[acb-hsp] Dealing with Disaster Trauma: How Behavioral Health Can Help

[Mary Ann Robinson]

Dealing with Disaster Trauma: How Behavioral Health Can Help
By Linda Ligenza, LCSW, Clinical Services Director, National Council for
Community Behavioral Healthcare
Traumatic events such as the one that recently occurred in Aurora, Colorado have
a significant impact on the individuals directly involved, their families and friends
and the larger community surrounding the location where the event took place.
The extent of the impact will depend on several factors including: how close the
person was to the event (actually shot or wounded, in the theater but not hurt, in
the theater
next door, relative or friend of someone wounded, deceased or present in the theater);
if the person has experienced previous trauma; the seriousness of the injury; loss
of someone close; and the perception of the person involved, about the experience.
A person's perception is a critical factor in how much of an impact the experience
has on them; someone who was in the theater who was not shot
but felt that their life was threatened may have more serious reactions than a person
who was shot and injured.  Everyone reacts differently to the same event.
The first responders, who were confronted with a chaotic, gruesome scene, are also
at risk for adverse reactions;
it is important to ensure that they have information and easily accessible and confidential
resources available to them as well.
Typical Reactions
Typical reactions fall into four categories:
emotional - such as shock, numbness, fear, anger, worry, sadness, and grief;
physical - including headaches, stomachaches, fatigue (the most common);
behavioral - such as crying, increased use of substances, agitation; and
cognitive - which may include forgetfulness and confusion.  It is important to recognize
that these reactions are expected after a traumatic event; these are normal or typical
reactions to an abnormal event.
Helpful Responses
In the aftermath of such an event, behavioral health organizations can distribute
informational and educational materials and resources to those affected when possible
and to the public. Materials can be made
available during public gatherings, through faith-based organizations, local religious
and community groups and via websites, to name a few.
Signs of Distress
People affected by traumatic events may require a mental health evaluation and treatment
when their reactions or symptoms become distressing. Distress can be identified by
such signs as: inability to
carry out daily functions; trouble with relationships; prolonged mourning of losses;
diminished ability to cope or problem-solve; isolating behaviors and hopelessness;
health problems; and uncertainty about the future. In children, we see regression
to a younger
developmental stage, poor school performance, isolation, acting out behavior, and
physical complaints. Clinicians can be very helpful to parents by teaching them how
to talk to their children about the disaster and helping them to recognize signs
of distress. It's important
to remember that most people will not develop PTSD after a disaster or a traumatic
event although many may experience signs of stress and some
will have symptoms of distress.
Community Resilience and Public Messaging
To promote community resilience, impromptu gatherings, as we have seen happening
near the site of the movie theater, and participation in
organized vigils, rituals, commemorations will assist in the healing process. Another
positive and effective approach to promoting community resilience is through messaging
by trusted community leaders. Leaders who project a sense of calm, reassurance and
provide ongoing or periodic
messages of empathy, compassion along with optimism, hope, healing and cohesion will
assist their community to heal and recover.
Mental Health First Aid
Behavioral health organizations can educate the community about mental illness and
offer support and resources to those in need through Mental Health First Aid. Mental
Health First Aid is a novel, evidence-based
public education program that teaches participants how to assess a situation, select
and implement appropriate interventions and help a person in crisis or developing
the signs and symptoms of mental illness.
This groundbreaking training equips people to provide initial help until appropriate
professional, peer or family support can be engaged. Participants
also learn about the risk factors and warning signs of specific illnesses such as
anxiety, depression, psychosis and addiction. And they learn how to initiate timely
referral to mental health resources available in the community.
The training has done much to expand people's knowledge of mental illnesses and their
treatments, and to help people understand and accept mental illness as a medical
condition. More than 60,000 people - including thousands at colleges and universities
- across the USA have
been certified in Mental Health First Aid. A listing of community courses and instructors
is available at
www.MentalHealthFirstAid.org
.
Avoiding Re-traumatization
Re-traumatization can inadvertently occur through repeated watching of news reports,
reading about the tragedy in newspapers and on line and
through hearing and reading inflammatory, disturbing language such as use of the
word, "massacre." The media, community leaders and others in the public eye must
be careful to choose their words and messages
carefully. Guidance from mental health professionals can be very helpful.
Self-care
Self-care is an important component of trauma work. Clinicians and others working
with trauma survivors are at risk for developing "secondary traumatic stress," experiencing
symptoms of trauma such as
anxiety, guilt, and stress resulting from working with survivors. This is also referred
to as "compassion fatigue" and "vicarious traumatization."
In order to prevent these symptoms, clinicians should follow a self-care plan that
includes connecting with support systems such as co-workers, family, friends and
maintaining a healthy lifestyle which includes
eating and sleeping well, getting regular exercise, avoiding alcohol and other harmful
substances, engaging in pleasurable activities, and not
working excessive hours.
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