Supporting civilians and professionals after crises: Implications for psychosocial care

Abstract

People are regularly confronted with stressful life events that can cause serious harm to themselves or others. Examples are the confrontation with violence or experiencing a severe accident. To prevent a negative mental health impact on those exposed as a result of these events, (international) guidelines and handbooks recommend early psychosocial support. Although widely supported by health care professionals, these strategies are in need of a more solid, scientific basis, to answer questions like: ‘How do we identify those at risk?’, ‘How actively should we approach them?’, and ‘What are their actual needs?’. To address these questions, we investigated support and identification after crises both among high-risk professionals (who are frequently exposed to critical incidents at work) and disaster victims. Among ambulance personnel and police officers investigating sexual assault and child pornography, we studied elements of a supportive work environment that facilitates their wellbeing. Among survivors of an airplane crash in the Netherlands in 2009, we focused on identifying individuals with high levels of distress. Finally, we studied whether a specific type of disaster, namely a chemical, biological, radiological, or nuclear event (CBRN event), warrants a different psychosocial response. The main findings concerning high-risk professionals were that, on top of critical incidents, the impact of daily organizational stress at work should not be neglected. We also underpinned the importance of social support of colleagues and supervisors after crises. Regarding timely identification of people with mental health problems, an active psychosocial response is recommended. Especially since we found that 3.5 years after the airplane crash, a significant minority still reported unmet mental health care needs. However, screening instruments to detect those at risk are in need of further refinement. Finally, in case of a CBRN event, crisis-communication to diminish uncertainty and the preparation of the healthcare system seem essential elements of psychosocial support. Ultimately these results have contributed to the knowledge on providing psychosocial support after crises. Juul Gouweloos-Trines is a psychologist and policy advisor. She currently works at Knowledge Centre Impact and the Institute for Psychotrauma (partners in Arq Psychotrauma Expert Group), where she combines research with clinical practice. She completed her PhD at Knowledge Centre Impact and the Department of Clinical Psychology at Utrecht University.