This high-level principles document outlines the importance of psychosocial recovery when planning how to respond to and recover from an emergency event.
It is aimed primarily at a health sector audience, but should also be useful for other agencies, organisations, providers and non-governmental organisations (NGOs). Its purpose is to help orient these organisations towards good practice principles for providing psychosocial support to promote recovery in an emergency event.
The document consists of two sections. Part A outlines key evidence-based principles and good practice for providing psychosocial support to promore recovery in an emergency event. Part B gives suggestions for operational planning actions – how to translate the principles into practice.
What is 'psychosocial recovery'?
It is important that everyone involved in emergency planning has a shared understanding of what is meant by the term ‘psychosocial recovery’. In the past, psychosocial recovery has been understood and implemented in different ways by different organisations, both in New Zealand and overseas. Recovery encompasses the psychological and social dimensions that are part of the regeneration of a community. The process of psychosocial recovery from emergencies involves easing the physical and psychological difficulties for individuals, families/whānau and communities, as well as building and bolstering social and psychological wellbeing.
Many components of psychosocial recovery will not be delivered by the health and disability system, but by individuals and families; community organisations such as church groups; welfare agencies; or other groups convened for recovery purposes under the umbrella of the regionally based Civil Defence Emergency Management (CDEM) groups. Most people affected by an emergency event will not need a psychiatrist or psychologist, but they will need food, shelter, security, family reunion and related social interventions. By meeting these needs, agencies and organisations are contributing to psychosocial recovery.
Good practice principles
This document summarises the principles derived from the evidence base, and covers:
- incidence and course
- risk and protective factors
- practice principles
- organisational principles.
The principles are drawn from an evolving knowledge base on the process of psychosocial recovery following a range of natural, technological and mass casualty emergency events. They also align with international best practice guidelines.
Challenges for agencies
The challenges for all agencies are to:
- be aware of the principles of psychosocial recovery
- recognise the breadth of the interventions required
- identify what your agency can deliver that will contribute to psychosocial recovery
- work out how to deliver that particular intervention in a way that co-ordinates with the efforts of other agencies involved with emergency management through the CDEM group governance structure.
What does it mean for service delivery?
This might mean service delivery practices such as:
- a district health board (DHB) mental health service working as part of a CDEM group welfare advisory group to identify staff with specialist skills who can assist with screening for higher-risk people at recovery centres
- a mental health service working with other partner agencies such as Work and Income, Oranga Tamariki – Ministry for Children, local authorities and Victim Support to help provide information for community groups
- a DHB mental health service contributing to the training of Victim Support or other psychological outreach community workers to assist with the appropriate delivery of social and psychological interventions.
However, these functions might also be provided by other agencies or individuals who have the requisite skills and links.
We need to plan for clients/patients and staff
The evidence indicates that most people will recover without the need for specific psychosocial interventions, but organisations with a mandate for psychosocial recovery will need to plan for access to outreach services, psychological first aid, screening and referral to assist those who may need other interventions to help in their recovery.
Health care and emergency service agencies also need to plan for the psychosocial welfare of staff working in emergency situations.
The Severe Acute Respiratory Syndrome (SARS) outbreak in 2003/04 provided critical research evidence for agencies to factor into their psychosocial recovery planning. The education of workers about expected stress reactions and the importance of stress management can help these workers to anticipate and manage their own response to the emergency event.
During the emergency event, consistent adherence to administrative controls is essential. For example, health worker shifts should be limited to no more than 12 hours, and staff should be rotated between high-, medium- and low-stress areas.