Geriatric Mental Health Disaster and Emergency Preparedness

184 Geriatric Mental Health Disaster and Emergency Preparedness
ineffective, or are perceived to be beyond one’s ability to implement,
the probability of people exercising them is low. Beliefs
such as “I can make it” or “We can get through it together” may
precede any specifi c intervention that would, indeed, help someone
manage intense emotions during crisis. At the community
level, disaster by defi nition can overwhelm a community and
give individuals the maladaptive thoughts that “Everything has
been destroyed” and “We can never recover . ” While a clinician
indicating that everything is going to be all right may be perceived
as disrespectful and likely invalidating, temperate and
modulated thinking at the individual and community level should
be encouraged as it sets the stage and enables active coping efforts
to be engaged.
4. Promote connectedness: Not feeling alone in personal, family,
and community contexts is a critical factor that can reduce an individual’s
current emotional duress and, in addition, may improve
his or her future prognosis. It is important to note that high levels
of perceived social and familial support are a signifi cant factor
underlying personal resilience in the wake of disaster. Grouporiented
helping behavior or activity may not only help promote
calming but may also promote connectedness.
5. Installation of hope: During a disaster, when all may seem lost, it
is often the basic sense of hope that keeps people going. If all of
the pain, suffering, and loss experienced by an individual during
a disaster are compounded by a growing sense that things will
only get worse, it may disable an individual’s ability to benefi t
from supportive help. Disasters can destroy temporal context,
and distorting a person’s cognitive sense of time can be quite debilitating.
The collective hope of a community must also be nurtured
by the disaster mental health clinician.
Given these symptoms and the very basic needs of individuals after
disasters, it is consistent that treatment should focus on a progression of
interventions to help a person establish a basic sense of safety, provide
skills that enable them to self-calm, promote interpersonal connection,
and, ultimately, lead an individual or group to feel they can manage and
get through it. During the early phase of disaster response, a collection
of very individualized interventions that promote all four of these elements
has become known as providing “Psychological First Aid,” or PFA
(NIMH, 2002, p.24). PFA, as described in the NIMH “Mental Health