• Content?

• Points of contact?


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Annex 2: Guide to Community Workshops on Emotional Resilience (Task C.1)

1. Introduction

This guide is for the Task B focal points in BRC, HRC and DRC who will conduct the Task C workshops in their target communities.

The guide has been developed by the IFRC Reference Centre for Psychosocial Support (PS Centre). Please contact Cecilie Dinesen ([email protected]) for questions or comments.

Purpose of Task C Community Workshops

The objectives of the community workshops are:

• To understand the effect of flooding on community structures and coping mechanisms

• To identify new ideas and solutions in relation to community resilience and psychosocial support in urban areas

Outputs

The partners should conduct minimum one workshop in Denmark, one in Hungary and one in Northern Ireland.

The Task B Coordinator is requested to complete the ‘Task C Workshop Report’ (Annex 1) for each workshop conducted.

The workshop reports be compiled and integrated into Deliverable C-D2: “Report with summary of findings from workshops and guidance on good practice” due in February 2015. The workshop reports be compiled and integrated into Deliverable C-D2: “Report with summary of findings from workshops and guidance on good practice” due in February 2015.

Adapting the guide

Note that this is a generic guide that will have to be adapted to the target population in each of the three partner countries. Remember that you don’t have to address all the questions but before you conduct the workshop it is important that you have selected which of the questions that you are going to use and that you make a structured guide based on those questions.


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2. Draft Agenda

Time Session Purpose

15 mins Session 1: Introduction To introduce participants to the CRUA project and the purpose of the workshop

60 mins Session 2: Looking back: how has flooding affected your community?

To understand the effect of flooding on community structures and coping mechanisms

30 mins Coffee break

60 mins Session 3: Looking forward: new solutions and ideas

To identify new ideas and solutions in relation to community resilience and psychosocial support

15 mins Session 4: Wrap-up and goodbye To summarise the key points from the workshop

There are a few things to consider when adapting the workshop guide:

• Participants. It is necessary to consider who your participants are. Questions may need to be adapted based on the participants attending the workshop.

• Community setting. It is important to take how “urban” the community is into consideration as this may influence the way in which you want to talk about community. In some settings as in larger cities, neighbourhood may be a better word.

• Language. Use words that people understand. For example, if words and concepts such as “resilience” and “psychosocial well-being” are not commonly understood, consider using alternative words that people understand as “ability to bounce back” and “doing well”.


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Resources What is Required?

Time 3 hours

Facilitators 3 facilitators:

1 primary facilitator: Overall facilitation

1 secondary facilitator: Supports the primary facilitator and arranges practical issues. Ensures participants are all right if they leave the room being emotionally overwhelmed.

1 Observer and note taker: Observers the session and takes notes from the discussions.

Space A regular meeting room or hall.

The room should be large enough to accommodate the group comfortably. The seating arrangement should permit people to see each other and it should foster interaction. Acoustics should be such that participants can hear each other, people outside the room cannot hear what is being said in the room, and outside noise is not disruptive.

Stationary Paper, pens, flipcharts, post-its, markers.

Participants 8-12 participants

Participants should preferably be community members from flooding affected communities.

If you want to invite participants from several different groups (for example community members, fire fighters, Red Cross volunteers and representatives from the authorities), consider group dynamics when selecting participants. If the relationship between authorities and community members is tense, it may be difficult for people to feel safe and speak their honest opinion. In this case, the best option may be to conduct separate sessions for community members and other stakeholders.

3. Practicalities


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4. Guidance notes for Session 1: Introduction

Introducing project staff and workshop participants

• Make a small round of introductions.

• Present the workshop team and the different roles.

• Explain that this is safe space where people can speak their honest opinion and that the team will treat the information with confidentiality. Explain that the note taker will be taking notes from the workshop but that s/he will only write what is being said, not who said what.

Introducing the CRUA project and purpose of the workshop

• Make sure you introduce the project and the purpose of the workshop. Participants should understand the purpose of the workshop and what their information will be used for.

– For example: “The CRUA project is a joint project by the Danish, British and Hungarian Red Cross funded by the European Union. It is designed to tackle one of the great challenges that we are facing across Europe: namely resilience in situations of flooding in urban areas.”

– For example: “We know that flooding can be very distressing for people and the experience can have long-term consequences for family- and community life. The purpose of this workshop is to understand the psychological and social needs after a flooding and to get your suggestions for how we as Red Cross can improve our work in the future. The workshop will be split into two main parts: the first part will focus on how flooding has affected the community(ies) in which you live. The second part will focus on ideas for the future and how your experiences can help us in better supporting other flooding affected communities in the future.”

• Explain that everyone’s opinion matters and that there are no right and wrong answers. The aim is not to reach consensus about the issue, but to exchange viewpoints and opinions.

• Agree on ground rules (for example: respect each other’s opinion, don’t interrupt, put your cell phone on silent etc.)

Practicalities

• Explain the programme and any practicalities (coffee breaks, bathrooms, fire exits etc.).


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This session focuses on understanding the effect of flooding on community structures and coping mechanisms.

This session could be conducted in a similar fashion to a Focus Group Discussion and it is important that the facilitator has experience with managing group dynamics. The facilitator should promote discussion by addressing questions to the entire group rather than individuals and it is important to use probing techniques to clarify answers and ensure a flow in the discussion. Refer to a general guide on how to conduct Focus Group Discussions if you need more information.

Flip charts may be useful to write down ideas that emerge from the discussion so that everyone can see them.

The box below (Figure 1) lists some questions for this session. The questions are adapted from the Rapid Assessment Guide for Psychosocial Support and Violence Prevention in Emergencies and Recovery21 and the CART toolkit22.

Note that it isn’t necessary to address all the questions but before conducting the workshop, it is important to select which questions be used and to make a structured guide based on these.

Wrap up the session by thanking people for their input. Explain that after the coffee break, the focus will be on how to improve the work in the future.

5. Guidance notes for Session 2: How has flooding affected your community?

21. IFRC and Canadian Red Cross 2015: Rapid Assessment Guide for Psychosocial Support and Violence Prevention in Emergencies and Recovery http://pscentre.org/wp-content/uploads/PSS-and-VP-Rapid-Assessment-Tool-Emergencies-and-Recovery-2015.pdf

22. Pfefferbaum, R.L., Pfefferbaum, B and Van Horn, R.L., (2013), Communities Advancing Resilience Toolkit: The CART Integrated System©, Terrorism and Disaster Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma: USA.


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Flooding in the community

1. We are interested in communities and how you understand the word community. What comes to mind when you think of a community?

• What about your community? [Settle on a general understanding of community for the session.]

• What characterizes your community? [probes: do people know each other, do people get along, diversity, connectedness, vulnerable groups etc.]

2. Could you explain a bit about the flooding in your community? What happened? [Note: participants might have a lot to share here. Make sure you take time to listen].

3. How has community life in general been affected by the flooding?• What brought about this change?• Have you experienced any unexpected or positive changes?

Stress, coping and community structures

4. Since the flooding, what changes have you noticed in yourself and others in the community?

5. What are some of the events or things that cause stress for people in the community?

• Are they different for women, girls, boys and men?• Have they changed over time?

6. Who responded to the psychosocial needs of the community after the flooding?• What did community members do?• What did authorities and other organisations such as the Red Cross do?

7. Who were the most vulnerable groups in terms of psychosocial needs after the flooding?

• Who supported them?

8. How do people support each other in the community?• Are there formal or informal support structures or resource in your community

to help people cope with the flooding? Can you give some examples?• Have some of these support structures or resources changed as a result of the

flooding? If so, how?

9. All in all, would you say that the psychosocial needs of the community were met?

FIGURE 1: Sample questions for session 2: How has flooding affected your community?[Comments to the facilitator in brackets]


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This session focuses on identifying new solutions and ideas for resilience building. The purpose is to get ideas and lessons learned from the participants themselves, but also to discuss new ideas and solutions that have been tried out in other countries.

The box below lists some questions that can be used for this workshop. The questions are adapted from the CART toolkit23. Note that not all the questions have to bed addressed but before conducting the workshop it is important to select which of the questions will be used and to make a structured question guide based on these.

Flip charts may be useful to write down input and ideas that emerge from the discussion so that everyone can see them. Participants may also be given post-its to write their ideas on.

6. Guidance notes for Session 3: New solutions and ideas

FIGURE 2:Sample questions for session 3: New Solutions and Ideas[Comments to the facilitator in brackets]

1. What have you learned from the flooding experience that might help you to respond to and recover from future disasters?

• Is it possible to formulate this as three key recommendations to others [probe: for example this could be recommendations if a flooding happened in a city close by or another area in the city?]

2. What could be done to improve your own community’s response after a flooding?

• [Probes: what could you do as community members? Where do you need support from Red Cross or the authorities?]

3. Here are some ideas and initiatives that have been tried in other communities around the world. [Select 2-3 ideas from the idea catalogue or use other ideas that you’ve come across. Make sure you take a few minutes to explain each of the ideas].

• Could they be relevant in your community?• If so, what could make it possible [probes: who could do this, how would

it look, do you need support from others such as the authorities or the Red Cross?]

• If not, do you think it could be relevant to other communities in a similar situation? [Probe: for example this if a flooding happened in a city close by or another area in the city?]

23. Pfefferbaum, R.L., Pfefferbaum, B and Van Horn, R.L., (2013), Communities Advancing Resilience Toolkit: The CART Integrated System©, Terrorism and Disaster Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma: USA.


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The table below (Table 3) lists a number of different resilience building initiatives that have been tried in other countries. Select 2-3 of these initiatives that you want to bring to the group for discussion. The point is not that they should reject or accept ideas as they are but that they ideas could start a discussion within the group.

Table 1: Idea catalogue on psychosocial resilience building activities

Resources What is Required? Country

Information event on normal reactions to stress

Danish Red Cross organised an information event in the community on normal reactions to stress in the weeks following a flooding. A psychologist specialised in crisis and psychotraumatology gave a presentation on normal reactions to stress and participants had the opportunity to ask questions.

Similar events have also been conducted in schools for caregivers and teachers to better support children and understand their reactions to the situation.

Denmark

Public Awareness campaigns

New Zealand Red Cross participated in a public awareness campaign on stress and coping with a number of other actors. The campaign was called “All right? Wellbeing Campaign” and it consisted of several phases.

The first phase was about normal reactions to stress. The second phase focused more on coping and about what people were doing to become alright again. The third phase was community-driven and community members organised different public stunts such as local orchestras playing concerts, well-being games, cooperates picking people up in limousines, competition on work places etc.

New Zealand

Workplace workshops

Supporting people during and after a disaster can be challenging for first responders and employees at local authorities, insurance companies, etc.

New Zealand Red Cross has offered workshops to such workplaces in order for the staff to understand the science of stress and its impact on themselves, their colleagues and clients.

The purpose of the workshop was to empower workplaces to support their staff and clients. Practical tips and tools to understand and support oneself and others through the recovery process.

New Zealand


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Resources What is Required? Country

Community workshops

New Zealand Red Cross designed 45 minute workshops developed with disaster recovery experts and led by trained Red Cross facilitators.

The workshops included practical tips and tools to understand and support loved ones, friends and neighbours through the recovery process. Understand the signs of stress, including problems with memory, decision making and managing responsibilities. These workshops were conducted by Red Cross volunteers.

New Zealand

Creative community projects

A number of community-led creative projects started in Christchurch after the Christchurch Earthquake. There were a lot of different initiatives such as gardens, poetry walls, a washing machine that could play music, and so on. The idea was to create something that could make people smile and laugh after the difficult times.

New Zealand


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Annex 3: Workshop report

[Comments to the facilitator in brackets]

1. Overview

Location: Date:

Facilitator: Number of people present:

Duration:

2. Minutes from Session 2

[Minutes should be written in the table below. You may alter the topics according to your discussion guide. Remember to note what is being said, not who said what].

Topic Detailed minutes of the discussions?

Flooding event

Stressors and coping

Community structures

Etc.


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2. Minutes from Session 3

[Minutes should be written in the table below. You may alter the topics according to your discussion guide. Remember to note what is being said, not who said what].

Recommendation from the community

Any relevant references/materials

Specific examples of innovation/good practice


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Key Actions for Psychosocial Support in Floodingwww.crua.eu

Toolbox for Psychosocial Support in Floodingwww.crua.eu

Local Action Plans per Crua Partners Integrated in Task B Emergency Planning and Template for Planningwww.crua.eu

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