Earthquakes : Psycho-social impacts and support. Nuray Karancı Middle East Technical University Psychology Department

Transcription

1 Earthquakes : Psycho-social impacts and support Nuray Karancı Middle East Technical University Psychology Department karanci@metu.edu.tr

2 EARTHQUAKES

3 Psychosocial Stressors Following Earthquakes(Distal exposure) Sudden and pronounced change of the physical environment Disruption of daily and social activities, routines Displacement, relocation, and homelessness, shelters Disruption of community functioning, institutions, etc. Decrease in social support Economic losses, loss of employment and income Emotional trauma (witnessing loss of lives, injury and property loss) Anxiety for future occurrences-aftershocks (Butler et al., 2009; Manyena, 2006; Norris et al., 2008)

4 Van after the earthquake

5 Effects of Van, 2011 Turkey Earthquakes on Survivors Positive Impacts 5% Family-Related Problems 4% Physical Problems 12% Health-Related Problems 25% Financial Hardships 6% Psychological Problems 88% Post-Quake Adversity 11% Resource Loss 24% Temporary Accomodation 25% 5

6 The Survivors Their relatives and friends Rescue workers, all emergency workers Volunteers Those who witness the event (secondary traumatization) Media exposure, increase of social media (twitter-facebook) more people exposed to gruesome sights and images (Lahad, & Crimando.,2010) Who are affected? Almost Everyone :SCALE

7 What should be done to support survivors? : Not a simple answer When? Starting immediately after the disaster to longer term Where? Accessiblity (general population shelters, field hospitals, and medical triage areas; schools; hospitals; homes; feeding locations;disaster assistance service centers; and other community settings) What? evidence-informed intervention strategies, culturally and ecologically suitable By Whom? Professionals and also trained nonprofessionals To Whom (children, adolescents, adults, elderly,

8 What is Psychosocial Support? process that deals with a broad range of psychosocial problems and promotes the restoration of social cohesion and infrastructure as well as the independence and dignity of individuals and groups. It serves to prevent pathologic developments and further social dislocation (Aarts, 2001) Psychosocial care is not a single time intervention, but a continuous process. In the initial phases of a disaster, it is primarily social in nature and has to be tailored to the needs of the community.

9 Who Suffers Most? :Vulnerability Factors Extensive loss; being exposed to severe disasters; fear of dying during the event Females, children, elderly Lack of social support Experiencing a loss recently History of psychiatric illness Having psycho-social problems Coping strategies (helplessness vs problem focussed) Personality characteristics (optimism; self-efficacy; Control; Self-esteem, etc) Adversities in the post-disaster period

10 Principles of Psycho-Social Interventions following earthquakes Building community resilience and supporting psychosocial wellbeing: community level psychosocial recovery and wellbeing Survivors need to be involved The management of the post-disaster environment and services is very important First attend to safety and basic needs Empowerment : resource loss Support loss. Support providers victims. Activate support networks Return to normalcy, facilitate social activities Normalization of psychological reactions :Psychoeducation ; Psychological first-aid Screen for PTSD, depression etc and refer

11 Intervention pyramid for mental health and psychosocial support in emergencies Taken from IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings, p.13.

12 Psycho-Social Support: Phase specific planning Culturally valid Psychoeducation (including suitable written material on reactions and ways of coping) Group activities, sharing, processing, making meaning, facilitate functional coping strategies Guidance /advice to emergency managers Screening and referral

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14 More specific psychological interventions: 1. Psychological processing groups-age groups considered 2. Relaxation 3. Imaginal and in-vivo exposure 4. CBT-Cognitive restructuring 5. Eye movement desensitization and reprocessing

15 Conclusions Services suitable for different phases following disasters needs to be planned and initiated Cultural considerationssuitability, trust, credibility Reaching out for all segments (e.g. Women s outreach, attitudes of men) Empowerment/ Resilient communities: Coping skills and sense of control, combatting helplessness

16 Sustainable training programs targeted at NGO members and professionals, like emergency workers, psychologists and members of the media before earthquakes. Disaster vs trauma psychology

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18 Organisational framework-collaboration with other professional groups e.g. TPA is in colloboration with other organizations that are involved in disaster work, is an active member of the Union of Disaster Psychosocial Services (udps) formed by six associations.

19 Thank you Comments and questions? A. Nuray Karancı