Hurricane Dorian Disaster Response and Recovery Resources
Catastrophic natural disasters, such as hurricanes, cause extreme disruption and can be distressful for individuals, families and communities. Those receiving assistance as well as those involved in disaster management efforts can be affected. Individual and community strength can be enhanced by interventions that address critical behavioral health issues throughout both the response and recovery phases. Ideal interventions promote the evidence-based principles of Psychological First Aid (PFA), including: safety, calming, self- and community-efficacy, social connectedness, and a sense of hope/optimism. Information relevant to this event and links to brief and action-oriented education fact sheets are below.
Grief: Understanding and Managing
Evacuation Centers and Behavioral Health Considerations
Common Responses to Disaster
Vulnerable Populations
Health Risk and Crisis Communication
Workplace and Organization Support
Exposure and Contamination Fears
FACT SHEET: Helping Communities After Disasters
Grief is a near universal experience for those directly impacted by an extreme natural disaster, such as a hurricane. In the immediate aftermath, loss of home, possessions (such as pictures, keepsakes and other items which comprise our lives), and life routine cause feelings of grief. Loss of control, life routine, as well as familiar people and places often compound feelings of grief. Community leaders and those leading disaster management efforts, and healthcare providers can help by proactively and respectfully inquiring about, acknowledging and then allowing individuals to process grief. Grief support also involves addressing feelings of loss, mourning losses, and fears about the future. Anxiety about the future is best managed through “problem solving” (supporting people in connecting with practical help when available). Being sensitive to the need for rituals, such as memorial and funerals, to support expressions of grief allow for healing, which ultimately strengthen communities. The following resource(s) address this topic in further detail:
FACT SHEET: Grief Leadership in the Wake of Tragedies
FACT SHEET: Leadership in Disasters & Lessons Learned
HOJA DE DATOS: Liderazgo ante el duelo: cómo dirigir tras una tragedia
Evacuation centers can support these efforts by training personnel in the principles of PFA which can significantly reduce distress of occupants displaced from their homes. Interventions at evacuation centers which promote PFA principles include: keeping children with primary caregivers, creating “school like” activities that involve routine for kids (obtain volunteer “teachers” and create “activity centers”), and accommodating pets when possible. In addition, creating “communities” which encourage formal and informal support and connection among residents. It is important to help those in significant distress with one-on-one interactions as having residents retell their distressing stories in great detail can unnecessarily increase distress in others around them. Creating and maintaining connections with healthcare support systems is important to address inevitable acute (lost medications, active illnesses, etc) and chronic (insulin for diabetes, dialysis for kidney disease, etc) health concerns that will inevitably arise.
Common responses to disasters include distress reactions (insomnia, irritability, loss of safety, social isolation, blaming and scapegoating) and health risk behaviors (increased use of alcohol and tobacco, reduced attention to health care). For healthcare personnel, being alert to these reactions and behaviors, promptly identifying them, and providing interventions can reduce distress and improve functioning and may decrease the likelihood of ultimately developing mental disorders. The following resource(s) address this topic in further detail:
FACT SHEET: Helping Communities After Disasters
HOJA DE DATOS: Seguridad, recuperación y esperanza después de un desastre Ayuda para la recuperación de comunidades y familias
Vulnerable populations may be at increased risk for adverse mental health effects after a disaster and warrant unique considerations. Children have developmental limitations in their understanding and ability to respond as well as from the distractions that occur for parents. Women who are pregnant or postpartum have increased risk during these physiologic states. Cognitively and mobility impaired as well as dependence on system of care may increase risk for elderly as and those with pre-existing mental illness. First responders and public health emergency workers (including volunteers) may be both responder and victim and have increased risk for exposure to death, dying, human remains, and considerable suffering. Marginalized populations (low socioeconomic status, migrants and refugees, LGBTQ persons, racial and ethnic minorities) may have limited access to resources, previous negative experiences using government services, and fear retaliation or reprisals by government and related organizations, ultimately leading to disparities in access and utilization of critical post-disaster resources. Community-based interventions can help address the unique needs of these (and other) populations by addressing vulnerabilities and reducing barriers to care. The following resource(s) address this topic in further detail:
FACT SHEET: Supporting Those with Pre-Existing Mental Health Conditions
HOJA DE DATOS: Cómo abordar las necesidades de las personas con enfermedades
mentales graves en un desastre
FACT SHEET: How Families Can Help Children
HOJA DE DATOS: Restablecimiento de la sensación de bienestar en los niños después de un desastre
FACT SHEET: How Schools Can Help Students
HOJA DE DATOS: Ayuda para estudiantes después de un desastre
FACT SHEET: First Responders, Emergency Workers & Volunteers and Exposure to Human Remains
HOJA DE DATOS: Información para los proveedores de servicios de emergencia sobre las reacciones emocionales a los cuerpos humanos en muertes masivas
FACT SHEET: Maintaining the Well-Being of Healthcare Providers
Health risk and crisis communication is a critical behavioral health intervention following a community disaster. For those leading disaster management efforts, understanding what to say and what not to say, when and how to say it are important elements. Basic principles include being clear and succinct; stating what is known and unknown; indicating when you do not know the answer, committing to following up at a specific time and then doing so; avoid misleading or efforts to be overly reassuring as these erode trust. Effective communication following a disaster can reduce distress and enhance well-being for affected communities. The following resource(s) address this topic in further detail:
FACT SHEET: Risk and Crisis Communication for Leaders
HOJA DE DATOS: Comunicación del liderazgo: prever y responder a eventos estresantes
Workplace management following a disaster is an important part of restoring community functioning. In addition to financial support, the workplace often provides a sense of meaning and social connectedness. Though workplaces may be understaffed during disasters, overworking remaining personnel leads to diminished functioning and demoralization. Effective support for personnel in the workplace can enhance functioning for both the individuals and the organization. The following resource(s) address this topic in further detail:
FACT SHEET: Workplace and Organization Management After Disaster
HOJA DE DATOS: Manejo de una organización o lugar de trabajo después de una crisis
Exposure and contamination can occur when chemical, biological, radiological or nuclear (CBRN) facilities are damaged, as can occur during large-scale ecological disasters, like a hurricane. Events involving actual or potential CBRN exposure and contamination often produce significant fear throughout a community. The novelty, potential imperceptibility, and uncertainty around prevention or treatment heighten concerns. Requirements for isolation and/or quarantine often exacerbate overall concerns in community members. Somatic symptoms are common and healthcare organizations are advised to anticipate increased utilization of services in affected communities. Health risk and crisis communication (see below) can help decrease distress for individuals, which may subsequently reduce unnecessary consumption of healthcare and related services. The following resource(s) address this topic in further detail:
FACT SHEET: Psychological and Behavioral Issues Healthcare Providers Need to Know about CBRN Events
Additional detailed resources can further knowledge about effective preparedness, response, and recovery measures. Some are brief while others are more detailed. Working with more detailed resources, such as books or online training, during an actual disaster response is not typically feasible. These more in-depth treatments of key topics may be helpful as the initial response slows and serve to inform later response and recovery efforts as well as enhance preparedness for future events. Links to additional websites, fact sheets, articles, training, and books can be found below:
Additional free fact sheet resources at the Center for the Study of Traumatic Stress
National Hurricane Center: Hurricane Preparedness
Ready.gov Hurricane Preparedness
Disaster Psychiatry; What Psychiatrists Need to Know (T Ng)
Textbook of Disaster Psychiatry, 2nd Edition
Disaster Psychiatry (F Stoddard)
Resiliency in the Face of Disaster and Terrorism (J Napoli)
Integrating Emergency Management and Disaster Behavioral Health
Psychiatric Dimensions of Disaster Online Training (Disaster Psychiatry Canada)