Mental health interventions for people involved in disasters: what not to do

The development of the UK's military policy includes the potential for military organisations to deploy in support of humanitarian aid operations. This paper offers an overview of the risks to people's mental health of their exposure to emergencies, major incidents, disasters, terrorism, displacement, postconflict environments in which humanitarian aid is delivered, and deployments to conflict zones. It summarises the psychosocial approach recommended by many contemporary researchers and practitioners. It differentiates the extremely common experience of distress from the mental disorders that people who are affected may develop and introduces the construct of psychosocial resilience. The authors recognise the importance of trajectories of response in separating people who are distressed and require psychosocial care from those who require mental healthcare. Finally, this paper summarises a strategic approach to designing, planning and providing psychosocial and mental healthcare, provides a model of care and outlines the principles for early psychosocial interventions that do not require training in mental healthcare to deliver them.

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“…Core principles: Evidence-informed and values-based principles inform planning, designing and delivering the services required 2 5 23…”

Section: A Strategic Frameworkmentioning

confidence: 99%

“…Certain interventions, such as single-session individual psychological debriefing, however should not be provided 23 26…”

Section: Implementation: Principles For Interveningmentioning

confidence: 99%

Principles for designing and delivering psychosocial and mental healthcare

Williams

Kemp

2018

BMJ Mil Health

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“…Recently, however, criticisms have been raised about the iatrogenic harms of screening. For example, Greenberg and Wessely (2017) warn against using screenings in the wake of natural disasters citing a distinct lack of evidence for their effectiveness. They also highlight the risk of the nocebo effect, (i.e., the iatrogenic effect of being labeled with a disorder; Thombs et al, 2012); “[screening] may cause considerable distress if people are incorrectly labelled as having a health problem when in fact they do not” (Greenberg & Wessely, 2017, p. 249).…”

Section: Public Health Good or Psychiatric Risk Profiling? Routine Dementioning

confidence: 99%

The poison in the cure: Neoliberalism and contemporary movements in mental health

Cosgrove

Karter

2018

Theory & Psychology

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Neoliberalism reaches beyond economic policy and material conditions and reformulates the subject and psychological life and therefore is best understood as an attitude toward science, knowledge making, and subjectivity. In a neoliberal climate, markets give us truth and individuals are encouraged to be self-concerned agents rather than members of a polis. Thus, at the very moment that neoliberal policies transfer responsibility to individuals, there is a simultaneous increase in surveillance in order to reinstall certain patterns of human behavior. Mental health research and practice risk becoming commodities dedicated to enforcing this logic. In this article, we explore medical neoliberalism in some of its recent manifestations: global mental health interventions, routine depression screening, and the monitoring of social media to assess mental health. We also consider the ways in which popular reforms in the mental health field are founded on neoliberal assumptions and may be abetting these ideological aims.

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“…Previously favored interventions involving discussion of trauma, such as the American Red Cross Psychological Debriefing, have declined in use because research has suggested that such discussions contributed to increased distress (Agorastos et al, 2011; Greenberg & Wessely, 2017). Conversely, models such as the Trauma Risk Management program (TRiM) designed for use by the U.S. military and emergency service providers have been endorsed because they do not require clients to recall trauma in detail (Alexander & Klein, 2009).…”

Section: Treatment Of Responder Trauma: a Vignettementioning

confidence: 99%

First responder mental healthcare: Evidence-based prevention, postvention, and treatment.

Lanza

Roysircar

Rodgers

2018

Professional Psychology: Research and Practice

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Recent national tragedies of hurricanes, mass shootings, gun violence in schools, wild fires, and mudslides have drawn our attention to the trauma of affected individuals and schoolchildren, but less to the stressors of first responders. While commonly regaled as "heroes," responders face a scarcity of systemic and tailored mental health support. First responders are susceptible to witnessing a wide array of traumatic events, often in their own communities, that contribute to their stress (Benedek, Fullerton, & Ursano, 2007;Castellano & Plionis, 2006;Kleim & Westphal, 2011). This article critiques systemic resources for first responders' mental healthcare; addresses their personal-social characteristics as well as workplace cultural stigma about help-seeking attitudes; and includes a needs assessment of first responders' resilience that was conducted by one of the authors (Roysircar, 2008a). Using this evidencebased practice knowledge about first responders, the authors present three hypothetical vignettes that highlight the different challenges that commonly effect first responders and recommend interventions. The authors advocate for access to specialized resources that enhance first responders' preparedness for a potentially traumatic event (i.e., prevention education); increase their coping skills and social connections after an event (i.e., postvention service); and provide ongoing mental healthcare (i.e., treatment) that is culturally tailored to first responders' unique needs arising from their work context and identity. Public Significance StatementThe information included may be beneficial to mental health providers who are considering acting as first responders, treating first responders, and/or engaging in healthcare access and reform.

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Mental health interventions for people involved in disasters: what not to do

Cited by 11 publications

References 10 publications

Principles for designing and delivering psychosocial and mental healthcare

Principles for designing and delivering psychosocial and mental healthcare

The poison in the cure: Neoliberalism and contemporary movements in mental health

First responder mental healthcare: Evidence-based prevention, postvention, and treatment.

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