Psycho- what?

When I talk about psycho-social preparedness, I often see people start to shift a little bit nervously, eyes darting around the room. “You mean psychological preparedness?” Well, no it’s not, it incorporates psychological preparedness, but it is more. So what is it then?

It is the term that we have coined to cover the unique approach that we take to disaster preparedness. There are a couple of important concepts here. Psycho-social referring to both internal processes (thoughts and feelings) and external processes (relationships). Psychosocial wellbeing,  experienced both in the personal and the social domain, and is also influenced by external factors and basic human needs such as livelihood, shelter and physical health.

The International Federation of Red Cross and Red Crescent refers to psychosocial wellbeing as a positive state of being when an individual, family or community thrives, it is influenced by the interplay of human capacity (psychological and physical), social ecology, culture and values.In a  preparedness sense, it is this we are seeking to protect.

Psycho-social support, based upon Steven Hobfell and others work, is based on five pillars,

  • Promote a sense of safety
  • Promote a sense of calming
  • Promote a sense of self and community efficacy
  • Promote connection
  • Instilling hope

The important thing here, is to take these pillars and apply them in the preparedness context.

Sense of safety involves understanding the hazard risk (I know what I am dealing with), ensuring that your plan involves safety (is my home cyclone proof, would I leave early on a catastrophic fire day).

Sense of calming, applying the AIM principles of psychological preparedness (Anticipate, Identify, Manage feelings), and develop strategies to manage stress prior to the event.

Sense of self and community efficacy, taking control, taking action (the plan) to reduce the long term impacts of the emergency (I can do this), is my health and wellbeing up to this, being part of the community, joining volunteer groups, or just doing local things amongst neighbours (Can we do it, yes we can!)

Promote connection, building those connections into community, as these are the people you will rely or will rely upon you for information, support and assistance.

Instilling hope involves overcoming the barrier that Douglas Paton has identified to preparedness, that it is all too overwhelming and you can do nothing about it. Framing the message positively, (while getting across the negative of what is at stake), avoiding fear, taking small, simple steps, talk about how easy it is to prepare (like the Greater City of Wellington’s approach), demonstrate how others prepare.

So it comes down to the practical and emotional things we can do to reduce the long term consequences of disasters by building our ability to cope, and our connections to those that can support us.

What does this mean practically? Most disaster preparedness programs, globally, focus upon the hazard, and how do we survive the hazard. Entirely appropriate, as no one wants to die. Success for hazard management agencies, like fire and rescue services is first and foremost lives saved. Secondly, it may be property saved, although less likely, given the primacy of life, and the shifts we have seen in Australia in the so called “Stay or Go policy”.

Again, these approaches are entirely appropriate, but what they don’t take on board is what comes next, dealing with the consequences of the disaster. What do you return to? How does your life change, when do you feel like you live the life you value living again, to quote Anne Leadbeater. This is the complexity of disaster impacts, of which life and death, while a big part, is but one element.

Our approach has been to take all of these things, these consequences into account, and suggest people take steps to reduce their impacts afterwards. We know that people receive great support from neighbours, friends, family after an emergency (See Daniel Aldrich’s work, Beyond Bushfires), take steps to improve your connections into your community. We know that people lose their jobs, or have reductions in income due to illness, time off etc. Explore income protection insurance. We know what a mess people’s estate can be when they die intestate, and what stress this causes the next of kin. Make a will. We know the impact of recovery can have on people’s health. Take steps to work out how to manage stress, learn first aid. The rebuilding of a life takes years, sometimes a decade. Identify the things that you want to have on that new journey. Having familiar things can help reduce the feeling that it is starting all over again.

These are the practical things that will help us have or regain a sense of control over the future. In  Psychological First Aid we focus upon helping people meet their practical needs, whether it is promoting strategies to help themselves, or providing assistance. It’s really about thinking practical, emotional, internal, external, and long term and what can we, as individuals, do to protect these things. The great thing about our preparedness approach is that it is complementary to that provided by the hazard management agencies, as  what they do falls into the first principle, promoting a sense of safety.

It’s taken me a long time to grab those words and concepts about why we do what we do in preparedness that have been swirling around in my head . Much of this has been stimulated by a new CEO who is challenging us (positively) about how we go about things. It’s also been pushed by having to explain our approach to non EM people, again and again. I’ve also been helped by my colleague Shona Whitton, who has done a terrific paper on psycho-social support that is informing all of the work that we do in Red Cross, and my team Antonia, Emily, Isobel, Jacqui, and Rachel, who have been really pushing to sharpen our focus. A number of things seem to be coming together that give me a good sense of hope for the future.

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