Dr Jozelle Miller
October 11, 2016
Psychological first aid

The theme of this year’s World Mental Health Day covers the concept of “psychological first aid”. Psychological first aid covers both psychological and social support. Just like general health care never consists of physical first aid alone, similarly no mental health care system should consist of psychological first aid alone. Indeed, the investment in psychological first aid is part of a longer-term effort to ensure that anyone in acute distress due to a crisis is able to receive basic support, and that those who need more than psychological first aid will receive additional advanced support from health, mental health and social services.{{more}} Psychological first aid is an evidence-informed approach for assisting children, adolescents, adults, and families in the aftermath of disaster and trauma.

What is psychological first aid?

o Providing practical care and support, which does not intrude;

o Assessing needs and concerns;

o Helping people to address basic needs (for example, food and water, information);

o Listening to people, but not pressuring them to talk;

o Comforting people and helping them to feel calm;

o Helping people connect to information, services and social supports;

o Protecting people from further harm.

It is also important to understand what psychological first aid is not:

o It is not something that only professionals can do.

o It is not professional counselling.

o It is not “psychological debriefing,” in that psychological first aid does not necessarily involve a detailed discussion of the event that caused the distress.

o It is not asking someone to analyze what happened to them or to put time and events in order.

o Although psychological first aid involves being available to listen to people’s stories, it is not about pressuring people to tell you their feelings and reactions to an event.

When is psychological first aid provided?

Although people may need access to help and support for a long time after an event, PFA is aimed at helping people who have been very recently affected by a crisis event. You can provide PFA when you first have contact with very distressed people. This is usually during or immediately after an event. However, it may sometimes be days or weeks after, depending on how long the event lasted and how severe it was.

How to help someone responsibly?

Helping responsibly involves four main points:

¢ Respect safety, dignity and rights.

¢ Adapt what you do to take account of the person’s culture.

¢ Be aware of other emergency response measures.

¢ Look after yourself.

Respect safety, dignity and rights:

When you take on the responsibility to help in situations where people have been affected by a distressing event, it is important to act in ways that respect the safety, dignity and rights of the people you are helping.

Respect people’s…

Safety » Avoid putting people at further risk of harm as a result of your actions.

» Make sure, to the best of your ability, that the adults and children you help are safe and protect them from physical or psychological harm.

Dignity » Treat people with respect and according to their cultural and social norms.

Rights » Make sure people can access help fairly and without discrimination.

» Help people to claim their rights and access available support

» Act only in the best interest of any person you encounter

Adapt what you do to take account of the person’s culture.

Whenever there is a crisis event, there are often people of various cultural backgrounds among the affected population, including minorities or others who may be marginalized. Culture determines how we relate to people, and what is all right and not all right to say and do. For example, in some cultures, it is not customary for a person to share feelings with someone outside their family. Or it may only be appropriate for women to speak with other women, or perhaps certain ways of dressing or covering oneself are very important. You may find yourself working with people of backgrounds different from your own. As a helper, it is important to be aware of your own cultural background and beliefs, so you can set aside your own biases. Offer help in ways that are most appropriate and comfortable to the people you are supporting. Each crisis situation is unique.

Be aware of other emergency response measures

Whenever possible in responding to a crisis situation:

¢ follow the direction of relevant authorities managing the crisis;

¢ learn what emergency responses are being organized and what resources are available to help people, if any;

¢ don’t get in the way of search-and-rescue or emergency medical personnel; and

¢ know your role and the limits of your role.

Look after yourself

Helping responsibly also means taking care of your own health and well-being. As a helper, you may be affected by what you experience in a crisis situation, or you or your family may be directly affected by the event. It is important to pay extra attention to your own well-being and be sure that you are physically and emotionally able to help others. Take care of yourself so that you can best care for others. If working in a team, be aware of the well-being of your fellow helpers as well.

(Adopted from WHO, 2011)