Psychology, Nontraditional First Responders

The term first responders refers to trained personnel who are expected to be first on the scene in an emergency, and traditionally includes professionals such as police officers, firefighters, and emergency medical technicians (EMTs). With increasing awareness of the trauma that often accompanies disasters and the importance of responding quickly to the psychological needs of victims, [Page 522]the definition of first responders has expanded to include those offering mental health and psychosocial services. Psychological first responders may be individuals with extensive training (e.g., psychiatrists) or persons such as clergy or relief workers who have received targeted training to provide emergency mental health and psychosocial care to survivors of disasters.

Emergency situations, including natural disasters, are abnormal conditions that can cause significant mental and psychosocial suffering to the survivors, and undermine the ability of both individuals and communities to recover and resume normal functioning. The purpose of psychological first response is to limit the immediate psychological damage experienced by victims of disasters, as well as to reduce future harm that may occur as a result of the trauma.

A good example of the use of psychological and other nontraditional first responders was the response to the terrorist attacks on the World Trade Center in New York City on September 11, 2001. Social workers, psychologists, psychiatrists, and clergymen were among first responders to this disaster, and they served the needs of not only the victims of the attacks, but also of traditional first responders such as firefighters and police officers who requested counseling or other mental health services.

It is now accepted as standard procedure that appropriate humanitarian response to any disaster include provisions to address the mental health and psychosocial needs of the affected population. This expectation is set forth in a set of guidelines issued in 2007 by the Inter-Agency Standing Committee (IASC), a committee including representation from the United Nations, Red Cross and Red Crescent, and many nongovernmental organizations (NGOs). The IASC guidelines also state that all aid workers are responsible for ensuring the mental health and psychosocial well-being of survivors, rather than regarding such needs as the province of specialists such as psychiatrists and psychologists.

Although all survivors are vulnerable to psychological trauma after a disaster, there is a large diversity of risks and special needs within any population, and psychological first responders must be sensitive to these differing needs among subgroups of a population. For instance, women may be dealing with pregnancy or childcare, and may be at particular risk for sexual assault if conditions of normal order have broken down. Men may be at particular risk for mental and psychosocial distress, because the disaster has robbed them of the ability to support their family. Children are vulnerable because of their dependent status, as are elderly people, and their vulnerability is exacerbated if they have been separated from their families. People with pre-existing psychological problems or disabilities require particular monitoring, because the stress of a disaster may worsen their condition or prevent them from accessing available humanitarian services (such as food distribution centers). People who are extremely poor, internally displaced, or are members of socially stigmatized groups may also require special consideration.

...