During the first week
Mental health and social care professionals should provide specialised advice to the people responsible for managing each level of the response. The advice should emphasise that initial responses should be based on the principles of psychosocial care as exemplified by psychological first aid (PFA).
Responding agencies should gather information about people affected by the emergency including their contact details and personal circumstances so that follow-up support can be offered as required. Recording systems should include the facility to collect information on those people considered to be at risk, such as people who have been injured, bereaved or made homeless as a result of the emergency.
Formal screening of everyone affected should not be conducted because there are no measures of sufficient sensitivity and specificity to make this intervention beneficial. Rather, the psychosocial response should be aimed at people who have been assessed as being at risk or members of vulnerable populations.
PFA should be initiated by first responders and carried forward by all relevant staff subsequently engaged in the response. Specific formal interventions, such as single session debriefing, should not be provided.
During the first week social care and mental health professionals should provide supervision and support for PFA providers. They should also plan their responses to people's emerging mental health needs, including the care and treatment of people who develop disorders.
Responders should be aware of the broad spectrum of ways in which people may react psychosocially to an emergency. They should be able to deliver PFA and should know who to make referrals for the very small minority of individuals who may need specialised mental health intervention at this stage.
People whose pre-existing mental health problems are exacerbated in the days after an emergency should be referred for specialised mental health intervention. People should be neither encouraged or discouraged from giving detailed accounts of their experiences but should be given the opportunity to talk if and when they wish to do so.
Support should be delivered in an empathic and open manner. It should be practical and pragmatic and should provide people with information about possible reactions, how they can help themselves, and where and when to access further help if necessary. Written leaflets should be pitched at a reading age of approximately 9 years of age and should be translated for people whose first language is not English.
Responders should be trained to recognise and respond to the needs of children affected by emergencies, whether or not they work with children normally. Reuniting children with a parent or other familiar or trusted adult should be a priority. Responders should begin from the assumption that parents and carers are best placed to support their children and should empower them to do so. Professionals should not work directly with children without the consent of a parent or guardian. They should do so only if there is no familiar and trusted adult who is able to provide the necessary care, for example if the parents' own reactions to the emergency overwhelm their ability to provide effective parenting.
People affected by the emergency may wish to meet with others who have been similarly effected. Practical advice and sensitive support should be offered to facilitate the formation of groups and networks that are able to increase opportunities for self-help and to develop and sustain psychosocial resilience and independence and more information can be found on Disaster Action.
While promoting mutual support among the people who are affected, responders should have processes for screening people who may pose as professional helpers to protect those affected from incompotent or exploitative behaviour. This should not prevent informal support from relatives and friends.
All telephone information lines should include provision to direct people to appropriate psychosocial support. They should be staffed by trained personnel who can provide information and support consistent with the approach of PFA and integrated with the broader Care for People and Public Communications strategies.
Pre-prepared websites should be adjusted to the specific circumstances of the emergency and made available online.
The Care for People team should work closely with the Public Communications Group to provide psychosocial advice.
Funerals, memorial services, acts of remembrance and cultural rituals should be planned in conjunction with the people who have been affected.
The managers of rescuers, responders and other staff working with people who are affected by the emergency should be aware of the risk to staff of secondary traumatisation or burnout. Special attention should be paid to staff who are directly affected by the emergency including, for example staff living or working in the affected communities. Support, based on the principles of PFA, and peer support should be provided for staff who are affected.