Catastrophic natural disasters, such as Hurricane Florence, 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. Below is brief information and online resources regarding the topics listed below. Click on the title will take you to the beginning of that section and applicable resources.
Grief: Understanding and Managing
Evacuation Centers and Behavioral Health Considerations
Exposure and Contamination Fears
Common Responses to Disaster
Vulnerable Populations
Health Risk and Crisis Communication
Workplace and Organization Support
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 those affected by gently 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
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.
Exposure and contamination can occur when chemical, biological, radiological or nuclear (CBRN) facilities are damaged, as can occur during natural disasters. 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 topics in further detail:
FACT SHEET: Psychological and Behavioral Issues Healthcare Providers Need to Know about CBRN Events
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: Healthcare Providers Helping Patients with Psychosocial Concerns
Special populations may be more vulnerable than others and warrant unique considerations. Such populations include: children, women, cognitively and mobility impaired, pre-existing mental health conditions, first responders and public health emergency workers (including volunteers). Focused interventions can more quickly and effectively address the unique needs of these populations. The following resource(s) address this topic in further detail:
FACT SHEET: Supporting Those with Pre-Existing Mental Health Conditions
FACT SHEET: How Families Can Help Children
FACT SHEET: How Schools Can Help Students
FACT SHEET: First Responders, Emergency Workers & Volunteers and Exposure to Human Remains
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 lying 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
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. 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
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)
Behavioral Health Emergency Response Field Guide (Oregon Dept of Human Services)