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Mental Health Preparedness. Agenda. Review how people react psychologically to a crisis Discuss relationship of mental health in public health emergency Discuss compassion fatigue related to public health responders. What Is Meant By “Crisis?”. Some type of turning point

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  • Review how people react psychologically to a crisis
  • Discuss relationship of mental health in public health emergency
  • Discuss compassion fatigue related to public health responders
what is meant by crisis
What Is Meant By “Crisis?”
  • Some type of turning point
  • An emotionally significant event or radical change in one’s life
  • An unstable or crucial time when decisive change is impending
what is a crisis
What Is A Crisis?
  • A “crisis” is a situation in which a person’s ability to cope is exceeded.
    • “Nothing will ever be the same.”
    • Triggering event within the last 24 – 48 hours.
    • Response emotionally driven (not rational).
    • Situation perceived as either physically or psychologically threatening.
    • If the subject feels he is in crisis he is.
characteristics of people in crisis
Characteristics Of People In Crisis
  • Thinking is constricted, emotions are expansive.
  • Lowered attention spans.
  • Inability to discern between small and large problems.
  • Often do not see way out of the situation.
  • Try out different behaviors to reduce stress.
during a crisis what do people feel
During A Crisis What Do People Feel?
  • Wide range of emotions
    • Fear
    • Anxiety
    • Anger
    • Hopelessness
    • Helplessness
what about panic
What About Panic?
  • Vast majority of people
    • Do not panic in times of crisis
    • Do not act unreasonably
    • Do not engage in extreme behavior
what do we know about stress reactions
What Do We Know About Stress Reactions?
  • Impacted by loss of control
  • Impacted by unpredictability
  • Can lead to experience/reaction called “learned helplessness”
stress is evaluated by
Stress Is Evaluated By:
  • Perceived danger/threat value
    • Irrelevant/harmless?
    • Threat/challenge?
  • Coping mechanisms available
    • Cognitive
    • Behavior
    • Neurophysiological
    • Emotional
why do people respond differently to stress
Why Do People Respond Differently to Stress?
  • Family/Genetic Influences
    • History of physical/psychological conditions
    • Personality and temperament
    • Cultural background
    • Gender
why do people respond differently to stress11
Why Do People Respond Differently to Stress?
  • Past Experiences – “wisdom”
    • Learned coping patterns
    • Previous exposure to similar stress
    • Lifestyle patterns
why do people respond differently to stress12
Why Do People Respond Differently to Stress?
  • Existing vulnerabilities/strengths
    • Health
    • Motivation
    • Support at work/home
    • Relationships with spouse/friends
    • Financial situation
    • Other’s health (i.e. child, parent)
    • Other?
why do people respond differently to stress13
Why Do People Respond Differently to Stress?
  • Existing Beliefs and Skills
    • Spiritual or religious influence
    • Open communication style
    • Moral Values
    • Accepts help (from pastor/counselor/other)
    • Self-Concept
troublesome behaviors in a crisis
Troublesome Behaviors In A Crisis
  • What you can count on:
    • Those who try to bypass official channels
    • Vicarious rehearsal
    • MUPS: Multiple Unexplained Physical Symptoms
    • Stigmatization
mental health and emergencies disasters
Mental Health And Emergencies/Disasters
  • Responding to emotional and psychological impact of event is critical part of response strategy
  • General agreement that all people involved in event are impacted some way
mental health and emergencies disasters16
Mental Health And Emergencies/Disasters
  • Emotional reactions to the event may vary person to person
  • Some people may exhibit symptoms of mental illness immediately after event but few develop long-term mental health problems
mental health and emergencies disasters17
Mental Health And Emergencies/Disasters
  • However, recent experience with catastrophic events have challenged this thinking
    • Large scale loss of life, property and disruption in community life reveals more serious patterns of psychological impact.
    • Particularly true when event is intentionally caused by human action
directed mental health interventions
Directed Mental Health Interventions
  • Seriously injured victims and bereaved family members
  • Victims with high exposure to trauma, victims evacuated from disaster area
priority setting in crisis counseling
Priority Setting In Crisis Counseling

C. Bereaved extended family members, emergency workers,

medical officers’ staff,

service providers providing death notification or working with bereaved families

priority setting in crisis counseling20
Priority Setting In Crisis Counseling

D. People who lost homes,



mental health providers,


emergency health care providers,

school personnel working with survivors, media personnel

priority setting in crisis counseling21
Priority Setting In Crisis Counseling

E. Government officials,

groups that identify with target victims group,

businesses with financial impact

F. Community at large

at risk persons
At-Risk Persons
  • Those with preexisting mental health problems
  • Children
  • Those displaced by event particularly if they have little support
  • Those with preexisting medical problems
  • Those with disabilities
preparedness developing resiliency
Preparedness: Developing Resiliency
  • Resiliency
    • The process of adapting well in the face of adversity, trauma, tragedy, threats, or even significant sources of stress (e.g. family problems, serious health problems, financial stressors)
    • “Bouncing Back” from some type of adversity
preparedness developing resiliency24
Preparedness: Developing Resiliency
  • Research has shown that resiliency is ordinary, not extraordinary; people demonstrate resiliency each day
  • Being resilient doesn’t mean that a person doesn’t experience difficulty or distress
  • It involves thoughts, behaviors, and actions that anyone can learn and develop
factors associated with resiliency
Factors Associated With Resiliency
  • Having caring and supportive relationships
  • Relationships that create love and trust
  • Capacity to make realistic plans and take action
  • A positive view of yourself
  • Skills in communication and problem solving
  • Capacity to manage strong feelings
steps to build resiliency
Steps To Build Resiliency
  • Make connections
  • Avoid seeing crises as insurmountable
  • Accept that change is part of life
  • Take decisive action and move toward life goals
  • Look for opportunities of self-discovery
  • Keep things in perspective
steps to build resiliency27
Steps To Build Resiliency
  • Take care of yourself
  • Learn from your past experiences and make positive changes
  • Stay flexible
  • Let yourself experience strong emotions
  • Learn to rely on others and let others rely on you
examples of preparedness activities
Examples Of Preparedness Activities
  • Educational campaign
  • Establish mental health response network with local providers
  • Target at-risk populations
    • Assist in development of safety plan
    • Assist in development of emergency kit
    • Assign liaisons to identify specific concerns in your community
secondary trauma
Secondary Trauma
  • Defined as the emotional residue of exposure to working with the suffering, particularly those suffering from the consequences of traumatic events
secondary trauma30
Secondary Trauma
  • Professionals who listen to the stories of fear, pain, and suffering are especially vulnerable to secondary traumatization

Emergency care workers, police officers, mental health professionals, medical professionals, clergy, and human services workers are vulnerable to secondary trauma

secondary trauma32
Is a state of tension and preoccupation with the individual or cumulative trauma of clients

Can be thought of as secondary post-traumatic stress

avoidance/numbing of reminders of the event

persistent arousal

Secondary trauma is not “burnout”

Secondary Trauma
consequences of secondary trauma
Consequences of Secondary Trauma
  • Job performance declines
  • Mistakes increase
  • Morale drops
  • Personal relationships are affected
  • Deterioration of home lives
  • Personality deterioration
  • Decline in general health
critical incident stress
Critical Incident Stress
  • A “critical incident” is any event that has a significant amount of emotional reactions which have the potential to interfere with their ability to function either at the scene or at a later time
key ideas
Key Ideas
  • Normal reactions to an abnormal event
  • Reactions include cognitive, behavioral, psychological
examples of critical incidents
Examples of Critical Incidents
  • Line of duty death
  • Serious line of duty injury
  • Suicide of co-worker
  • Disasters
  • Law enforcement shooting
cis interventions
CIS Interventions
  • Demobilizations
  • Defusings
  • Debriefings
  • One-on-One meetings
self care and stress management
Self-care and Stress Management

Prior to assignment

  • Personal Preparedness
  • Team and Organizational Preparedness
  • Safety of Family Members
  • Social and Organizational Support
self care and stress management39
Self Care and Stress Management

During an Assignment

  • Work with a partner
  • Limit length of shifts
  • Use stress management techniques
  • Keep a notebook
  • Defuse regularly
  • Call home regularly
  • Closures
self care and stress management40
Self-Care and Stress Management

Following an Assignment

  • Returning home
    • Express gratitude to those who have covered your normal responsibilities
    • Expect an adjustment period of a week or two
      • Mild depression
      • Physical let-down
    • Expect a lot of questions from others
  • Mental health preparedness/response must be part of all emergency management plans
  • Individuals respond differently to events
  • Promote resiliency to minimize impact of life changing events
  • Taking care of oneself is just as important as caring for victims