Mental Health in the Aftermath of War, Hurricanes & Other Disasters 

A Lunch & Learn program sponsored by the Department for Professional Employees, AFL-CIO, Washington, DC
Wednesday, April 26, 12 Noon–2 p.m. 

Resources
Anne Anderson, LICSW, Coordinator
Psychologists for Social Responsibility 

Talking Points 

1)      Carlinda Monteiro, a community organizer in Angola, uses an icebreaker exercise in her community education workshops.  She asks people to spend a couple of minutes carefully and creatively tearing a piece of paper she provides.  Then, once the paper has been torn, she gives the participants 20 minutes to do their best to put their piece of paper back together.  In this way she makes the point that prevention is the treatment of choice in dealing with violent conflict, and how much better it is for everyone to work hard on community problem-solving processes because of the irreparable mess violence makes. 

2)      Once catastrophes have happened, how we go about providing emergency aid and relief and re-development of the community affects the future of that community.  For example, during an intervention in Kosovo, a community committee asked Christian Children’s Fund’s team to fund a morning breakfast roll for every school child, since they were coming to school hungry.  CCF worked with the community to develop a bakery in an unused part of the school, creating an ongoing business, much-needed jobs, and a chance for the community to take care of their own.  Psychologists for Social Responsibility (PsySR) has been bringing together experts in humanitarian aid to discuss some of the problems they experience in delivering psychosocial humanitarian aid.  Our contention is that there is a psychosocial component in every humanitarian aid activity.  Think for a moment of the familiar scene of a pick-up truck racing through a refugee camp, dumping off sacks of rice, while everyone frantically grabs for some to feed himself and his family.  This emphasizes scarcity; every person for themselves; minimizes cooperation.  Humanitarian aid is now a multibillion dollar industry and needs to be studied and improved.  Fortunately experts are doing that.  The World Health Organization website is a good resource for an update on these issues.  There is also a whole new set of guidelines under construction by the IASC Task Force on Mental Health and Psychosocial Support in Emergency Settings.  These outline social responses in the initial phase of emergencies and how to integrate supports into various sectors such as water and sanitation, food aid, etc.  If anyone would like more information on that, please contact me at psysr@psysr.org. 

3)      Here in the United States we have many more resources and capacities to draw upon.  The handout gives short descriptions and contact information for the National Organization for Victim Assistance, the Capital Area Crisis Response Team, and the American Psychological Association Disaster Response Network.  These volunteer networks are set up to help in a whole variety of community catastrophes.  What I think is important to underscore here is that none of these professionals will be providing traditional therapy, since it is, in general, not an appropriate intervention in the wake of disasters.  People will certainly be affected powerfully by the events they have experienced, but most will not end up experiencing PTSD.  Again, how we intervene can help people’s rapid recovery.  We are generally finding that if people can get involved in the recovery process for themselves and their communities, they are better off.  A side note is that through some back channel communications with FEMA after Katrina, I provided information supporting the advisability of hiring folks from the area to work on the recovery.  FEMA did eventually put a local hiring team on the ground, but I don’t know how far they have taken that at this time.  This would be a good issue to pursue with FEMA and other relevant policy-makers.  I have another example from CCF’s experience:  Their technical assistance group (TAG) landed shortly after the outbreak of violence in East Timor to find the East Timor CCF team feeling devastated and unable to function.  CCF has developed a protocol for quickly establishing child-friendly spaces in the wake of disasters.  The TAG was able to help identify a possible site for the space, and by the end of the afternoon of the first day, villagers had pitched in to clean up a partially standing building—picking up every bit of broken glass—so that children would have a safe place to play while their parents worked on recovery.  This is a good demonstration of how important it can be to the grown-ups to find ways to take care of children, and how empowering it is to do so effectively.  So, we need to think about ways to help communities help themselves. 

4)      Training is another critical issue.  Psychologists and social workers have been finding themselves placed in difficult situations, post catastrophes, with skills and experience that do not necessarily match the needs of the moment.  PsySR sees people in the context in which they live.  So, for instance, if you have someone come in who is very anxious, it will be wise to find out more about their living situation—what they are going back to—before diagnosing an anxiety disorder.  A few years ago we helped develop a blueprint for a one-year graduate level curriculum that brings together training in trauma response, conflict resolution, cross-cultural competencies, and peace education.  While the readings are now a little out of date, the basic framework is still a very valuable resource for considering the needs of a community that has been devastated.  It can be downloaded directly from our website (www.psysr.org) 

5)      This also brings me to the needs of the humanitarian aid workers.  Please check out Idealist.org for lots of resources that focus on “Tending the Helpers’ Fire”, which was the name of a conference they put on a couple of years ago.  Workers are subjected to very difficult conditions, go in with lots of energy and good will, but without support and an understanding of the psychological wear and tear they may experience, they could burn out, or make poor judgments in the field, and end up doing more harm than good, as well as finding themselves devastated.  It is worth noting that the world-wide security issues for humanitarian aid workers is growing worse, especially as the pressure to join one side or the other grows. 

6)      In conclusion, there are many good resources available, and many more being developed.  A key element for successful recovery is to understand the critical importance of taking care of the community as well as the individual.  We human beings are community-based animals.  Our community and social relations are among the most important contributors to resilience that individuals display in the face of catastrophes.  We are probably going to be most effective if we think in terms of providing resources for communities to help themselves recover.