Adapted from:The Crisis Counseling Program Trainer’s GuideU.S. Department of Health and Human ServicesSubstance Abuse and Mental Health Services AdministrationFederal Emergency Management Agency

Disaster Impact on Mental Health

•Everyone who experiences a disaster is affected by it in some way

•People pull together during an after a disaster

•Stress and grief are common reactions to uncommon situations

•People’s natural resilience will support individual and collective recovery

Key Concepts

• Poverty

• Race

• Age

• Ethnicity

•Unemployment

•Gender

Vulnerability Factors

• Category A-Injured survivors, bereaved family members

• Category B-Survivors with high exposure to disaster trauma or evacuated from disaster zones

• Category C-Bereaved extended family members and friends; first responders

• Category D-People who lost homes, jobs, and possessions; people with pre-existing trauma and dysfunction; at-risk groups; other disaster responders

• Category E-Affected people from the larger community

Risk FactorsPopulation Exposure Model

•Some will have severe reactions

•Few will develop diagnosable conditions

•Most do not seek help or treatment

•Survivors often reject help

Typical Outcomes of Disaster

IndividualMay cause stress and griefMay cause fatigue, irritability, hopelessness and relationship conflicts

CollectiveMay damage community supportMay affect individual coping

Two Reaction Types

•Physical

•Emotional

•Cognitive

•Behavioral

Types of Individual Reactions

•As a small group, answer the following:

▫1. What specific reactions have you seen in this category?

▫2. What differences in reactions have you seen- or could you imagine- across age groups?

Choose a spokesperson to report answers.

Exercise

Gastrointestinal Eased startle

Headaches, aches, and pains Chronic fatigue or sleep disturbance Weight change Immune system disordersSweating or chills Sexual dysfunction

Tremors or muscle twitching Positive response can includealertness

Clumsiness, increased accidents

Physical Reactions

•Heroic, euphoric or invulnerable feeling•Denial•Anxiety or Fear•Depression•Guilt•Apathy•Grief

•Positive responses can include feeling challenged, involved and pressured to act

Emotional Reactions

• Disorientation and Confusion Preoccupation with Disaster

• Poor Concentration Positive responses can include group identification and sharpened perception

• Difficulty Setting Priorities or Making Decisions

• Loss of Objectivity

• Recurring Dreams, Nightmares, or Flashbacks

Cognitive Reactions

Change in activity level Irritability, anger, or frequent arguments

Alcohol and drug use or abuse Frequent crying

Increased use of over the counter Avoidance of triggering places or activitiesmedications

Difficulty communicating or listening Difficulty sleeping

Behavioral Reactions

•Unselfishness

•Helping Behavior

Positive Behavioral Reactions

•Spiritual beliefs influence how people make sense of the world

▫Survivors may seek the comfort that comes from spiritual beliefs

▫Spiritual beliefs will assist some survivors with coping and resilience

▫Survivors may question their beliefs and life structure

Role of Spiritual Beliefs

Depressive Disorders Posttraumatic Stress Disorder (PTSD)

Substance Abuse Dissociative Disorders

Social Isolation Paranoia

Acute Stress Disorder Suicidal Behavior

Anxiety Disorders

Severe Individual Reactions

•Severity is affected by the type and level of exposure

•Casualties associated with the disaster

•Pre-existing trauma may increase the risk of severe reaction

•Pre-existing levels of support will affect the severity of reactions

Severe Individual ReactionsFactors

•Pre-disaster phase

▫Disasters with no warning can cause feelings of vulnerability, lack of security, loss of control, fear of future unpredicted tragedies, and inability to protect one’s self and family

▫Disasters with warning can cause guilt or self-blame for failure to heed warnings

Collective Reactions

•Reactions can range from shock to overt panic

• Initial confusion and disbelief are followed by a focus on self-preservation and family protection

Impact Phase

•Many survivors exhibit adrenaline-induced rescue behavior, as well as high activity with low productivity

•Risk assessment may be impaired

•There is a sense of altruism

Heroic Phase

•Disaster assistance is readily available

•Community bonding occurs

•Many are optimistic that everything will quickly return to normal

Honeymoon Phase

•Stress and fatigue take a toll

•Optimism turns into discouragement

•Need for substance abuse services may increase

•The larger community returns to business as normal

Disillusionment Phase

• Individuals and communities begin to accept responsibility for rebuilding their lives

•People begin adjusting to new circumstances, “new normal”

•There is a recognition of growth and opportunity

Reconstruction Phase

How do you define resilience?

What helps foster the resilience of individuals? Communities?

What factors decrease resilience?

Resilience

•The ability to recover from or adjust easily to misfortune or change

-Merriam-Webster Online Dictionary-

Resilience

Life situation Perceived presence of control and hope

Individual traits and coping styles Availability of accurate information

Disaster and trauma experienceEffective and caring emergency response

Family and social supportSpiritual beliefs

Factors Affecting Resilience

• Improved relationships (closer to loved ones)

• Increased confidence (ability to rebuild one’s life)

• Increased spirituality (finding deeper meaning and purpose in life)

• Increased inner strength (belief in one’s ability to endure)

Resilience and Personal Growth

Questions?... Comments?...

Acquanetta Knight, DirectorPlanning and Resource DevelopmentAL Dept of Mental Health100 N. Union Street-Suite 554Montgomery, AL 36130Acquanetta.knight@mh.Alabama.gov334-353-9168

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