ROCKY MOUNTAIN REGION DISASTER MENTAL HEALTH NEWSLETTER
Learning From The Past and Planning For The Future
MENTAL HEALTH MOMENT
August 10, 2001
"The most called-upon prerequisite of a friend is an accessible ear."
- Maya Angelou
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One-stop Health Information
http://www.kidshealth.org
Formatted like an online magazine, this site - a service of the Nemours Foundation - offers
health information for parents, children and teen-agers. Information on a variety of topics
is presented as articles in all three age group sections in familiar and age-appropriate
language. The site includes a wide range of physical and mental health information, such as
birth stories and information about children's developmental stages for parents and a tour
of the human body and health-learning games for kids and teens. Other sections include
questions about mental health for children and information on depression and suicide for
teens. Visitors can ask questions and all information is reviewed by a team of editors and
medical professionals.
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The Disaster Mental Health Institute will host its fourth annual conference August 19-21,
2001 at the Radisson Innin Rapid City, SD. The topic will be "International Psychosocial
Responses to Disaster and Humanitarian Emergencies". Information and registration materials
are available online at: http://usd.edu/dmhi/conf01/index.html
or by Phone: (800) 522-9684 or email: dmhi@usd.edu
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The World Association for Infant Mental Health is accepting papers to be presented at the
World Congress in amsterdam, July 16-19, 2002. Papers may include clinical issues, research
findings, or policy issues. Award nominations may be submitted for the Sonya Bemporad Award
(significant contributions to social and public policies affecting infants' mental health),
Serge Lebovici Award (contributions to international development of infant mental health),
Rene Spitz Award (lifetime achievement award for clinical research) and the New Investigator
Award (contributions by a new investigator). Deadline: Sept. 7. Contact: Hiram Fitzgerald,
Executive Director, WAIMH Central Office, Kellogg Center #27, Michigan State University, East
Lansing, MI 48823.
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The Red Cross Disaster Mental Health Services-I (DMHS-I) course will
be offered in Casper, WY on Friday-Saturday, September 14-15, 2001.
If you want to take this course as a Disaster Mental Health
Professional, please send an email for further details on how to
register to: larlion@callatherapist.com The enrollment is limited to 20
participants. APA has approved this course for 12 CEUs. Other
mental health professions have also approved it for continuing
education.
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CRITICAL INCIDENT STRESS WORKSHOP sponsored by The University of Wyoming Counseling Center
and The Rocky Mountain Region Disaster Mental Health Institute will be held in Laramie, WY
on November 16, 17, 2001. There will be two workshops. One will be in Basic Critical Incident
Stress Management (CISM) on 11/16-11/17 and will be a certification course taught by
International Critical Incident Stress Foundation (ICISF) certified trainers. The Advanced
Issues in Critical Incident Stress Debriefing will be taught by U.S. Navy Psychologist
CDR Bryce Lefever, PhD, ABPP. Enrollment in both workshops is limited. There is an early bird
registration period. If you wish to receive a printed brochure, please email:
larlion@callatherapist.com with your name and mailing address.
Online Brochure can be accessed at: https://www.angelfire.com/biz3/news/cismuw.html
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BATTLE AGAINST POLIO IN CENTRAL AFRICA CONTINUES
Some 16 million children under the age of five in Angola, Gabon,
Congo-Brazzaville and Democratic Republic of Congo were targeted
against polio in a five day campaign which was launched on July 5th.
Teams of Red Cross volunteers and personnel from Ministries of Health,
WHO, UNICEF and Rotary International took part in the first synchronized
national immunization days (NIDs) in Central Africa. According to WHO,
the region is one of the last bastions of the polio virus which causes a
highly infectious and crippling disease, principally affecting children under
the age of three.
One of the largest countries in Africa covering 2.34 million square
kilometres and a population of more than 50 million that is spread out, the
Democratic Republic of Congo represents a major challenge in the fight to
eradicate polio on the continent. For further information, go to:
http://www.ifrc.org/Docs/News/01/071801/
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HELPING DISASTER SURVIVORS AND THE FAMILY
Disasters hit children and families hard. It can be difficult for them (especially children) to
understand and accept that there are events in their lives that can't be controlled or predicted.
Worst of all, we adults can't "fix" a disaster, can't solve it, can't keep it from happening
again.
Help For Disaster Survivors Following Rescue
* Talk to the disaster survivor to reassure him/her and reorient him/her in time and space.
Tell him/her where you are, the date and time of day, and since when he/she has been missing.
This is particularly important if he/she is injured.
* See to his/her basic needs by keeping him/her warm and sheltered.
* Tell him/her what you are going to do before you act. It is unwise to surprise him/her when he/she
is very anxious.
* At the appropriate time, discuss rescue strategies and techniques with the person. By telling
him/her your plan of action, you will encourage him/her to cooperate in carrying out the plan.
* Acts of kindness such as protecting personal belongings are greatly appreciated.
* Encourage the person to express him/herself, to talk to you if they so wish.
* Be honest. Lies will only complicate matters. You do not have to go into detail, but be sure
you give accurate information. If you are not sure, it is preferable to say so to the person
and add that you will try to obtain the information as soon as possible.
Help For Families During The Rescue Period
* Keep family and friends of the disaster survivor informed of the measures being taken to
help him/her.
* Provide information which is exact and verifiable on a regular basis. If no official information
is provided, family and friends will seize upon any rumor going around.
* Place a single person in charge of communicating with the family. Family members will feel
confused and unsure if too many people are in communication with them.
* Acknowledge the fears, anger and anxiety of the disaster survivor's family and friends.
* Keep the media away from family members so that their stress is not intensified.
* Find safe, quiet and private places where family members can be together.
* Bring all family members together. If some members are a source of disturbance, ask that one
person represent the family so that he/she serves as the family spokesperson and liaison.
Support For Persons In Stressful Situations
When offering support to people experiencing a stressful situation, it is important to have a
particular attitude to be effective:
* Begin contact in a calm, courteous and reassuring manner.
* Be understanding, warm and comforting.
* If anger is expressed, do not take it personally. Keep calm.
* Give accurate information to those who ask for it.
* Let people express their thoughts and emotional reactions freely so that they can gradually
gain control of the emotions triggered by the disaster.
* Comfort and reassure people who are anxious or upset by staying close to them.
* Make friendly gestures.
* As soon as possible, remove from the scene of the disaster any people who are disturbed and
may disrupt the group.
* If you are worried by the intensity of a person's reactions, refer him/her to counseling
services.
Persons experiencing stressful situations need compassion, an empathetic listener and,
sometimes, silence.
Verbalization Session
A session to verbalize about the event is a simple but effective means to reduce stress
reactions manifested at the site of the disaster and those which persist, until they are
ultimately eliminated. This type of psychological-instructive intervention is provided in
the area where the disaster occurred. It has three specific goals:
* Help people express their feelings.
* Help them understand their emotional reactions and their behavior.
* Facilitate the return to their usual level of functioning.
The literature suggests that this type of intervention yields good results when provided shortly
following the disaster. Basic needs (shelter, clothing, food, etc.) must be met prior to holding
such sessions so that cognitive activity leaves space for feelings and emotions.
Losses And The Grieving Process
Any person involved in a disaster, whether it is caused by nature, human activity or
technological development, experiences losses. Losing a loved one and the ensuing grieving is
one occurrence. However, one can also experience loss of health, material possessions,
animals, work, social environment, or dreams.
When we grieve, the link with what we have lost is more important, more determining, than
the nature of the loss itself.
Losses Experienced By Disaster Survivors
Loved Ones
* Any significant person (child, parent, friend, neighbor, teacher, day-care worker,
priest/minister, nurse, convenience store owner).
Health
* Physical damage and its consequences (amputation, paralysis).
* Diminished physical capacities.
* Loss of illusion of mortality.
Material Possessions
* Possessions (house built by oneself, new car, bicycle, stuffed toy, plants).
* Goods with tangible links to the past (heirlooms, photo albums).
Animals
* Any animals that fetch an income (farm animals and animals that are bred).
* Any pet (dog, cat, bird, hamster).
Work
* Loss of job due to incapacitation.
* Loss of business concern.
* Loss of workplace.
Social Environment
* Loss of one's living space and social network.
Dreams
* Impression of starting over.
* Questioning future accomplishments.
It is normal to feel shaken by a major loss and to suffer.
Grieving Process
Denial, anger, bargaining, depression and acceptance are all part of the grieving process.
Denial
When we receive news of a tragedy, our first reaction is to deny it: "No! It
can't be! No! That's impossible!" This refusal to believe is the beginning of awareness of
the terrible occurrence and serves to protect us from the violent impact of the shock.
Anger
Anger is a reaction to helplessness when something unfair has happened to us.
This anger is inevitable and must be accepted. It helps the person express his/her
helplessness. We should not be surprised, then, when survivors vent their anger on people
around them (government and local officials, rescue workers, insurance companies, family,
friends, etc.). This is why it is necessary to talk and dissipate the anger in verbalization
sessions.
Bargaining
The person accepts the loss he/she may experience or has experienced due
to the disaster or tragedy but seeks to gain time, financial or some other kind of
compensation by bargaining with God, with the authorities, with the insurance companies,
etc. When the person bargains with God, even if he/she has never talked to God before, he/she
promises to be "good" or to do such and such in exchange for what he/she wants.
Depression
Acceptance of grieving occurs in the stage of depression. At the onset of grieving and for a
long time after, the dead person is always present. We have lost him/her in reality and we
admit it, we try to accept it. However inside, our ties grow stronger with him/her since
we do not have him/her in reality anymore. This process of intense reappropriation serves
to lessen our sadness. We are consoled by the temporary survival of the loved one inside
us. At the same time, it allows us to let go, little by little. The steps of letting go
gradually become more spaced out, the pain lessens, as does the sadness. The person we have
lost seems less present. He/she tends to become less important. The end of grieving draws near.
Acceptance
This stage is neither happy nor unhappy. Grieving leaves a scar like any other injury, but we
become free to live, to love and to create again. We find ourselves looking toward the future,
making plans. The grieving process is over.
These five stages are a useful guide to understanding the different phases a disaster survivor
or a grieving person goes through. People do not necessarily go through all the stages nor do
so in the same order or at the same place. If the model is applied in a flexible and intuitive
manner, it is a useful tool to understand disaster survivors' behavior.
Initial contact with a disaster survivor is a determining factor in the psychosocial impact
of the event on that person. For this reason, it is important to be familiar with the
characteristics and reactions of disaster survivors in order to act appropriately with them
from the start.
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REFERENCES
Kubler-Ross, E. (1997). On detah and dying Reprint.
Mangelsdorff, A.D. (1985). Lessons learned and forgotten: The need for prevention and mental
health interventions disaster preparedness. Journal of Community Psychology, Vol 13, 239-257.
Mitchell, J. (1982). The psychological impact of the Air Florida 90 disaster on fire-rescue,
paramedic and police personnel. In Cowlery, R.A. Mass casualties: A lesson learned approach,
accidents, civil unrest, natural disasters, terrorism. Washington, D.C. Dept. of Transportation
(DOT HS 806 302) Government Printing Office.
Mitchell, J. & Everly, G. (1993). Critical incident stress debriefing: A operations manual for
the prevention of traumatic stress among emergency services and disaster workers. Chevron
Publishing Corporation, Ellicott City, MD.
Mitchell, J. & Bray, G. (1990). Emergency services stress: Guideline for preserving the health
and careers of emergency services personnel. Brady Publishing, Englewood Cliffs, NJ.
Snelgrove, T. (1992). Critical incident stress. Easton Snelgrove, North-Vancouver.
Toubiana, Y. et al. (1986). A therapeutic community in a favored Army field hospital: Treatment,
education and expectancy in combat stress reaction. In N.A. Milgram. Stress and coping in
time of war: Generalizations from the Israeli experience. New York: Brunner/Mazel.
Williams, C.L. et al. (1988). Primary prevention in aircraft disasters. American Psychologist,
Vol. 43, 12, 730-739.
To search for books on disasters and disaster mental health topics and purchase them online,
go to the following url:
https://www.angelfire.com/biz/odochartaigh/searchbooks.html
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Contact your local Mental Health Center or
check the yellow pages for counselors, psychologists,
therapists, and other Mental health Professionals in
your area for further information.
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George W. Doherty
O'Dochartaigh Associates
Box 786
Laramie, WY 82073-0786
MENTAL HEALTH MOMENT Online: https://www.angelfire.com/biz3/news
