Preparing in advance

Health Boards have an advisory role in the development of the psychosocial resilience and wellbeing of adults and children, families, communities, schools, workplaces and other groups through public mental health programmes.

Care for People teams should identify senior mental health and social care professionals from the Health Board and local authority to give real-time advice to responders during both the emergency response and recovery phase. Advice should be available to all levels of responders and coordinated with other specialist support, for example Scientific and Technical Advice Cell.

Care for People teams should develop arrangements to utilise local expertise to understand specific local issues and identify the most appropriate community resources (for example, schools, faith groups, youth clubs and leisure facilities) to draw on in an emergency.

Care for People teams should include people who have been affected by past emergencies when developing and exercising plans, and should be aware of the support available from organisations such as Disaster Action.

Health, social care, education and third sector services should identify in advance those people within their organisations with appropriate skills who could contribute to psychosocial care response. Appropriate screening should be conducted for suitability.

An essential component of a comprehensive psychosocial response is providing information for people and communities that are affected. This should be consistent with the broader Care for People response and communications strategy and should:

• signpost access to additional services
• acknowledge and respect the possible range of reactions across the age range
• protect and promote social and community relationships
• involve the public and the media
• be comprehensive in its reach
• consider the specific psychosocial needs of different groups of people

Further guidance on communications is available in the Preparing Scotland guidance on 'Warning and informing Scotland'.

All agencies should ensure that their staff receive appropriate training in the psychosocial aspects of emergencies. This should include emergency service staff, those working in local authorities (particularly welfare and social care) and health services (particularly GPs). Where third sector organisations are involved in a response or care provision, consideration should be given to the benefits of joint training with statutory providers. Training should be developed in conjunction with specialists in psychosocial and mental health care and should include:

• the psychosocial and mental health effects of emergencies on people of all ages
• the principles of psychosocial care and psychological first aid
• awareness of possible longer-term consequences
• awareness of referall pathway for people who need more specialised care
• self-care for staff

The multi-agency training programme should include explicit arrangements for the testing and exercising of the psychosocial and mental health components of the emergency plans.

Responder agencies should agree on the types of personal information that will be collected from people who are affected by emergencies and should ensure that paper and electronic systems are compatible with respect to information sharing.

Agencies in all areas of service provision should be aware that there is clear legal power to share information in the context of emergencies and they should develop information sharing protocols (particularly about identifiable people) as part of their data-sharing partnership arrangements. Specialist advice should be sought on data protection and duties of care as they apply to different organisations and can be found on the Cabinet Office website.

The following factors are associated with an increased likelihood of dysfunctional distress and risk of developing post-traumatic stress disorder: 

• perception of high threat to life
• physical injury
• circumstances of low controllability and predictability
• the possibility that the emergency might recur
• an experience of disproportionate distress at the time
• experience of multiple losses (of relatives, friends or property)
• exposure to dead bodies or grotesque scenes
• a high degree of destruction of community infrastructure and social networks
• perceptions of limited social support or actual lack of this
• pre-existing or previous mental disorder

Agencies that deliver care should have processes in place to support staff and to recognise early signs of their distress, possible secondary traumatisation and experiences of burnout. This should be available to volunteers and interpreters involved in the response. Recommended interventions include peer support programmes.

Communications resources relating to psychosocial impacts should be integrated with the broader Care for People and Public Communications strategies coordinated by the Care for People and Public Communications Groups, more information can be found on usuing social media in emergencies in Preparing Scotland guidance on 'Warning and informing Scotland'. These should also dovetail with pre-existing material available from government sites and statutory sources.

Agencies should ensure there is appropriate specialist input when preparing websites concerning humanitarian, welfare, psychosocial and mental health matters, including draft or 'dark site' material prepared in advance.

The content of leaflets should take account of the needs of different groups of people who might be affected by an emergency such as survivors, people who are bereaved and children. While every emergency is unique, it is likely that materials and text produced in response to other incidents can be adapted to fit the current situation.