By:

MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT SERVICES(MHPSS), MOH Sector of Mental Health, Substance Abuse and Violence Injury Prevention

Disease Control Division

Ministry of Health

PRE-DEPLOYMENT BRIEFING : MENTAL HEALTH

PREPAREDNESS FOR FIRST LINE RESPONDERS

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designed. I hope and I believe that this Template will your Time. MENTAL HEALTH IMPACT

IN CRISIS/ OUTBREAK 01

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DEPLOYMENT AND MENTAL

HEALTH PREPAREDNESS 02

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COPING SKILLS AND

MENTAL HEALTH CARE

OF RESPONDERS

03

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• Crisis / Outbreaks / Disaster inflicts psychological burden

• Aftermath may bring major life changes and uncertainty about future life

Psychological Trauma

Grief, Loss, Anger, Guilt

Social and Lifestyle Stress

Mental Health in Disaster

overwhelmed

confused

fearful

anxious

numb

detached

mild/ severe

reactions

Communities can be severely affected in many ways.

Patients are

separated from their

loved ones, due to

illness or death.

Those associated with

COVID -19 can be

vulnerable to social

stigma, worsening their

distress & isolation

Health workers /

frontliners need to

deal with a high

workload & a lot of

stress.

people

experience a

wide range

of reactions eg:

Exposed to long hours of work

Poor / Horrible conditions

Dangerous / Life threatening

Lack of Information

Lack of Coordination

Fear of unexpected

Any Individual may be affected emotionally

Everyone reacts or responds differently to stressful situations WORRY

FeAR

Helpless

Anxious

BOREDOM

LONELY

ANGER

CATEGORIES OF RESPONDERS IN CRISIS

• Fire fighters, Rescue and Emergency workers

• Medical doctors and Nurses • Mental Health Professionals

• Police Officers

• Local Government Officers / Private Sectors

• Soldiers

• Volunteers from different background

Relief work Service provided to the individuals in need, especially in

an emergency context such as disasters/crisis.

Relief worker, the service provider Anyone with or without experience involving in a disaster

but preferably someone with specific training or knowledge.

AN EFFECTIVE RESPONDER

•Willingness to undergo training •Able to care and be empathetic •Able to work in a team and accept different views and opinions of others (TEAMWORK ) •Able to follow instruction from higher management

DEPLOYMENT MISSION : COVID-19

•Uncertainties •What to expect next? •What happens when you come back? •Need to quarantine? •Need to test… swab?

Deployment

Pre • Before the mission

Intra • During the mission

Post • After the mission

PRE- DEPLOYMENT (1)

This stage refers to the preparation phase before going for a mission

1. Pre-deployment Briefing – Anticipation of the mission

• the event • scope of service • target groups • length of service • availability of updated information • relevant training

PRE- DEPLOYMENT (2)

2. Mental Health Preparedness

(i) Personal Consideration : - Assess your comfort level with the various situations you may experience - Working in environments where the risk of harm or exposure not fully known

(ii) Health Consideration - Recent emotional or psychological challenges - Enough medication available for the total length of assignment plus some extra days

(iii) Family consideration - Family prepared with your absence

- Do you have a strong supportive environment to return to after your work assignment ?

Intra- DEPLOYMENT This stage refers to the management and maintenance

during a mission

1. Pre-incident education and discussion on mobilization

• Update about the current status of disaster/crisis condition

• Discuss job scope and responsibilities

• Report writing, discussion or group briefings

2. On-site group dynamic • Team spirit, communication, trust, peer supervision and

support

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Intra- DEPLOYMENT Thus, it is important for us to constantly monitor the

following aspects Keeping updated with current status

- Emergency contacts, changes of situation and mission

Personal care and safety Ensure proper PPE at workplace Good personal hygiene: hand washing Healthy diet i.e. vitamin and mineral supplements, Avoid

taking excessive caffeine Comfortable accommodation i.e. clean tent, sufficient

toiletries Appropriate workload i.e. reasonable work shift, time off Availability to contact with loved ones

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Intra- DEPLOYMENT

Good team dynamic peer supervision and support mutual understanding

Emotional management Stress management, monitor stability of mood, motivation level Be able to identify potential symptoms of acute stress condition

Spiritual empowerment Allow time for personal spiritual restoration if needed

Relaxation practice

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Intra- DEPLOYMENT

Every mission is a new exposure and experience to any relief worker.

You may experience on-going

stressors associate with the nature of disaster/crisis work

16

Volunteers may experience horrific or dangerous situations that leave them tormented by strong stress reactions

Need to be readily prepared in terms of – Physical well being √ – Mental well being √

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Physical

Dry mouth

Tremor

Headaches

Sleep difficulty

Change of appetite

Fatigue

Body aches

Palpitation

Rapid breathing

Stomach ache

Diarrhoea

Restless

Easily agitated

Low motivation

Worry

Poor concentration

Forgetful

Self-defeating

Low self-esteem

Anxiety

Loss of interest (Anhedonia)

Feel bored

Low mood

Psychological

How to recognize Stress in Yourself?

Behavioural

Execessive smoking

Inappropriate drug and alcohol used

Change of appetite

Aggressive behavior i.e. bully, vandalism

18

Mental Health Self Check

Easily anxious

Extremely sad/hopeless/helpless

Feeling guilt

Easily irritated / angry

Extremely tired

Difficulty in sleeping

Crying without any specific reasons

19

Intra- DEPLOYMENT

Identify affected worker who presented with:

Preference not to talk

Refrain from group activities during off time

Tired of continual interaction with other

individuals

Tendency of isolation / social withdrawal

20

End of Mission?

Post- DEPLOYMENT This stage refers to completion of mission

Post-deployment briefing Updated with current status Announced completion of mission Thought sharing and passing over of duties Make necessary referral to local health care provider

if needed

Psychosocial management Assessment for mood and stress level Aware of potential mood instability

22

Post- DEPLOYMENT

Take a break ! Quarantine if required Enjoy a few days off Rest to restore energy Spend quality time with family and friends

Readiness of job resume Return to work station

To maintain healthy mentally

23

Coping Skills and Mental Health Care Of

Responders

Developing healthy coping skills

and learning to be resilient may help you during times of high stress.

Resilience is the ability to adapt well to stress, adversity, trauma or tragedy

25

HOW TO COPE…

• TALK to someone you trust to share upsetting emotional responses and strengthen support system

• Recognize HALT – Hungry, Angry, Lonely, Tired

• Allowing time off or breaks during deployment

• Suitable level of humour

• Constant communication with the loved ones helps prevent sense of alienation

26

Personal Care

• Practise good hygiene: hand washing

• Maintain regular meal intake

• Have regular physical activity

• Schedule time for yourself – Leisure activities, activities of interest

• Maintain good sleep hygiene

• Avoid drug and alcohol use

• Seek out social support

27

• A type of relaxation • Expansion of abdomen instead of chest • Benefits:

• Relaxation • Release tension • Manage pain • Improve digestive system

• Mentally Present!!

28

Inhale through nose and expand your belly (1..2..3..4..)

Hold for a while (1..2..)

Exhale through mouth and empty your belly (1..2..3..4..5..6..)

Hold for a while (1..2..)

29

Expect a readjustment period

upon returning home.

You may need to make personal reintegration a priority for a while

30

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IF SYMPTOMS PERSIST AND DISTRUPTS LIFE

SEEK MENTAL HEALTH AND PSYCHOSOCIAL

SUPPORT FROM MHPSS PROVIDERS / SEEK

PROFESSIONAL HELP

33

Mental Health Alert Card

34

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Public Health

Physicians

Family Medicine

Specialists

Medical

Practitioners

MHPSS PROVIDER

Resource Person:

Medical Social

Workers trained in

mental health

Paramedics

trained in mental

health

Registered

counselors from

NGOs/ Trained

Volunteers

Psychiatrists

Psychology

Officer

or click the following link: https://tinyurl.com/INFOMHPSS1

PSYCHO-EDUCATION MATERIALS FOR HEALTH CARE WORKERS AND

OTHER RESPONDERS

Scan this QR Code:

THANK YOU

TERIMA KASIH

ACKNOWLEDGEMENT TWG PEACE (Technical Working Group for Psychosocial Empowerment & Crisis Education): LEP 2.0 JICA – Psychosocial Response to Disaster