DISASTER AND MENTAL

HEALTH REVIEWER
PSYCHOLOGICAL FIRST AID (PFA)
Psychological First Aid (PFA) has been recommended by many international and national expert groups,
including the Inter-Agency Standing Committee (IASC).

In 2011, WHO released the Psychological First Aid

Humane, supportive response to a fellow human being who is suffering and who may need support.

- The IASC (WHO, 2011)

PFA involves the following themes

- Providing practical care and support which does not intrude;

- Assessing needs and concerns;
- Helping people to address basic needs;
- Listening to people but not pressuring them to talk;
- Comforting people and helping them to feel calm;
- Helping people get access to information, services, and social supports; and
- Protecting people from further harm.

PFA involves factors that seem to be most helpful to people’s long-term recovery. These include:

- feeling safe, connected to others, calm and hopeful;

- Having access to social, physical, and emotional support; and
- Feeling able to help themselves, as individuals and communities.

PFA is NOT:

- something that only professionals can do;

- professional counseling;
- psychological debriefing;
- asking someone to analyze what happened to them onto put time and events in order; and
- pressuring people to tell you about their feelings and reactions to an event.

The things to remember when providing PFA are to:

- Respect safety, dignity, and rights;

- Adapt what you do to take account of the person’s culture
- Be aware of other emergency response measures; and
- Look after yourself.
Below are the basic action principles of PFA and its components:

Look Check for safety.

Check for people with obvious urgent basic

needs.

Check for people with serious distress reactions

Listen Approach people who may need support

Ask about people’s needs and concerns.

Listen to people, and help them feel calm.

Link Help people address basic needs and access

services.

Help people cope with problems.

Give information.

Connect people with loved ones and social

support.
Do's and Don'ts when providing PFA

- It Is important that DMH workers are sensitive to ethical issues that could be influenced by
gender, age, customs, sexual, orientation, religion, and so on
- DMH workers have an ethical duty to respect cultural differences.

The world Health Organization (2011) suggests the following questions before conducting PFA.
Dress Do I need to dress a certain way to be
respectful?

Will the affected people be in need of certain

clothing items to keep their dignity and
customs?

Language
What is the customary way of greeting people
in this culture?

What language do they speak?

Gender, Age and, Power Should affected women only be approached

by women helpers?

Who may I approach? (In other words, the

head of the family or community?)

Touching and Behavior What are the usual customs around touching
people?

Is it alright to hold someone’s hand or touch

their shoulder?

Are there special things to consider in terms of

behavior around the elderly, children, women,
or others?

Beliefs and Religion Beliefs and Religion

Who are the different ethnic and religious

group among the affected people?

What beliefs or practices are important to the

affected people?

How might they understand or explain what

has happened?
With respect to communicating with someone in distress, below are some suggestions for dos and
don’ts on what to say and do:

REMOTE PSYCHOLOGICAL FIRST AID

LOOK refers to how to assess The current situation

Who seeks support what the risks are

The needs of the affected

Expected emotional reactions

LISTEN refers to how to begin the conversation

Introduce the helper pay attention

and listen actively

accept feelings

calm someone in distress

ask about needs and concerns

help find solutions to needs and

problems

accessing information

connecting with loved ones and problems

LINK refers to how to assist with social support

tackling practical problems

accessing services and other help

- Proper communications a critical component of remote psychological first aid. Regardless of the
communication method used, DMH workers must be clear, calm, and concise on how they
communicate with the clients.
 - To convey empathy, the International Federation of Red Cross (2020) suggests that DMH workers
incorporate the following phrases when providing remote psychological first aid:

Understand your concerns, and most people do think a lot about the situation…

- It is very natural to be sad, angry, upset or…

- I hear what you are saying about having to..”
- “I fully understand that you are feeling this way…”
- “in this situation, your reaction is quite natural…
- “Maybe we can discuss possible solutions…
- “What we can offer is…”
- “I am concerned about you and would like to suggest referring you to someone who can help
you.

Do’s and Don’ts when providing remote Psychological First Aid

Responsibilities During Disaster

Responsibilities of DMH Workers during Disaster

1. Registration Tasks
- It is the responsibility of all DMH workers to complete registration tasks before deployment.
2. Orientation
- The DMH supervisor ensures that the DMH worker or volunteer is property oriented before
deployment to work assignment.
3. Job Assignments
- The DMH worker receive an assignment from a DMH supervisor or a site manager (e.g., shelter
manager)
- The DMH worker may be asked for some information prior to receiving an assignment, such as
human resources system position, disaster training, disaster experience, leadership and
communication skills and experience, employment experience, worker interests and worker
promotion and development plans.
4. Gathering Needed Information
- Before the DMH worker can begin his or her work assignment
- he or she should understand the specific job expectations and chain of command at his or her
assigned job site.

The following information’s are critical for disaster relief assignment:

- Name and contact information of immediate supervisor Name and contact information of DMH
leader
- Specific assignment address and directions
- Name and contact information for the administrative supervisor or manager of a service delivery
site Hours of operation for the site
5. Acquiring Needed Supplies
- Before traveling to his/her assigned service site, the DMH worker should obtain the supplies
necessary to perform his/her function.
Materials and Supplies Situation for Use

A cell phone will be assigned to each team and not

Cellphone to individual workers.

Service Vehicle When available and necessary for travel to service

delivery sites, a service vehicle may be made
available for the DMH activity. A service vehicle may
be shared and can be reassigned to other activities
at any time.

PsyStart Aggregated Worksheet and PsyStart These are used by field staff and supervisors to
Supervisor Daily Summary aggregate client risk factors and record contacts
with clients and workers.

Client Consent to share information This form is used for the informed consent process
in working with clients and staff.

Educational Materials DMH print materials should be made available to

assist both clients and workers in coping with
disasters.

Basic Office Supplies Office supplies usually include paper and pens

Maps and Directions Maps and directions to service delivery sites should
be made available to help DMH workers navigate to
and from work sites.

6. Using PsySTART to Report Client Contacts

- A DMH workers is expected to use the PsySTART aggregated worksheet to record client risk
factors and contacts with clients and workers.
7. Receiving a Work Performance Evaluation
- Performance evaluation is used to gauge the work performance of the DMH worker.
8. Out-processing from the Relief Operation
- This process occurs upon completion of the job assignment. Out-processing is necessary for
accountability reasons such as returning of service vehicle and cell phone.
 - Making travel arrangements for returning home and arranging for a performance review are
important parts of out-processing.
- Assessment are also conducted to determine if DMH workers have been negatively affected by
their deployment work and to what extent. The assessments could be used as a basis for mental
health and psychosocial interventions for DMH workers if needed.

Responsibilities of DMH Supervisor

- DMH Supervisor Tasks. The DMH supervisor has the following responsibilities with regard to
assigned workers

- Ensuring the quality of consent care.

- Implementing the service delivery plan.
- Mitigating worker risks of compassion fatigue or secondary traumatization.
- Providing useful support, feedback and direction
- Clearly explaining expectations for job performance.
- Providing technical supervision related to DMH interventions
- Answering questions about DMH policies and procedures.
- Ensuring that each worker receives a day off within every seven days of work.
- Ensuring the safety of each worker during a disaster operation.
- Providing updates on service delivery plans

Personally thanking DMH workers for their service.

Adjusting Worker’s Assignments

- As the service delivery plan changes. DMH worker assignments many change
- Flexibility is considered a critical skill for all DMH staff.
Arranging Days Off of Workers
- To help DMH workers balance life and work, supervisors should provide days off, in the form of
rest periods and vacations.
Reporting to DMH Leader
- It is the responsibility of the supervisor to report to the DMH leader about the teams’ success
and challenges
- Important information includes client and worker issues and concerns.
Regular Communication with Staff
- Supervisors should hold regular meetings with workers to provide positive feedback
- Updates on disaster operations and issues should be discussed during these meetings
Recordkeeping using successes
- It is the responsibility of the supervisor to report to the DMH leader about the teams’ successes
and challenges.
 Using PsySTART to Enhance Service Delivery
- The responsibility of the supervisor to complete and submit the PsySTART supervisor daily
summary shows the total number of client risk factors and client and worker contacts recorded
by workers under their supervision

Several key pieces of information are:

- Number of DMH contacts with workers and clients:

- Number and type of PsySTART risk factors;
- Sites with clients that have greater numbers of PsySTART risk factors; and
- Workers who have been working with clients with greater numbers of PsySTART risk factors.

8. Conducting Performance Evaluations

- It is the responsibility of the supervisors to complete the performance evaluation for workers
assigned to them.
- It is their responsibility to review job assignment expectations and performance evaluations
criteria with workers prior to sending them to their job site. They are also expected to monitor
job performance and provide feedback to all assigned workers.

Responsibilities of DMH Leader

The DMH leader, otherwise known as disaster site manager, is the person responsibilities for planning,
coordinating and leading immediate DMH response efforts.

1. Organizing DMH Service Delivery

- The DMH leader organizes the following activities during the initial stage of disaster response.
a. Establishing a Leadership Team

Examples of some common DMH leadership positions and their duties

b. Mentoring DMH Workers

Mentoring is a vital role of any DMH leader. He/she guides and helps the DMH workers
to improve their knowledge, skills, and performance to progress in their own growth and
careers.
c. Planning for Service Delivery
When a disaster operation scales up from a local to a national level, it is important to
integrate all existing DMH efforts into Service delivery efforts.

- The DMH plan is then integrated into the overall relief operation plan to ensure that the
necessary. Logistics, transportation, supplies, technology, and manpower resources are available
to support the service plan and sites.
 d. Disaster Operation Structure
During disaster operation, it is the responsibility of DMH leader to provide specific
instructions and closely supervise the performance of the leadership team, along with
health services, client casework, recovery planning and assistance, and mass care (i.e.,
sheltering, feeding and bulk distribution).
e. Headquarters Space for DMH
The major purpose of headquarters is to provide a workplace primarily for DMH
administrative and managerial work

2. Staffing DMH. During disaster operations

- DMH workers and volunteers are often more readily available that DMH professionals.
Beforehand, it is important to communicate and gather information regarding where to gather
workforce and to whom the people will report when an emergency situation arises.

3. Supporting DMH Services during a Disaster

- The DMH leader is responsible for obtaining sufficient material for DMH response. The DMH
leader needs to review what supplies may be needed for DMH workers to perform their roles
and responsibility effectively.

4. Partnering with Internal and External Group

- Collaborative relationships among DMH services are a critical component to the success of any
disaster response. It is the responsibility of DMH leader to maintain good working partnerships
with other leaders in a disaster operation.

Scaling Down the DMH Activity

- The DMH leader recognizes the need for handling over activities from the relief operation to
local community DMH workers and volunteers. Essentially, the DMH leader needs to prepare and
make an inventory of the capabilities of the DMH workers and volunteers as well as the
resources available to them before transferring or assigning roles and responsibilities.