New Delhi: Prompt psychological first aid needs to be provided to victims of natural calamities to minimise the impact of trauma, and people may also be trained to provide such first aid apart from recruiting more counsellors, several experts said at a recent workshop organised on post-disaster mental health.
The workshop titled “Navigating Post-Disaster Mental Health —Calm amid Chaos” was co-organised by the National Disaster Management Authority (NDMA), the Union Ministry of Health and Family Welfare (MoHFW) and United Nations Children’s Fund (UNICEF).
The experts said that post-disaster trauma can last for years and hence needs immediate and long-term healing through the Staged Recovery Approach. This is a structured, long-term intervention involving Psychological First Aid (PFA) and Psycho-Social Support (PSS), they said.
NDMA said, in association with ministry of health, it is also looking to scaling up digital mental health platforms – expand access to digital and tele-mental health services; establish a dedicated pool of trained counsellors equipped for rapid deployment; push for public-private partnerships with the corporate sector for sustainable funding and technical support.
Experts said this is particularly significant in view of the rise in extreme weather events in India.
MoHFW presently has 2,000 trained psycho-social counsellors and 1.1 million PSS-trained teachers.
‘Vacant expressions’
During the workshop, the psychological support team of NDMA said a review of images of two girls who survived Mandalay’s massive 7.7 M earthquake on March 28 indicated “vacant expressions”, “tonic immobility,” and “minimal facial engagement”. Safi Ahsan Rizvi, advisor, NDMA, said these expressions were signs of the oncoming post-traumatic stress disorder in the girls and lakhs of others, unless they received early psychological first aid.
While Mandalay witnessed an earthquake, which caused a certain trauma, in Wayanad, following the July 2024 landslides, victims complained of a sudden thundering sound followed by the feeling of being trapped, a vision that keeps visiting them again and again.
In Sikkim, following the 2023 Glacial Lake Outburst Flood disaster, survivors experience a range of symptoms.
“Sleep difficulties were one of the commonly reported concerns followed by worries about the future and experiences of hopelessness. Many reported worries associated with employment, income, and long-term rehabilitation. A small number of community members reported trauma symptoms such as fear of rains, strong winds, loud noises, flashbacks, palpitations and panic attacks, and were afraid of another natural calamity occurring. A few of them also reported sadness in mood, fatigue, lack of motivation and headaches,” said an NDMA advisor based on reports in the aftermath of Sikkim GLOF disaster.
Psychological First Aid (PFA) and Psycho-Social Support (PSS)
Experts said prompt psychological first aid needs to be provided to victims to minimise the impact of trauma, mitigate distress and help prevent sequelae of disasters e.g. sleep disturbance, post-traumatic stress disorders, anxiety, depression. They said a far larger number of counsellors for psychological first aid is needed and people from general population may also be trained in providing such first aid.
Prof Vikas Dhikav, Senior Medical Scientist, Department Of Health Research, MoHFW, said Psychological First Aid (PFA) is essential as it helps provide emotional support to survivors and aids them in coping with the immediate aftermath of disasters. Brief psychotherapeutic interventions like Cognitive Behavioural Therapy (CBT) can be effective in addressing post-disaster distress.
“Mental health and psychosocial support can take the form of counselling, therapy, and peer group support. Prevention and mitigation efforts will help reduce the risk of future disasters and their impact on mental health and prevent long-term mental health issues, improved recovery,” he said.
Dr Bhavuk Garg, Associate Professor of Psychiatry at Lady Hardinge Medical College highlighted the dearth of psychiatrists and psychologists. It was discussed and concluded that in general; school children, teachers, civil society volunteers and youth in particular need to be sensitised about disasters, disaster preparedness, sensitivity, gentleness and cultural context with which we need to approach disaster victims and provide help. Among them, mental health volunteers could be chosen and further trained, he said.
It is recommended that volunteers utilise art-based therapy, non-pharmacological treatment options including yoga, meditation, regular exercise, and child plays etc. to support resilience and recovery.
Major recommendations from the PSS trained volunteers are 1. do not de-brief – that leads to re-traumatisation. This essentially means do not get victims to narrate their experience again and again. 2. avoid trauma voyeurism 3. Insurance payouts from parametric heat insurance policies as de-stressors for the socio-economically weak should be done immediately for heat disasters and for other disasters such cyclones and floods. 4. Corporates do not focus enough CSR funds on disaster management, which receives under 3% of annual spend of Rs.25-30,000 crore to CSR, according to NDMA.
Senior officers of union and state governments, and experts from Tata Institute of Social Sciences and National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, participated in the workshop held on April 16 and 17.