Traumas can happen anytime, ranging from natural disasters to tragedies and terrorism. And the worst part is that India has been witnessing many traumatic events since few years such as Kerala floods, Vizag gas tragedy that has occurred recently, and the devastating cyclone Amphan. There are various organizations that come up with help and assistance for victims during such traumas. However most of them focus on providing medical assistance and ignores the psychological threats emerging from experiencing the trauma. Though physical injuries and other needs have to be addressed immediately after the trauma, it is equally important to provide a first aid to the mental health issues as it can adversely impact the life of victims in the long run. This is where the concept of psychological first aid (PFA) becomes relevant.
Psychological first aid (PFA) is a humane, supportive response to an individual who is suffering and who may need support (Sphere, 2011; IASC, 2007). It is an immediate care and support provided to trauma victims who are more prone to mental health conflicts and who have suicidal ideations or self-harming tendencies as well as to those who are vulnerable to development of PTSD symptoms.
Traumas and disasters can have a potential impact on mental health. Most significantly, it makes people mentally broken and hopeless of future. It is important to provide immediate psychological first aid to victims of disaster and tragedies, to heal the mental wounds from trauma and loss of properties or loved ones. It is also important to improve their resilience and to encourage them to come out of the tragedy and rebuild their lives. Traumas also lead to various psychological disorders like Post-traumatic stress disorder (PTSD), Anxiety, Depression, and Conduct disorder as well as Suicidal ideations and Substance abuse. Recently, Dr S Radha Rani, superintendent of Government Hospital for Mental Care (GHMC) and professor of psychiatry, commented after the Vizag gas tragedy, that the victims may suffer from mental health issues such as post-traumatic stress disorder (PTSD), depression, generalized anxiety disorder, and aggression. It is common that unprecedented conditions like tragedies and natural disasters make people startled and worried about their future. Thus it is necessary to handle their mental health issues and provide them with psychological first aid during such times.
There are several models and steps conceptualized for how to implement the process of providing psychological first aid. Ruzek et al. had formulated the following steps for the process:
- Contact and engagement
- Safety and comfort
- Stabilization
- Information gathering; current needs and concerns
- Practical assistance
- Connection with social supports
- Information on coping support
- Linkage with collaborative services
Dr Vinod Singaravelu in his guide on psychological first aid for field workers had mentioned about the following seven major themes of PFA:
- Assess needs and concerns
- Help with basic needs like food, water, and information
- Listen to their worries
- Comfort the victims help them to feel calm
- Connect the victims to information, services, and social support
- Protect them from future harm
- Provide practical care and support
PFA can be provided by any individual who is working for disaster management and not necessarily be a mental health professional. The John Hopkins Center for Public Health Preparedness had developed the RAPID model of psychological first aid that can be used by non-mental health trained public health workers. The RAPID model constitutes the following steps:
- Reflective listening
- Assessment
- Prioritization
- Intervention
- Disposition
Several other models and guides for effective implementation of PFA are available across nations. Exploring the dimensions of PFA and mastering its foundational skills will be beneficial and necessary for any mental health professional as well as other public health personnel to efficiently manage crisis situations and traumatic events. However, while applying psychological first aid, it has to be noted that PFA is not about providing counseling or diagnosing psychological disorders in individuals. It is more about providing an immediate assistance and helping to cope with the sudden changes that had happened due to the crisis. Thus assessment in PFA should be to identify those who are affected by the trauma and to facilitate them for any kind of psychological assistance if required. And while providing PFA, it has to be ensured that no individual is approached with a preconception of suffering from mental health conflicts. Some of them may be resilient and able to deal with the challenges. Such individuals should be discriminated from affected victims. Moreover, PFA shouldn’t be misunderstood as a treatment for PTSD. PFA is only an immediate assistance provided for mental health conflicts and is widely used during traumatic events because trauma victims are more vulnerable to sudden psychological threats. Besides, as Dr Singaravelu mentioned in his guide for PFA, whenever you’re working as a volunteer or professional to provide PFA, don’t forget that PFA is provided to reduce distress, assist with immediate needs, and enhance adaptive functioning, not to evoke details of traumatic experiences and losses.
