Crisis intervention in natural disasters is important to look at from many different angles. The points of view of those experiencing the disaster and those of relief workers should be considered when developing models and considerations for interventions and emotional care.
Other factors, including cultural context and faith, play an enormous role in implementing crisis interventions. This paper will compare and contrast some of these elements and models to examine how crisis interventions can be best handled now and in the future.
Crisis management after a natural disaster is critical. Going about it properly is key to the success of crisis aversion.
There are many elements to examine when looking at a natural disaster. These include: disaster type; disaster zone environment; available resources; and delivery of resources to the area in which the disaster occurred.
Psychological First Aid
It is important to consider psychological first aid when talking about crisis management for natural disasters. This model examines the needs of the first responders and those involved with crisis recovery and management. Such people can include rescue workers, police officers, firefighters, humanitarian relief workers and any others who are in a position to help out during a natural disaster. This model includes key aspects such as education, providing support of peers, speedy recovery, mental health accessibility and a continuum of care (Castellano & Plionis, 2006).
As Castellano and Plionis (2006) discuss, first responders view themselves as having to be strong for others. Showing emotion is considered a type of weakness. This often develops into a hesitancy to seek help, which ican lead to worsening mental health. This creates a domino effect. The first responder needs to be psychologically and physically healthy enough to assist others. However, if their own physical and psychological health is ignored, the person in need may not be taken care of either (Kronenberg, Osofsky, Osofsky, Many, Hardy, & Arey, 2008).
However, psychological first aid is not applicable only to the first responder. It also is a model of how the first responder is able to help those in need. Providing compassionate engagement is key to helping those who are faced with a natural disaster, as well as allowing those in need to know that the first responder’s purpose is to provide safety and emotional comfort (Vernberg, Steinberg, Jacobs, Brymer, Watson, Osofsky, et al., 2008).
The first responder also must be able to collect information pertinent to disaster victims’ immediate needs. The first responder must be clear-headed enough to recognize the population’s needs and resources available to meet those needs. This requires the first responder to maintain psychological steadiness (Vernberg, Steinberg, Jacobs, Brymer, Watson, Osofsky, et al., 2008).
Stabilization is another key to psychological first aid. A first responder must be able to calm those who are in crisis due to a recently experienced trauma. This is applicable to those who are helping the first responders as well. However, the level and immediacy of stabilization may be different according to the different scenarios and to the needs of a crisis victim vs. those of a first responder. (Vernberg, Steinberg, Jacobs, Brymer, Watson, Osofsky, et al., 2008).
As with most other topics, cultural considerations come into play when looking at crisis management for natural disasters. For instance, within an Asian setting, emphasis may be placed in different areas of a crisis intervention model than it would in a Western one (Udomratn, 2008).
In India, the Nitte Rural Psychiatric Project was adapted for those with limited access to resources. This project offers free care. Its goal is to overcome the stigma of mental health care by utilizing respected community members of, such as religious leaders and local doctors. Education, lectures and awareness are components to mental health care and crisis management. (Akiyama, Chandra, Chen, Ganesan, Koyama, Kua et al., 2008).
However, in another part of Asia, Senior Peer Counseling may be viewed as important in crisis intervention. In Singapore, the respect given to elders may play a valuable role in developing models of overcoming crises after a natural disaster (Akiyama, Chandra, Chen, Ganesan, Koyam, Ku., et al., 2008). In Korea, the Seoul Mental Health 2020 project offers a review of key components of the community mental health resources available to those in the area. This includes looking at adequate coverage, diversifying services in particular areas and also an integration of services. This model is looks at the overall structure of mental health and crisis intervention and aims to improve it (Akiyama, Chandra, Chen, Ganesan, Koyam, Ku., et al., 2008).
Holistic support also may be an important consideration in crisis intervention needs within an Asian population, as discussed in the Yuli psychiatric rehabilitation model for Taiwan.
Faith-based models also may be considered when dealing with crisis intervention following natural disasters. One model in particular, called the Camp Noah model, focuses mainly on children who have been affected by natural disasters. It is a week-long camp that allows children to express their trauma and be in an environment that supports their faith. It also relies on fun activities to provide therapeutic relief of trauma for these children (Zotti, Graham, Whitt, Anand, & Replogle, 2006).
The Camp Noah model is similar to some of the culturally-based Asian models in that it takes the context of the individual and community to heart. However, its format differs. It does not take on the viewpoint of therapy, but of a therapeutic means of expression. The Camp Noah model is more of a strategy, whereas the Asian-based models are more of an implementation. The Camp Noah model utilizes Bible study, therapist consultation, music, games and crafts. It also has the elements of low participant ratios for quality care and highly trained staff to provide adequate care for children (Zotti, Graham, Whitt, Anand, & Replogle, 2006).
Camp Noah seeks to improve disaster trauma processing and coping skills related to natural disasters. Most of the Asian-based models focus on reducing the stigma of seeking mental health care when a natural disaster does occur. There also are similarities between these models: the community setting is taken into account, and the community and its available resources are included.
An examination of the purpose, sample, method, procedure and results of differing models is a good means of conducting an integrative review for crisis intervention models. Walsh (2009) examined different means of cultural crisis interventions for relief workers after natural disasters had occurred. A cross-cultural sample was examined in-depth to see what governmental and non-governmental agencies could do to intervene.
Walsh (2009) focused primarily on the incidence of reducing post-traumatic stress disorder and how each model worked within the context of cultures such as New Zealand, Germany, the United States, Australia, Turkey, Taiwan, Israel and Iran. Walsh found that three key elements in the data reduction model were relevant to each culture. These three elements included: debriefing, team building and preparation. These elements were different according to the cultural context; however, each proved effective in each of the cultures (Walsh, 2009). Walsh notes that long-term effects on relief workers should be further researched for future crisis intervention models (Walsh, 2009).
Crisis intervention has many elements in the context of a natural disaster. There are the considerations toward the population involved in the natural disaster and the aftercare of not only this population, but the relief workers as well. Models based on cultural contexts are necessary to provide effective intervention and treatment to particular populations. There is also the element of faith when developing crisis intervention models, so as to look at ways of coping with and overcoming trauma. And finally, there is the relevance of examining a model within the cross-cultural context that integrates key elements so as to be globally applicable and efficient in reducing such traumas as post-traumatic stress disorder and other mental health concerns.
Akiyama, T., Chandra, N., Chen, C., Ganesan, M., Koyama, A., Kua, E., et al. (2008). Asian models of excellence in psychiatric care and rehabilitation. International Review of Psychiatry, 20(5), 445-451. doi:10.1080/09540260802397537.
Castellano, Cherie, and Elizabeth Plionis. 2006. “Comparative analysis of three crisis intervention models applied to law enforcement first responders during 9/11 and Hurricane Katrina.” Brief Treatment and Crisis Intervention 6, no. 4: 326-336. PsycINFO, EBSCOhost.
Kronenberg, M., Osofsky, H., Osofsky, J., Many, M., Hardy, M., & Arey, J. (2008). First responder culture: Implications for mental health professionals providing services following a natural disaster. Psychiatric Annals, 38(2), 114-118. doi:10.3928/00485713-20080201-05.
Udomratn, P. (2008). Mental health and the psychosocial consequences of natural disasters in Asia. International Review of Psychiatry, 20(5), 441-444. doi:10.1080/09540260802397487.
Vernberg, E., Steinberg, A., Jacobs, A., Brymer, M., Watson, P., Osofsky, J., et al. (2008). Innovations in disaster mental health: Psychological first aid. Professional Psychology: Research and Practice, 39(4), 381-388. doi:10.1037/a0012663.
Walsh, D. (2009). Interventions to reduce psychosocial disturbance following humanitarian relief efforts involving natural disasters: An integrative review. International Journal of Nursing Practice, 15(4), 231-240. doi:10.1111/j.1440-172X.2009.01766.x.
Zotti, M., Graham, J., Whitt, A., Anand, S., & Replogle, W. (2006). Evaluation of a Multistate Faith-based Program for Children Affected by Natural Disaster. Public Health Nursing, 23(5), 400-409. doi:10.1111/j.1525-1446.2006.00579.x.