INTRODUCTION TO MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT FOR DISASTER PREPAREDNESS
MR. ROMELITO MANUEL D.S. CLORINA
1st SEMESTER – FINALS | A.Y. 2022-2023
INTRODUCTION TO MENTAL HEALTH AND PSYCHOSOCIAL
SUPPORT
INTRODUCTION
• Armed conflicts and natural disasters cause significant
psychological and social suffering to affected populations.
• The psychological and social impacts of emergencies may be
acute in the short term, but they can also undermine the longterm mental health and psychosocial well-being of the affected
population.
• These impacts may threaten peace, human rights and
development. One of the priorities in emergencies is thus to
protect and improve people’s mental health and psychosocial
wellbeing.
• Achieving this priority requires coordinated action among all
government and nongovernment humanitarian actors. The
composite term mental health and psychosocial support is used
to describe any type of local or outside support that aims to
protect or promote psychosocial well-being and/or prevent or
treat mental disorder.
• Although the terms mental health and psychosocial support are
closely related and overlap, for many aid workers they reflect
different, yet complementary, approaches.
• Aid agencies outside the health sector tend to speak of
supporting psychosocial well-being.
• Health sector agencies tend to speak of mental health, yet
historically have also used the terms psychosocial rehabilitation
and psychosocial treatment to describe non biological
interventions for people with mental disorders.
• Exact definitions of these terms vary between and within aid
organizations, disciplines, and countries.
• As we try to cover intersectoral, interagency guidelines … the
composite term mental health and psychosocial support
(MHPSS) serves:
- to unite a broad group of actors; and
- underscores the need for diverse, complementary
approaches in providing appropriate supports.
MENTAL HEALTH AND PSYCHOSOCIAL IMPACT ON
EMERGENCIES
Problems
• Emergencies create a wide range of problems experienced at the
individual, family, community and societal levels.
• At every level, emergencies erode normally protective supports,
increase the risks of diverse problems and tend to amplify preexisting problems of social injustice and inequality.
• For example, natural disasters such as floods typically have a
disproportionate impact on poor people, who may be living in
relatively dangerous places.
• Mental health and psychosocial problems in emergencies are
highly interconnected yet may be predominantly social or
psychological in nature.
• Significant problems of a predominantly social nature include:
- Pre-existing (pre-emergency) social problems - e.g.
extreme poverty; belonging to a group that is discriminated
against or marginalized; political oppression.
- Emergency induced social problems - e.g. family
separation; disruption of social networks; destruction of
community structures, resources and trust; increased gender
based violence.
- Humanitarian aid induced social problems - e.g.
undermining of community structures or traditional support
mechanisms.
• Similarly, problems of a predominantly psychological nature
include:
- Preexisting problems - e.g. severe mental disorder; alcohol
abuse.
- Emergency induced problems - e.g. grief, non-pathological
distress; depression and anxiety disorders, including posttraumatic stress disorder
- Humanitarian aid related problems - e.g. anxiety due to a
lack of information about food distribution.
• Thus, mental health and psychosocial problems in emergencies
encompass far more than the experience of PTSD.
People at increased risk of problems
• In emergencies, not everyone has or develops significant
psychological problems.
• Many people show resilience, that is the ability to cope relatively
well in situations of adversity.
• There are numerous interacting social, psychological and
biological factors that influence whether people develop
psychological problems or exhibit resilience in the face of
adversity. context, particular groups of people are at increased
risk of experiencing social and/or psychological problems.
• Although many key forms of support should be available to the
emergency affected population in general, good programming
specifically includes the provision of relevant supports to the
people at greatest risk, who need to be identified for each specific
crisis.
• All sub groups of a population can potentially be at risk,
depending on the nature of the crisis.
• The following are groups of people who frequently have been
shown to be at increased risk of various problems in diverse
emergencies:
- Women (e.g. pregnant women, mothers, single mothers,
widows and, in some cultures, unmarried adult women and
teenage girls);
- Men (e.g. ex combatants, idle men who have lost the means
to take care of their families, young men at risk of detention,
abduction or being targets of violence);
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INTRODUCTION TO MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT FOR DISASTER PREPAREDNESS
MR. ROMELITO MANUEL D.S. CLORINA
1st SEMESTER – FINALS | A.Y. 2022-2023
- Children (from newborn infants to young people 18 years of
age), such as separated or unaccompanied children
(including orphans), children recruited or used by armed
forces or groups, trafficked children, children in conflict with
the law, children engaged in dangerous labour , children who
live or work on the streets and undernourished/
understimulated children;
- Elderly people (especially when they have lost family
members who were care givers);
- Extremely poor people;
- Refugees, internally displaced persons (IDPs) and migrants
in irregular situations (especially trafficked women and
children without identification papers);
- People who have been exposed to extremely stressful
events/trauma (e.g. people who have lost close family
members or their entire livelihoods, rape and torture
survivors, witnesses of atrocities, etc.);
- People in the community with preexisting, severe physical,
neurological or mental disabilities or disorders;
- People in institutions (orphans, elderly people, people with
neurological/mental disabilities or disorders);
- People experiencing severe social stigma (e.g.
untouchables/dalit, commercial sexworkers, people with
severe mental disorders, survivors of sexual violence);
- People at specific risk of human rights violations (e.g.
political activists, ethnic or linguistic minorities, people in
institutions or detention, people already exposed to human
rights violations).
• It is important to recognize that:
- There is large diversity of risks, problems and resources
within and across each of the groups mentioned above.
- Some individuals within an at risk group may fare relatively
well.
- Some groups (e.g. combatants) may be simultaneously at
increased risk of some problems (e.g. substance abuse) and
at reduced risk of other problems (e.g.Some groups may be
at risk in one emergency, while being relatively
- privileged in another emergency.
- Where one group is at risk, other groups are often at risk as
well (Sphere Project, 2004).
Resources
• Affected groups have assets or resources that support mental
health and psychosocial wellbeing.
• The nature and extent of the resources available and accessible
may vary with age, gender, the socio-cultural context and the
emergency environment.
• A common error in work on mental health and psychosocial wellbeing is to ignore these resources and to focus solely on deficits
the weaknesses, suffering and pathology of the affected group.
• Affected individuals have resources such as skills in problem
solving, communication, negotiation and earning a living.
• Examples of potentially supportive social resources include
families, local government officers, community leaders, traditional
healers (in many societies), community health workers, teachers,
women’s groups, youth clubs and community planning groups,
among many others.
• Affected communities may have economic resources such as
savings, land, crops and animals; educational resources such as
schools and teachers; and health resources such as health posts
and staff.
• Significant religious and spiritual resources include religious
leaders, local healers, practices of prayer and worship, and cultural
practices such as burial rites.
• To plan an appropriate emergency response, it is important to
know the nature of local resources, whether they are helpful or
harmful, and the extent to which affected people can access them.
CORE PRINCIPLES OF MHPSS
1. Human Rights and Equity
• Humanitarian actors should promote the human rights of all
affected persons and protect individuals and groups who are at
heightened risk of human rights violations.
• Humanitarian actors should also promote equity and nondiscrimination.
• That is, they should aim to maximize fairness in the availability and
accessibility of mental health and psychosocial supports among
affected populations, across gender, age groups, language
groups, ethnic groups and localities, according to identified needs
2. Participation
• Humanitarian action should maximize the participation of local
affected populations in the humanitarian response.
• Participation should enable different subgroups of local people to
retain or resume control over decisions that affect their lives, and
to build the sense of local ownership that is important for achieving
program quality, equity and sustainability.
• From the earliest phase of an emergency, local people should be
involved to the greatest extent possible in the assessment, design,
implementation, monitoring and evaluation of assistance.
3. Do no harm
• Humanitarian aid is an important means of helping people affected
by emergencies, but aid can also cause unintentional harm
(Anderson, 1999).
• Work on mental health and psychosocial support has the potential
to cause harm because it deals with highly sensitive issues.
• Also, this work lacks the extensive scientific evidence that is
available for some other disciplines
• Humanitarian actors may reduce the risk of harm in various ways,
such as:
- Participating in coordination groups to learn from others and
to minimize duplication and gaps in response;
- Designing interventions on the basis of sufficient
information;
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INTRODUCTION TO MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT FOR DISASTER PREPAREDNESS
MR. ROMELITO MANUEL D.S. CLORINA
1st SEMESTER – FINALS | A.Y. 2022-2023
- Committing to evaluation, openness to scrutiny and external
review;
- Developing cultural sensitivity and competence in the areas
in which they intervene/work;
- Staying updated on the evidence base regarding effective
practices; and
- Developing an understanding of, and consistently reflecting
on, universal human rights, power relations between
outsiders and emergency affected people, and the value of
participatory approaches.
4. Building on available resources and capacities
• All affected groups have assets or resources that support mental
health and psychosocial well-being.
• A key principle even in the early stages of an emergency is building
local capacities, supporting self-help and strengthening the
resources already present.
5. Integrated Support System
• Activities and programming should be integrated as far as
possible.
• The proliferation of stand-alone services, such as those dealing
only with rape survivors or only with people with a specific
diagnosis, such as PTSD, can create a highly fragmented care
system.
• Activities that are integrated into wider systems (e.g. existing
community support mechanisms, formal/non formal school
systems, general health services, general mental health services,
social services, etc.) tend to reach more people, often are more
sustainable, and tend to carry less stigma.
6. Multi-layered Support
• In emergencies, people are affected in different ways and require
different kinds of supports.
• A key to organizing mental health and psychosocial support is to
develop a layered system of complementary supports that meets
the needs of different groups.
• All layers of the pyramid are important and should ideally be
implemented concurrently.
6. Multi layered Support: Basic services and security
• The well-being of all people should be protected through the
(re)establishment of security, adequate governance and services
that address basic physical needs (food, shelter, water, basic
health care, control of communicable diseases).
• In most emergencies, specialists in sectors such as food, health
and shelter provide basic services.
• An MHPSS response to the need for basic services and security
may include:
- advocating that these services are put in place with
responsible actors; documenting their impact on mental
health and psychosocial well being;
- and influencing humanitarian actors to deliver them in a
way that promotes mental health and psychosocial well
being.
- These basic services should be established in
participatory, safe and socially appropriate
6. Multi layered Support: Community and Family Supports
• The second layer represents the emergency response for a
smaller number of people who are able to maintain their mental
health and psychosocial well being if they receive help in
accessing key community and family supports.
• In most emergencies, there are significant disruptions of family
and community networks due to loss, displacement, family
separation, community fears and distrust.
• Moreover, even when family and community networks remain
intact, people in emergencies will benefit from help in accessing
greater community and family supports.
• Useful responses in this layer include:
- family tracing and reunification,
- assisted mourning and communal healing ceremonies,
- mass communication on constructive coping methods,
- supportive parenting programs,
- formal and non formal educational activities,
- livelihood activities and the activation of social networks,
such as through women’s groups and youth clubs.
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INTRODUCTION TO MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT FOR DISASTER PREPAREDNESS
MR. ROMELITO MANUEL D.S. CLORINA
1st SEMESTER – FINALS | A.Y. 2022-2023
6. Multilayered Support: Focused, non specialized supports
• The third layer represents the supports necessary for the still
smaller number of people who additionally require more focused
individual, family or group interventions by trained and supervised
workers (but who may not have had years of training in specialized
care)
• For example, survivors of gender based violence might need a
mixture of emotional and livelihood support from community
workers.
• This layer also includes:
- psychological first aid (PFA); and
- basic mental health care by primary healthcare workers.
6. Multilayered Support: Specialized Services
• The top layer of the pyramid represents the additional support
required for the small percentage of the population whose
suffering, despite the supports already mentioned, is intolerable
and who may have significant difficulties in basic daily functioning.
• This assistance should include psychological or psychiatric
supports for people with severe mental disorders whenever their
needs exceed the capacities of existing primary/general health
services.
• Such problems require either
(a) referral to specialized services if they exist, or
(b) initiation of longer-term training and supervision of
primary/general health care providers.
• Although specialized services are needed only for a small
percentage of the population, in most large emergencies this group
amounts to thousands of individuals.
Dos and Don’ts
• The uniqueness of each emergency and the diversity of cultures
and sociohistoric contexts makes it challenging to identify universal
prescriptions of good practice.
• Nevertheless, experience from many different emergencies
indicates that some actions are advisable, whereas others should
typically be avoided.
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INTRODUCTION TO MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT FOR DISASTER PREPAREDNESS
MR. ROMELITO MANUEL D.S. CLORINA
1st SEMESTER – FINALS | A.Y. 2022-2023
UNDERSTANDING CONCEPTS OF
PSYCHOLOGICAL FIRST AID
How do crisis events affect people?
• Different kinds of distressing events happen in the world, such as
war, natural disasters, accidents, fires and interpersonal violence
(for example, sexual violence).
• Individuals, families or entire communities may be affected.
• People may lose their homes or loved ones, be separated from
family and community, or may witness violence, destruction or
death.
• Although everyone is affected in some way by these events, there
are a wide range of reactions and feelings each person can have.
• Many people may feel overwhelmed, confused or very uncertain
about what is happening.
• They can feel very fearful or anxious, or numb and detached.
Some people may have mild reactions, whereas others may have
more severe reactions.
• How someone reacts depends on many factors, including:
- the nature and severity of the event(s) they experience;
- their experience with previous distressing events;
- the support they have in their life from others;
- their physical health;
- their personal and family history of mental health problems;
- their cultural background and traditions;
- their age (for example, children of different age groups react
differently).
What is PFA?
• According to Sphere (2011) and IASC (2007), psychological first
aid (PFA) describes a humane, supportive response to a fellow
human being who is suffering and who may need support.
• PFA involves the following themes:
- providing practical care and support, which does not intrude;
- assessing needs and concerns;
- helping people to address basic needs (for example, food
and water, information);
- listening to people, but not pressuring them to talk;
comforting people and helping them to feel calm; helping
people connect to information, services and social supports;
- protecting people from further harm.
• PFA involves factors that seem to be most helpful to people’s long
term recovery.
• These include:
- feeling safe, connected to others, calm and hopeful
- having access to social, physical and emotional support; and
- feeling able to help themselves, as individuals and
communities.
• PFA is not the following:
- It is not something that only professionals can do.
- It is not professional counselling.
- It is not “psychological debriefing”
- 1 in that PFA does not necessarily involve a detailed
discussion of the event that caused the distress.
- It is not asking someone to analyze what happened to them
or to put time and events in order.
- Although PFA involves being available to listen to people’s
stories, it is not about pressuring people to tell you their
feelings and reactions to an event.
PFA: Who, When and Where?
PFA: Who
• PFA is for distressed people who have been recently exposed to
a serious crisis event.
• You can provide help to both children and adults.
• However, not everyone who experiences a crisis event will need
or want PFA.
• Do not force help on people who do not want it, but make yourself
easily available to those who may want support.
PFA: When
• Although people may need access to help and support for a long
time after an event, PFA is aimed at helping people who have
been very recently affected by a crisis event.
• You can provide PFA when you first have contact with very
distressed people.
• This is usually during or immediately after an event.
• However, it may sometimes be days or weeks after, depending
on how long the event lasted and how severe it was.
PFA: Where
• You can offer PFA wherever it is safe enough for you to do so.
• This is often in community settings, such as at the scene of an
accident, or places where distressed people are served, such as
health centers, shelters or camps, schools and distribution sites
for food or other types of help.
• Ideally, try to provide PFA where you can have some privacy to
talk with the person when appropriate.
• For people who have been exposed to certain types of crisis
events, such as sexual violence, privacy is essential for
confidentiality and to respect the person’s dignity.
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INTRODUCTION TO MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT FOR DISASTER PREPAREDNESS
MR. ROMELITO MANUEL D.S. CLORINA
1st SEMESTER – FINALS | A.Y. 2022-2023
HOW TO HELP RESPONSIBLY
Respect Safety, Dignity And Rights.
• When you take on the responsibility to help in situations where
people have been affected by a distressing event, it is important to
act in ways that respect the safety, dignity and rights of the people
you are helping.
• The following principles apply to any person or agency involved in
humanitarian response, including those who provide PFA:
• Ethical Do’s and Don’ts as guidance to avoid causing further harm
to the person, to provide the best care possible, and to act only in
their best interest.
Be Aware of Other Emergency Response Measures
• PFA is part of a broader response to large humanitarian
emergencies (IASC, 2007)
• When hundreds or thousands of people are affected, different
types of emergency response measures take place, such as
search and rescue operations, emergency health care, shelter,
food distribution, and family tracing and child protection activities.
• Often it is challenging for aid workers and volunteers to know
exactly what services are available where.
• This is true during mass disasters and in places which do not
already have a functioning infrastructure for health and other
services.
• Try to be aware of what services and supports may be available
so you can share information with people you are helping and tell
them how to access practical help.
Adapt What You Do To Take Account Of The Person’s Culture.
• Whenever there is a crisis event, there are often people of various
cultural backgrounds among the affected population, including
minorities or others who may be marginalized.
• Culture determines how we relate to people, and what is all right
and not all right to say and do.
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INTRODUCTION TO MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT FOR DISASTER PREPAREDNESS
MR. ROMELITO MANUEL D.S. CLORINA
1st SEMESTER – FINALS | A.Y. 2022-2023
PROVIDING PFA
Good communication with people in distress
• The way you communicate with someone in distress is very
important.
• Being calm and showing understanding can help people in distress
feel more safe and secure, understood, respected and cared for
appropriately.
• Someone who has been through a distressing event may want to
tell you their story.
• Listening to someone’s story can be a great support.
• It is important not to pressure anyone to tell you what they have
been through. Some people may not want to speak about what has
happened or their circumstances.
• However, they may value it if you stay with them quietly, let them
know you are there if they want to talk, or offer practical support
like a meal or a glass of water.
• Don’t talk too much; allow for silence. Keeping silent for a while
may give the person space and encourage them to share with you
if they wish.
• To communicate well, be aware of both your words and body
language, such as facial expressions, eye contact, gestures, and
the way you sit or stand in relation to the other person.
• Each culture has its own particular ways of behaving that are
appropriate and respectful.
• Speak and behave in ways that take into account the person’s
culture, age, gender, customs and religion
Preparing to help
• Crisis situations can be chaotic and often need urgent action.
• However, wherever possible before entering a crisis site, try to get
accurate information about the situation.
The PFA action principles of look, listen and link
• Crisis situations can change rapidly.
• What you find at the scene may be different from what you learned
before entering the crisis situation. Therefore, it is important to take
time even a few moments to “look” around you before offering help.
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INTRODUCTION TO MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT FOR DISASTER PREPAREDNESS
MR. ROMELITO MANUEL D.S. CLORINA
1st SEMESTER – FINALS | A.Y. 2022-2023
• Listening properly to people you are helping is essential to
understand their situation and needs, to help them to feel calm,
and to be able to offer appropriate help.
• Learn to listen to your:
- Eyes; giving the person your undivided attention
- Ears; truly hearing their concerns
- Heart; with caring and showing respect
1. Approach People who may need support:
• Approach people respectfully and according to their culture.
• Introduce yourself by name and organization.
• Ask if you can provide help.
• If possible, find a safe and quiet place to talk.
• Help the person feel comfortable; for example, offer water if you
can.
• Try to keep the person safe.
- Remove the person from immediate danger, if it is safe to do
so.
- Try to protect the person from exposure to the media for their
privacy and dignity.
- If the person is very distressed, try to make sure they are not
alone.
2. Ask about people needs and concerns:
• Although some needs may be obvious, such as a blanket or
covering for someone whose clothing is torn, always ask what
people need and what their concerns are.
• Find out what is most important to them at this moment, and help
them work out what their priorities are.
3. Listen to people and help them to feel calm:
• Stay close to the person.
• Do not pressure the person to talk.
• Listen in case they want to talk about what happened.
• If they are very distressed, help them to feel calm and try to make
sure they are not alone.
Action principles of PFA - Link
• People may feel vulnerable, isolated or powerless after a
distressing event.
• They may be unable to access their usual supports, or they may
find themselves suddenly living in stressful conditions.
• Thus, linking people with practical support is a major part of PFA.
1. Help people address basic needs and access services
• Immediately after a crisis event, try to help the person in distress
to meet the basic needs they request, such as food, water, shelter
and sanitation.
• Learn what specific needs people have such as health care,
clothing or items for feeding small children (cups and bottles) and
try to link them to the help available.
• Make sure vulnerable or marginalized people are not overlooked
• Follow up with people if you promise to do so.
2. Help people to cope with problems
• help people identify supports in their life, such as friends or family,
who can help them in the current situation;
• give practical suggestions for people to meet their own needs (for
example, explain how the person can register to receive food aid
or material assistance);
• ask the person to consider how they coped with difficult situations
in the past, and affirm their ability to cope with the current situation;
• ask the person what helps them to feel better. Encourage them to
use positive coping strategies and avoid negative coping strategies
3. Give information
• the event loved ones or others who are impacted
• their safety
• their rights
• how to access the services and things they need
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INTRODUCTION TO MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT FOR DISASTER PREPAREDNESS
MR. ROMELITO MANUEL D.S. CLORINA
1st SEMESTER – FINALS | A.Y. 2022-2023
3. Give information Things to consider
• find out where to get correct information, and when and where to
get updates;
• try to get as much information as you can before you approach
people to offer support;
• try to keep updated about the state of the crisis, safety issues,
available services, and the whereabouts and condition of missing
or injured people;
• make sure people are told what is happening and about any
plans;
• if services are available (health services, family tracing, shelter,
food distribution), make sure people know about them and can
access them;
• provide people contact details for services, or refer them directly;
• make sure vulnerable people also know about existing services
• explain the source of the information you are providing and how
reliable it is;
• only say what you know do not make up information or give false
reassurances;
• keep messages simple and accurate, and repeat the message to
be sure people hear and understand the information
4. Connect with loved ones and social support
• Help keep families together, and keep children with their parents
and loved ones.
• Help people to contact friends and relatives so they can get
support; for example, provide a way for them to call loved ones.
• If a person lets you know that prayer, religious practice or support
from religious leaders might be helpful for them, try to connect
them with their spiritual community. See the following box for
suggestions about crisis situations and spirituality.
• Help bring affected people together to help each other. For
example, ask people to help care for the elderly, or link individuals
without family to other community members.
Ending your help
• When and how you stop providing help will depend on the context
of the crisis, your role and situation, and the needs of the people
you are helping.
• Use your best judgment of the situation, the person’s needs and
your own needs.
• If appropriate, explain to the person that you are leaving, and if
someone else will be helping them from that point on, try and
introduce them to that person.
• If you have linked the person with other services, let them know
what to expect and be sure they have the details to follow up.
• No matter what your experience has been with the person, you
can say goodbye in a positive way by wishing them well.
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INTRODUCTION TO MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT FOR DISASTER PREPAREDNESS
MR. ROMELITO MANUEL D.S. CLORINA
1st SEMESTER – FINALS | A.Y. 2022-2023
CARING FOR YOURSELF AND YOUR COLLEAGUES
Getting ready to help
• Consider how you can best get ready to be a helper in crisis
settings.
• Whenever possible:
- Learn about crisis situations, and roles and responsibilities
of different kinds helpers.
- Consider your own health, and personal or family issues that
may cause severe stress as you take on a helping role for
others.
- Make an honest decision about whether you are ready to
help in this particular crisis situation and at this particular
time.
Managing stress: Healthy work and life habits
• A main source of stress for helpers is day to day job stress,
particularly during a crisis.
• Long working hours, overwhelming responsibilities, lack of a
clear job description, poor communication or management, and
working in areas which are not secure are examples of job
related stress that can affect helpers.
• Consider how you can best manage your own stress, to support
and be supported by your fellow helpers.
• The following suggestions may be helpful in managing your
stress.
- Think about what has helped you cope in the past and what
you can do to stay strong.
- Try to take time to eat, rest and relax, even for short periods.
- Consider, for example, dividing the workload among
helpers, working in shifts during the acute phase of the crisis
and taking regular rest periods.
- People may have many problems after a crisis event. You
may feel inadequate or frustrated when you cannot help
people with all of their problems.
- Remember that you are not responsible for solving all of
people’s problems.
- Do what you can to help people help themselves.
- Minimize your intake of alcohol, caffeine or nicotine and
avoid non-prescription drugs.
- Check in with fellow helpers to see how they are doing, and
have them check in with you. Find ways to support each
other.
- Talk with friends, loved ones or other people you trust for
support.
Rest and Reflect
• Taking time for rest and reflection is an important part of ending
your helping role.
• The crisis situation and needs of people you have met may have
been very challenging, and it can be difficult to bear their pain and
suffering.
• After helping in a crisis situation, take time to reflect on the
experience for yourself and to rest. The following suggestions
may be helpful to your own recovery.
- After helping in a crisis situation, take time to reflect on the
experience for yourself and to rest.
- The following suggestions may be helpful to your own
recovery:
- Talk about your experience of helping in the crisis situation
with a supervisor, colleague or someone else you trust.
- Acknowledge what you were able to do to help others, even
in small ways. Learn to reflect on and accept what you did
well, what did not go very well, and the limits of what you
could do in the circumstances.
- Take some time, if possible, to rest and relax before
beginning your work and life duties again.
• If you find yourself with upsetting thoughts or memories about the
event, feel very nervous or extremely sad, have trouble sleeping,
or drink a lot of alcohol or take drugs, it is important to get support
from someone you trust.
• Speak to a health care professional or, if available, a mental
health specialist if these difficulties continue for more than one
month.
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INTRODUCTION TO MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT FOR DISASTER PREPAREDNESS
MR. ROMELITO MANUEL D.S. CLORINA
1st SEMESTER – FINALS | A.Y. 2022-2023
ROAD TO RECOVERY
Some of the realities of life:
• Life is suffering (Four Noble Truth, Buddha)
• Life is a series of problems
• Adversities are inevitable
• However, these adversities are Opportunities
• We all have stories of burden or struggles or challenges… and
these are all valid
• What is important is to find meaning on these experiences that
make sense to us…
• …and to established hope…
PAGDADALA MODEL
• Burden bearing (pagdadala ), because it is an experience of the
common Filipino, is used as a model ( Pagdadala ) for viewing the
life experiences of the Filipino and used, as well, as a way to help
the Filipino in difficult times.
• By Edwin T. Decenteceo
• The Filipino is then revealed as committed to his or her tasks,
responsibilities and relationships, taking these to their
destinations, crawling on hands and knees if needed.
• The Filipino is seen to gain meaning not only from fulfilling
accountabilities but also from a sense of belonging to a community
of coburden bearers that in return gives meaning to acts of burden
bearing.
• The model also reveals ways of helping a burden bearer in
difficulty which allow a helper to move sensitively with the burden
bearer
• Ang dinadala: The burden.
• Ang nagdadala: The burden bearer.
• Ang pagdadala: The manner by which the burden bearer carries
the burden.
• Ang patutunguhan: The destination of the burden bearer.
• Ang pagdadaanan: The path of the burden bearer.
• Ang pinagdadaanan: The experiences of the burden bearer on
the way to the destination
STAGES OF GRIEF
Existential and Death
• Death in inevitable.
• Awareness of death as a basic human condition gives significance
to living.
• It is necessary to think about death if we are to think significantly
about life.
• If we defend ourselves against the reality of death, life becomes
insipid and meaningless.
• If we realize that we are mortal, we know that we don’t have an
eternity to complete our projects and that each present moment is
crucial
• Our awareness of death is the source of zest for life and creativity.
• Death and life are interdependent, and though physical death
destroys us, the idea of death saves us.
• Those who fear death also fear life.
• If we affirm life and live in the present as fully as possible, we will
not be obsessed with the end of life.
• Yalom, Irvin.,1980
Stages of Death and Dying (Elisabeth Kubler Ross, 1969)
First Stage: Denial
• Serves as buffer after unexpected shocking news.
• A temporary defense and soon be replaced with partial
acceptance.
Second Stage: Anger
• When denial cannot be maintained any longer, it is replaced by
feelings of anger, rage, envy and resentment.
• “Why me? Why couldn’t it have been him”
• Very difficult to cope.
• Anger is displaced in all directions and projected onto the
• environment at times almost at random (to God, to others).
• Person provokes rejection and anger, and are yet the most
desperate of them all.
Third Stage: Bargaining
• Brief period of time.
• Promises for doing good behavior (associated with guilt).
Fourth Stage: Depression
• Patient can no longer deny his illness.
• Numbness, anger, rage will be replaced with a sense of great loss.
• Reactive depression
• Preparatory depression
• If allowed to express sorrow, the patient will find a final acceptance
easier.
• No or little need for words. It is much more a feeling that can be
mutually expressed and is often done better with a touch of a hand,
stroking of hair, or just a silent sitting together.
• Patient may just ask for prayer.
• The type of depression is necessary and beneficial for them to
work on their anguish and anxieties.
Fifth Stage: Acceptance
• Increased need to extend hours of sleep.
• Not resignation or giving up but indicates the beginning of the end
of the struggle.
• Not a happy stage; it is almost void of feelings.
• “The final rest before the long journey.”
• Hold hand and silence as meaningful communication.
• Decathexis: The final stage of death; detachment to the world’s
concerns.
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INTRODUCTION TO MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT FOR DISASTER PREPAREDNESS
MR. ROMELITO MANUEL D.S. CLORINA
1st SEMESTER – FINALS | A.Y. 2022-2023
HIERARCHY OF NEEDS
• Maslow describes these needs as “being arranged in a hierarchy
of prepotency”, with physiological needs making up the bottom of
the pyramid
• PREPOTENT: they must be satisfied or mostly satisfied before
higher level needs become activated
• The WHO model is a service organisation pyramid describing an
optimal mix of services for mental health
• The most costly services are the least frequently needed, whereas
the most needed services can be provided at a relatively low cost.
PROCESS OF RECOVERY
• Recovery is a process
• One of the definitions of personal recovery the capacity of an
individual to create and live a meaningful and contributing life in a
community of choice or without the presence of mental health
issues.
• Recovery oriented mental health “the application of sets of
capabilities that support people to recognize and take
responsibility for their own recovery and well being and to define
their goals, wishes and aspirations.”
• Australian Health Ministers’ Advisory Council, 2013
(Adresen , Oades and Caputi , 2003; 2006 & 2011)
The four processes involved with Personal Recovery:
1. Finding and maintaining hope
- Believing in oneself; having sense of personal agency;
optimistic about the future.
2. Re-establishing a positive identity
- Incorporates mental health issues or mental illness but retains
a positive sense of self.
3. Building a meaningful life
- Making sense of illness or emotional distress; finding a
meaning in life beyond illness; engaged in life.
4. Re-establishing a positive identity
- Incorporates mental health issues or mental illness but retains
a positive sense of self.
(Glover, 2012)
The five processes in personal recovery journeys:
1. From passive to active sense of self
- Moving from the passive space of being a recipient of services
to reclaiming one’s strengths, attributes and abilities to restore
recovery.
2. From hopelessness and despair to hope
- Moving from a space of hopelessness and despair to one of
hope.
3. From others’ control to personal control and responsibility
- Moving from others taking responsibility for recovery to the
person taking, holding and retaining responsibility.
4. From alienation to discovery
- Finding meaning and purpose in the journey, doing more of
what works and less of what does not work;
- Learning from past experiences and incorporating that lesson
into the present;
- Acknowledging that journeys always have something to teach
us and contribute to our sense of discovery.
5. From disconnectedness to connectedness
- Moving from an identity of illness or disability to an appreciation
of
personal roles and responsibilities and to ‘participating in life as
a full citizen and not through the powerlessness of illness’.
THE PSYCHOLOGY OF HOPE
Hope is defined as the perceived ability to produce pathways to
achieve desired goals and to motivate oneself to use those pathways.
Hope Theory
• “If there’s a will , there’s a way
• Is a cognitive set that is based on a reciprocally derived sense of
successful agency and pathways (Snyder et al., 1991; Snyder,
Rand, and Sigmon , 2002)
• Does not discount the emotional component of hope; rather this
concept focuses on the cognitive component of hope.
• Three components that people can relate to hope, being:
1. you need to have focused thoughts.
2. you must develop strategies in advance in order to achieve
these goals.
3. you have to be motivated to make the effort required to
actually reach these goals.
Locus of Hope (Bernardo, A., 2010)
Locus of Hope an extension of the hope theory that considers both
internal and external agency in generating plans for pursuing goals.
• Internal Locus of Hope
• External Spiritual Locus of Hope
• External Parent Locus of Hope
• External Peer Locus of Hope
Role of Hope to Recovery
• As recovery process involves positive outcomes such as well
being, good adaptation and resilience. Hope is found to be a
salient factor that fosters these outcomes (Snyder et al.,1991).
• Hope either internal or externally drawn contributes to the students’
better way of dealing with daily academic challenges (Marquez,
2014), and promotes well being (Iglesias & Marquez, 2019).
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INTRODUCTION TO MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT FOR DISASTER PREPAREDNESS
MR. ROMELITO MANUEL D.S. CLORINA
1st SEMESTER – FINALS | A.Y. 2022-2023
MAINTAINING AND PREVENTIVE MEASURES
Self-care
• the ability of individuals, families, and communities to promote
health, prevent disease, maintain health, and to cope with illness
and disability with or without the support of a healthcare provider.”
• By the World Health Organization
• “Self-care is anything that you do for yourself that feels nourishing,
that can be something that’s relaxing or calming, or it can be
something that is intellectual or spiritual or physical or practical or
something you need to get done”
• By Marni Amsellem, PhD, a licensed psychologist based in
Trumbull, Connecticut.
• Self-Care includes health literacy as a pillar of self care, meaning
that any steps you take toward better understanding health
information you need to make appropriate decisions about your
health and well being counts as self care, too.
• By the International Self-Care Foundation
• Self-care describes a conscious act one takes in order to promote
their own physical, mental, and emotional health.
Benefits of Self-care
• Self-care can improve your physical health
• A big part of self care is committing to looking after your body and
becoming more attuned with its needs.
• Whether it’s brushing your teeth, exercising more or getting enough
sleep each night, part of any programme of self care should focus
on looking after your physical health.
• Self-care can reduce stress and anxiety
• Making time for relaxing activities, such as taking a warm bath,
listening to music or practicing yoga or meditation, is another
common theme of self care.
• Any activity that makes you feel more relaxed can help to reduce
symptom of stress and anxiety and to lift your mood.
• Self-care can boost your self esteem
• As well as helping to calm your nerves, taking time to relax and look
after yourself can have a positive impact on the way you see
yourself: treating yourself with kindness can make you look upon
yourself more kindly.
• Studies have found that people with higher self esteem find it easier
to deal with setbacks and are more likely to achieve goals of self
improvement.
• Self-care protects your mental health
• Self-care can help to manage mental health issues and might even
prevent them from getting worse.
• Self-care is not a substitute for professional help, and you shouldn’t
feel you have to tackle your problems alone.
• If your mental health is suffering, you should always talk to
someone.
• However, if you’re looking to improve your mental wellbeing, taking
the time to care for yourself both mentally and physically is really
important.
• Self-care can lead to better relationships
• The happier and healthier you are, the more you can give to a
relationship.
• This is especially important if you are a parent or carer . It can be so
easy to put someone else’s needs first, but you must look after your
own health too.
Lack of self-care; What are the costs?
We run a risk of depletion, loosing perspective and burn out if we do
not focus on activities that truly renew us.
Burnout leads to …
• Inflexible, cynical, negative, and rigid personality
• Depressive symptoms
• Turnover rates in work will increase in the workplace
• Negative student academic outcomes, negative student teacher
relationships, and lower quality classroom climates in the academe.
Resiliency
• To bend but not break
• To bounce back
• To grow amidst adversities
• The word “resilience”, from the Latin verb resilire (re salire : to jump
back), means literally the tendency or ability to spring back, and thus
the ability of a body to recover its normal size and shape after being
pushed or pulled out of shape, and therefore figuratively any ability
to recover to normality after a disturbance (K. Wolter et al. 2012)
• Resiliency is the process of adapting well in the face of adversity,
trauma, tragedy, threats, or significant sources of stress such as
family and relationship problems, serious health problems, or
workplace and financial stressors. (American Psychological
Association, 2014)
Resiliency is not …
• Being resilient doesn’t mean that a person won’t experience
difficulty or distress.
• People who have suffered major adversity or trauma in their lives
commonly experience emotional pain and stress.
• In fact, the road to resilience is likely to involve considerable
emotional distress.
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INTRODUCTION TO MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT FOR DISASTER PREPAREDNESS
MR. ROMELITO MANUEL D.S. CLORINA
1st SEMESTER – FINALS | A.Y. 2022-2023
How to Develop Resiliency?
Build your connections
• Prioritize relationships
• Connecting with empathetic and understanding people can remind
you that you’re not alone in the midst of difficulties.
• Focus on finding trustworthy and compassionate individuals who
validate your feelings, which will support the skill of resilience.
• Join a group
• Along with one on one relationships, some people find that being
active in civic groups, faith based communities, or other local
organizations provides social support and can help you reclaim hope.
Foster Wellness
• Take care of your body
• Promoting positive lifestyle factors like proper nutrition, ample sleep,
hydration, and regular exercise can strengthen your body to adapt
to stress and reduce the toll of emotions like anxiety or depression.
• Practice mindfulness
• Mindful journaling, yoga, and other spiritual practices like prayer or
meditation can also help people build connections and restore hope,
which can prime them to deal with situations that require resilience.
• Avoid negative outlets
• It may be tempting to mask your pain with alcohol, drugs, or other
substances, but that’s like putting a bandage on a deep wound.
• Focus instead on giving your body resources to manage stress,
rather than seeking to eliminate the feeling of stress altogether.
Find Purpose
• Help others
• Whether you volunteer with a local homeless shelter or simply
support a friend in their own time of need, you can garner a sense
of purpose, foster self worth, connect with other people, and tangibly
help others, all of which can empower you to grow in resilience.
• Be proactive.
• It’s helpful to acknowledge and accept your emotions during hard
times, but it’s also important to help you foster self discovery by
asking yourself, “What can I do about a problem in my life?”
• If the problems seem too big to tackle, break them down into
manageable pieces.
• Move toward your goals.
• Develop some realistic goals and do something regularly even if it
seems like a small accomplishment that enables you to move
toward the things you want to accomplish.
• Instead of focusing on tasks that seem unachievable, ask yourself,
“What’s one thing I know I can accomplish today that helps me move
in the direction I want to go?”
• Look for opportunities for self-discovery
• People often find that they have grown in some respect as a result
of a struggle.
• For example, after a tragedy or hardship, people have reported
better relationships and a greater sense of strength, even while
feeling vulnerable.
• That can increase their sense of self worth and heighten their
appreciation for life.
Embrace Healthy Thoughts
• Keep things in perspective
• How you think can play a significant part in how you feel and how
resilient you are when faced with obstacles.
• Try to identify areas of irrational thinking and adopt a more balanced
and realistic thinking pattern.
• You may not be able to change a highly stressful event, but you can
change how you interpret and respond to it.
• Maintain a hopeful outlook
• It’s hard to be positive when life isn’t going your way.
• An optimistic outlook empowers you to expect that good things will
happen to you.
• Try visualizing what you want, rather than worrying about what you
fear.
• Along the way, note any subtle ways in which you start to feel better
as you deal with difficult situations.
• Learn from your past
• By looking back at who or what was helpful in previous times of
distress, you may discover how you can respond effectively to new
difficult situations.
• Remind yourself of where you’ve been able to find strength and ask
yourself what you’ve learned from those experiences.
Seeking Help
• Getting help when you need it is crucial in building your resilience.
• It is important to get professional help if you feel like you are unable
to function as well as you would like or perform basic activities of
daily living as a result of a traumatic or other stressful life
experience.
• A licensed mental health professional such as a psychologist can
assist people in developing an appropriate strategy for moving
forward.
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