Monday, 18 January 2021

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Psychological first aid: first-line support in emergency situations

A woman poses in front of a graffiti representing the sun on the occasion of the observance of the World Mental Health Day. Photo: UN Photo/Martine Perret

10.10.2016 – Mental health is everyone's business; it affects the lives of people with mental health problems, their carers, and the productivity of society as a whole. 10 October marks Mental Health Day; while in a vital sense every day is a day for mental health, on this day we raise awareness of it around the world. Psychological first aid, which is a necessary part of living, is given special attention as the theme to this year’s action.

Mental ill health accounts for almost 20% of the burden of disease in the World Health Organisation (WHO) European Region, where an estimated 83 million 18-65 year olds have experienced mental disorders in the past year (including problems arising from substance use, psychoses, depression, anxiety, and eating disorders). Six European countries fall within the top 20 countries with the highest estimated suicide rates globally. While rates of mental ill health for women are generally significantly higher compared to those for men, men have higher rates of substance abuse disorders and suicide. Suicide apparently has an economic aspect; in high-income countries, 3.5 males commit suicide for every female, yet in low and middle-income countries in Europe the suicide rate is as high as 4.1 males for every female.

infographic depression 250
Image: WHO

Psychological first aid is humane, supportive and practical help to fellow human beings suffering serious crisis events. It extends to social support, and is provided by people in a position to help others who are experiencing extreme distress. We must support people in ways that respect their dignity, culture and abilities. It entails:

  • Providing non-intrusive practical care and support,
  • Assessing needs and concerns,
  • Listening without pressuring the sufferer to talk,
  • Offering comfort and helping them to feel calm,
  • Helping them connect to information, services and social supports, and
  • Protecting them from further harm.

It does not necessarily involve detailed discussion of the event that caused the distress. Nor is psychological first aid confined to the work of first-line responders such as police and fire officers, health staff in emergency units and humanitarian aid workers; it is something non-professionals can do.

It has successfully been used in Guinea, Liberia and Sierra Leone during the recent Ebola epidemic, Syria, and for thousands of displaced persons in Greece and Nigeria.

Psychological and Social Work with Survivor and Affected Families in Liberia. Photo: UN Photo/Martine Perret

Investment in psychological first aid is part of a longer-term effort to ensure that anyone in acute distress due to a crisis is able to receive basic support. It is therefore crucial to acknowledge that first aid is just the start of treatment for some, followed by the need for support from health, mental health and social services.  Just like general health care never consists of physical first aid alone, similarly no mental health care system should consist of psychological first aid alone.

A recent note by the Secretary-General on the ‘Right of everyone to the enjoyment of the highest attainable standard of physical and mental health’ explains how mental health is affected by a host of development matters. In fact, almost all of the 17 Sustainable Development Goals are connected to health, which is both an outcome of, and a path to, achieving poverty reduction and sustainable development. Mental Health Day gives us yet more urgency to achieve the Sustainable Development Goals.

The Day provides an opportunity for everyone working on mental health issues to talk about their work, and what more needs to be done to make mental health care a reality for people worldwide. The WHO’s comprehensive mental health action plan focuses international attention on long-neglected problems of dealing with mental health. It calls for a change in the attitudes that perpetuate stigma and discrimination that have isolated people since ancient times, and it calls for an expansion of services in order to promote greater efficiency in the use of resources. An essay on psychological first aid is available here and a field guide for practicing psychosocial first aid is available here.

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