Disaster - community level

Question 1

Steps / consideratoin

Answer 1

Risk

Basic needs

PTSD
Diathesis stress

How to spread recourses

General population action plan
Psychoeducatoin
relaxation
Oppertunities to give back
Research

Higher risk
EQ inspo
Group therapy
Parental sessions
Family support
One on one/telehealth

Healthcare worker self care
Hope

Question 2

Risk
consideration
rational
ethics

Answer 2

• High risk during pandemic/EQ (YL)
• Higher abuse during the pandemic (shakti)
• Higher stress/unemployment/financial/loss/grief/disruption to life
• Children – ethically have to prioritise (COE 1.5,2.5)
• Helplines, access to reporting risk, emergency line workers

Question 3

Basic needs met

Answer 3

• Know that basic nutrition, shelter, warmth, exercise, and water are necessary for mental health (holistic approach)
• Food grants, handout packets, money grants, transport etc

Question 4

Spread recourses COE

Answer 4

Will be people predisposed to greater psychological problems (PTSD/mood/ etc) will need to target those + Will also need to target nation as a whole = need to spread recourses in efficient way = ethically need to look after the wellbeing of ALL people (COE 4)

Question 5

General pop marketing

Answer 5

Parents/schools/churches/ mail boxes – Radio/TV (breathe with cartoon)

Question 6

General pop psychoeducation

Answer 6

Psychoeducation - During the Christchurch earthquake, they completed household leaflet drops
- importance of maintaining routines and trying to get things ‘back to normal’
- “having a plan” for children so they can have some kind of control in the unknown (i.e., survival plan, where to meet, keeping safe)
- what to expect at certain developmental ages and stages: what is a typical response to a natural disaster and signs that the family might need more specialist help. E.g., Sleep behaviour, Anxiety generalised to weather and noise

Question 7

General pop relaxatoin

Answer 7

Relaxation/soothing/calming techniques
- Belly breathing, safe place imagery

Question 8

General pop oppertunities to give back

Answer 8

Opportunities to give back – studies show that kind acts of giving back make people feel better – don’t have internal attention on themselves (decreases rumination), feel a sense of control, feel sense of purpose, feel a sense of togetherness- not lonely or isolated
- This is also a sufficient use of recourses

Question 9

General pop rational thorugh study

Answer 9

Evidence: Research by Freeman asked young people what they found most helpful and they said;
- Psychoeducation – ‘understanding what is happening to me’ – need to adapt explanation to age, stage, situation;
- Soothing/calming strategies-relaxation, diaphragmatic breathing, safe place imagery.
- Exposure – imaginal/in-vivo – return to the scene
- Re-establishing usual routines – doing what they used to do.

Question 10

For higher risk/more difficulty - inspo from EQ

Answer 10

• Community interventions should be prioritised in the most hard-hit regions
• Christchurch earthquakes showed that psychological adjustment was negatively impacted in the areas where the earthquake had the most impact.

Question 11

Higher risk group therpay

Answer 11

Group therapy
- More effiecent
- normalise, encourage, and build support network
- In Times of stress people unit together

Question 12

Higher risk parental sessions/ family support

Answer 12

Parental sessions
- Understanding and managing strategies for stress, coping and resilience
- Education about emotions
- Normalising emotional reactions, increase sense of control over emotional experience
- Help the parents to understand the importance of ‘some’ certainty for children, for example
- Validate child but careful not just to reinforce scared behaviour (don’t go to school etc)
Family support
- PTSD literature that family support is a predictor of adjustment (higher social support was related to less severe PTSD symptoms).

Question 13

High risk One on one

Answer 13

• Can offer telehealth (cover notes from that document)

Question 14

Health care workers and self care

Answer 14

Note: Healthcare workers are busy time being there for everyone – watch out to not burn out, not just responsibility on them, self-care imperative not a luxury – (need to acknowledge our limits COE 4)

Question 15

Hope/prognosis

Answer 15

• Of children who were on a typical developmental trajectory with no mental health issues or trauma experiences, 80% would recover

Question 16

PTSD

Answer 16

PTSD
- PTSD is not just an event but background factor too
- Risk factors:
o Pre trauma: low education, low SES, anxiety, pre-cognitions (the world is dangerous = confirmed, the world is safe = world flipped upside down when first bad thing)
o Peri-trauma: severe, unpredictable, uncontrollable, (fit from behind more difficult to conceptually process)
o Post-trauma: support, validation, shame, appraisals, suppression, selective attention, safety behaviours, rumination

Question 17

Diathesis stress model

Answer 17

• Stressful situations but also coping strategies, social support, resilience, and Personality processes (internal locus of control, self-esteem, assertiveness). Good emotion regulation/distress tolerance skills
• Building up protective factors (bucket analogy) -