Documentos de Académico
Documentos de Profesional
Documentos de Cultura
Aleyna R. Caras
Global Connections
Gregory Falls
December 2017
PSYCHOLOGICAL FIRST-AID 2
Abstract
This paper explores the psychological and economic impacts of natural disasters, what
Psychological First-Aid is, how it helps disaster survivors, why it is important, and why it should
be improved in the Philippines to benefit their communities. Natural disasters cause tremendous
amounts of damage, not only to the environment and infrastructure, but to the people affected
along with their livelihoods and futures. Psychological First-Aid plays a vital role in helping
disaster survivors cope with their trauma and be lead to and through the path of recovery. It is
crucial that it is available for any individual in need of it at any time. The Philippines is known to
be one of the top most disaster-prone countries, which makes the presence and availability of
Psychological First-Aid very crucial. With the implementation of improved Psychological First-
Aid in The Philippines, the country can be better prepared for natural disasters and improve the
Table of Contents
Abstract…………………………………………………………………………………………....2
Table of Contents………………………………………………………………………………….3
Introduction………………………………………………………………………………………..4
Limitations………………………………………………………………………………………...5
Literature Review…………………………………………………………………….……………6
Discussion………………………………………………………………………………………....8
Psychological First-Aid……………………………….………………..………………..16
Conclusion……………...…………………………………………………………..…………....25
References……………………………………………………………………………..………....27
Appendices………………………………………………………………………...…………......31
PSYCHOLOGICAL FIRST-AID 4
Introduction
It all began with the shifting of a few tectonic plates along the East Bohol Fault. On
October 15th, 2013 at 8:12 a.m., a deadly magnitude 7.2 earthquake hit The Philippines, with the
epicenter at the island of Bohol. The earthquake affected 3 million people, displacing more than
300,000 of them and damaging 73,000 homes along with historic buildings, ports, schools, and
airports. There were over 800 people injured, over 200 killed, and some that went missing and
were never found. However, Mother Nature was not done with The Philippines just yet.
Less than a month following the Bohol Quake, Typhoon Haiyan struck. One of the
strongest typhoons recorded in history, it affected the lives of hundreds of thousands of people.
Forming on November 3rd, 2013, it continued to develop and intensify until finally dissipating
on November 11th, 2013. Throughout its rampage, nearly 800,000 people were forced to flee,
millions of homes were damaged, at least 6,300 people were killed in the Philippines alone, and
over a thousand people still remain missing. Within the span of a few weeks, the lives of millions
were altered forever, and these are only two of the countless tragic calamities that the Philippines
The Philippines is one of the most disaster-prone countries in the world. Over the past
two decades, almost 300 natural disasters have occurred. From earthquakes to floods to tsunamis
and hurricanes, natural disasters are large scale catastrophic events that cause tremendous
amounts of damage in many ways. The severity of disasters are measured in regards to the
amount of lives lost, economic losses, and a population’s ability to recover and rebuild. The
people that survive them are more likely to develop mental health issues due to their experiences.
Not only are they psychologically distressed, but they can be physically injured as well as
financially unstable due to expensive medical bills or the extensive loss or damage of property.
PSYCHOLOGICAL FIRST-AID 5
With all of these unfortunate events piling up on thousands of individuals, it is critical that they
receive the proper care they need. Psychological First-Aid is one of the most necessary
immediate responses following a natural disaster that helps individuals affected, and in disaster-
prone areas like The Philippines, with the proper aid, they can be helped psychologically and
economically.
Limitations
Geographical Limitations. While natural disasters have occurred and continue to occur in
numerous locations around the world, the author has decided to narrow down the geographic
region to one specific country: the Philippines. The Philippines has a long history of being
disaster-prone and offers a plethora of research, experimental results, records, and other sources
of information throughout the years on the topic area. Narrowing down the research to this one
country makes for a more centralized and in-depth analysis of the issue. However, this does not
lessen the impact of natural disasters on other countries around the world.
Aspects Addressed. Although there are several aspects that are affected following natural
disasters, the author chooses to focus on the psychological and economic effects, and further
focus on on a few aspects of the economic effects. This does not lessen the importance of other
aspects and procedures concerning Psychological First-Aid. This helps to further narrow down
the research and provide the most important information necessary to support the research.
Access to Information. The author does not have the ability to physically retrieve information
from the Philippines. They can not travel there to conduct research such as physically
interviewing individuals that have been affected by natural disasters. They are limited to
databases, finding connections electronically, and local resources. However, these resources still
Literature Review
disasters. As they are common geologic and meteorological occurrences, they can be
earthquakes, tsunamis, volcanic eruptions, floods, droughts, mudslides, tropical storms, and even
famine such as pandemics. Technological disasters usually result from industrial accidents or the
failure of large scale infrastructures. Regardless of the type of natural disaster, it is important that
workers providing PFA have the ability to provide basic mental health support to survivors.
Organized and supportive interventions can reduce stress, increase efficacy, and help to prevent
future mental health issues like depression and Posttraumatic Stress Disorder (PTSD). Mental
health issues such as depression and PTSD are described in Sustainable community mental
health: psychological first aid in humanitarian emergencies, a report done by Thomas F. Ditzler,
In an article from the Journal of Consulting and Clinical Psychology, Treatment of Acute
another article from the Journal of Applied Social Psychology, Coping self-efficacy and
psychological distress following the Oklahoma City bombing, with an increase in self-efficacy,
people develop increased positive outlooks on their abilities to cope with and manage distressing
events, which can be done through self-regulation of thought, behavior, and emotions. From the
Journal of the American Medical Association, the research from the article Exposure to
terrorism, stress-related mental health symptoms, and coping behaviors among a nationally
representative sample in Israel indicates the relation between social support and improved
PSYCHOLOGICAL FIRST-AID 7
emotional well-being and recovery following mass trauma is the basis for promoting
connectedness.
any size, up to and including an entire society, can be a complex issue to deal with. In
“One can only try to support their recovery by re-establishing dignity, self-worth
and appreciation for life and individuals; some will recover on their own, while
others will not. Unfortunately, people tend to return to violence soon after being
exposed to chronic, continuous trauma. The future is very bleak for countries
where the population has been heavily traumatized as a whole.”
With this said, providing PFA can be quite difficult dealing with different types of people
in several different types of situations. This makes the need for the implementation of PFA as
well the proper training for workers providing it even more crucial. From the article
Bioterrorism: what are we afraid of and what should we do? by RM Demartino, between 4 and
50 people are psychologically affected by a traumatic event for each person physically affected.
DiMaggio, PhD, MPH, PA-C, and Sandro Galea, MD, DrPH, of those directly affected by
trauma caused by humans, 12% to 16% of them will develop PTSD. 75% of those people will
There are several aspects of the lives of individuals that are impacted by natural disasters.
Not only are there the obvious possible physical and psychological effects, but there are the
social and economic effects as well. Property becomes damaged, lost, or completely destroyed,
which can range from small personal belongings to entire homes. The right to housing is
discussed in Sheltering and Housing Recovery after Disasters: Dissecting the problems of policy
PSYCHOLOGICAL FIRST-AID 8
Public Administration at the BJ-ML School of Public Affairs, in the International Journal of
Humanities and Social Science. Access to resources may be limited and those in poverty suffer
extensively. On a report from VOA news by Joe DeCapua, Natural Disasters Worsen Poverty,
the connection between the two issues and how not only do natural disasters worsen poverty, but
how poverty itself causes disasters as well. Schools may be destroyed or damaged, and without a
place to conduct education, education is hindered as a whole. This issue is discussed in the report
Education Disrupted: Disaster Impacts on Education in the Asia Pacific region in 2015 Article
by Sarah Ireland, Humanitarian Advocacy and Policy Advisor from Save the Children Australia.
Discussion
Natural disasters are natural events that cause great damage or loss of life. They fall into
3 broad categorized groups. There are those that are caused by the movements of the Earth, those
caused by the weather that can usually, to some degree, be warned of in advance, and those
caused by extreme weather conditions, usually the result of extreme and unforeseen conditions.
Their impacts can vary depending on different aspects, such as the type and size of the disaster
and the population affected and their vulnerability to disasters. Some examples of natural
mudslides, landslides. The lives of those affected by disasters like these can be impacted in
several ways. This paper will focus on the psychological and economic effects of natural
disasters.
affected. Evidence has provided that they can severely compromise the wellbeing of affected
PSYCHOLOGICAL FIRST-AID 9
persons and inhibit their ability to function normally and various studies have been conducted to
show the impact natural disasters have on humans psychologically (Sandhu & Kaur, 2013). Most
psychological responses to trauma are relatively immediate, mild, and transient (Norris,
Friedman, Watson, Byrne, Diaz, & Kaniasty, 2002). However, there is a significant amount of
individuals that develop trauma from stress reactions of higher degrees. Among these
psychological impacts, the most common consist of Peritraumatic stress reactions, Post
Traumatic Stress Disorder (PTSD), grief symptoms, depression, anxiety disorder, substance
abuse disorders, distorted perceptions, pessimism, and thoughts of suicide and attempts at
suicide.
Traumatic events can all begin with some type of stress. Stress is a response that can be
physical or emotional caused by heightened tension or worry. Natural disasters cause changes in
social systems, which in turn requires people to adapt. Peritraumatic stress reactions are an
extreme tier of stress reactions, which can be considered extreme if they cause a significant
decrease in the ability to be oriented in reality, issues with communicating, a negative influence
traumatic event, avoidance, numbing, and hyper arousal occurs. In order for PTSD to be
diagnosed, symptoms must be present for at least one month in the individual. It must also cause
is the second most common psychological disorder observed in disaster survivors. Research
suggests that PTSD prevention and decreased depressive symptoms, in comparison to repeated
PSYCHOLOGICAL FIRST-AID 10
assessment, self-help, education, and support, can be done through immediate intervention,
which in turn benefits in psychological functioning (Bryant, Moulds, Guthrie, Dang & Nixon,
2003).
Grief is a response to loss following a tragic event, typically the loss of a loved one or
several loved ones. Although grief itself is a normal response, complicated grief involves
stronger and deeper emotions. It can consist of an extensive yearning for the deceased, intense
sorrow, bitterness, hopelessness, preoccupation with the loss, and the inability to go on living
life. Individuals with extreme grief tend to focus on things that remind them of loved one or
When put into a situation with limited information, humans tend to make decisions based
on just the information given at the specific moment in time (Sandhu & Kaur, 2013). For
example, people in more positive moods are more likely to handle a situation with a more
positive outlook and make more favorable evaluations rather than people in more negative
moods who would lean more towards pessimism. Pessimism can have detrimental effects on a
person’s behavior and actions. Metacognitive feelings can modify the effect on judgments and its
impacts (Sandhu & Kaur, 2013). As a result, these feelings and moods influence the views
Economic Effects. Natural disasters impact the lives of people in several ways
economically. They can affect those living in poverty, impact education, damage homes and
Natural disasters hits those in poverty the hardest. Until they’re better prepared to face
them, extreme poverty cannot be eliminated. Dr. Tom Mitchell, ODI’s head of Climate Change
PSYCHOLOGICAL FIRST-AID 11
and author on a report on The Geography of Poverty, Disasters and Climate Extremes in 2030,
“What we found is there’s a very close overlap between the countries that we
expect to have very high levels of poverty still in 2030 and the countries most
exposed to natural hazards. And now this shouldn’t really come as a surprise
because we know that the poorest and most vulnerable people get hit hardest by
extreme events. So there really is a very close link between poverty and
disasters.”
He also stated the following on how their misfortune is not solely due to bad luck:
“Natural hazards don’t discriminate. It’s actually people who discriminate and
governments who discriminate. So what you find is that the poorest and most
vulnerable people are living in the most exposed areas – whether in informal
settlements on the edge of cities or in remote rural areas with poor access to early
warnings or to infrastructure. And in that regard they are in an acute position in
terms of their exposure, and they have very little assets to cope.”
With this said, it is evident that those in poverty are in no financial position to account for the
In countries that have been affected by natural disasters, government programs tend to
focus more on big cities or areas with infrastructures with higher value rather than areas with the
poorest and most vulnerable people, even if they are the most affected by the event, this results
in socio-economic inequality. Those living in poverty are more likely to live in areas that are
more exposed to hazards and are less able to develop or maintain risk-reducing measures
(UNISDR, 2015). Because they lack access to insurance and social protection, they are forced to
use up the limited assets they have, driving them even further into poverty. Therefore, poverty is
not only a consequence of disaster risk, but also a cause of them and are a determinant to what
extent and extremity risks reach following disasters. Along with loss of life, injury, and damage,
disasters cause displacement, food insecurity, poor health, and several other negative
PSYCHOLOGICAL FIRST-AID 12
consequences. Health-related and social aid are not always readily available (See Appendix B for
a table with information on High-Quality Health, Behavioral Health, and Social Resources).
Poverty is affected in both rural and urban areas when natural disasters hit, but in
different ways. Rural areas have a very limited capacity to handle the damage of disasters and
recover from them. This is due to the area being highly vulnerable and exposed to weather-
related hazards. In poor urban households, shelter is the principal economic asset that provides
people with sanctuary and security. Natural disasters cause physical damage to these households,
destroying personal possessions as well as housing as a whole. As a result, replacing these assets
determined by a wide range of economic and social factors shape disaster risk (Shepherd,
Mitchell, Lewis, Lenhardt, Jones, Scott, & Muir-Wood, 2013). Disaster risk and resilience are
directly affected by access to resources, political voice, and economic and social status.
Underprivileged areas have insecure and low-quality housing. This limits access to basic
The following are a few more facts and data from Disasters and Responses, News, an
article by Beth Kanter from FAMVIN, NewEN, on the connections between poverty and natural
disasters. “About 95 percent of deaths caused by disasters occur in poor countries. A disaster of
similar nature and size causes more deaths in poor countries than in rich ones” (Kanter, 2005).
After a disaster, disease spreads quickly if there is no clean water and limited toilets available.
Limited healthcare resources in poor countries can be inadequate for dealing with the health
emergencies that result from disasters” (Kanter, 2005). “Children orphaned by disasters in poor
countries are vulnerable to exploitation of various sorts, including sex trafficking. Poor countries
PSYCHOLOGICAL FIRST-AID 13
have limited or no resources to deal with the post-traumatic stress that survivors may face for
decades to come, especially for parents who feel guilty that their children perished” (Kanter,
2005).
Along with those in poverty, disasters majorly impact children and youth and their
education. The lives of around 200 million children per year will be severely impacted in the
Asia Pacific region in future decades due to natural disasters. Natural disasters prevent children
from getting the quality education in which they have a right to. Disaster risk reduction is not
prioritized and the resources for them are not provided by governments. This makes the recovery
Communities and countries as a whole can gain benefits with the support of education,
prior to, during, and after disasters hit. Schools can have a catalytic effect on strengthening
humanitarian effectiveness, reducing vulnerabilities and supporting risk mitigation for future
hazards (Ireland, 2016). Investing in the protection of national education systems and reducing
their vulnerability would allow for a smoother and less expensive recovery. Thus, children will
The following are a few facts from the report Education Disrupted by Sarah Ireland on
disaster impacts on education in the Asia Pacific region. “Pre-existing challenges with school
enrolment, alongside the damage to education infrastructure, often leave many children in need
of critical education support to help ensure their longer-term development” (Ireland, 2016).
of damaged schools is often belated. Almost a year after the earthquakes in Nepal and Cyclone
Pam in Vanuatu, children are still being taught in temporary learning centres that were meant for
use for weeks or months, not years” (Ireland, 2016). “There are significant gaps in information
PSYCHOLOGICAL FIRST-AID 14
from the education sector on both the short- and long-term impact disasters have on education. A
lack of official data collection and analysis on the number of children and schools affected by
bodies and community organizations, and on the effectiveness of the education response as a
Along with the impact natural disasters have on groups of people, there is the evident
physical damage done to homes and infrastructure. It deals with not only the recovery of houses,
but also debris removal, infrastructure, and economic development. In Chapter 14 of the
Handbook of Disaster Research, authors Smith and Wenger write about sustainable disaster
recovery. They describe the recovery phase as the process of restoring, rebuilding, and reshaping
the physical, social, economic, and natural environment through pre-event planning and post
Many people run into problems restricting their right to housing. The right to housing is
one of the most recognized social, economic, and cultural rights, yet people still fail to acquire
housing, especially following natural disasters. Housing and sheltering issues are very important
in many places all around the world, especially to victims that are vulnerable and at a social
disadvantage following natural disasters (Bolin & Bolton, 1986; Smith, 1999). The United
Nations Economic and Social Council established the Committee on Economic, Social and
Cultural Rights (CESCR). CESCR stated that, “victims of natural disasters” and “people living
in disaster prone areas” as among those disadvantaged groups should be ensured “some degree of
The right to housing goes hand in hand with the process in which housing recovery
occurs. Whenever communities experience natural disasters that cause substantial damage or
PSYCHOLOGICAL FIRST-AID 15
complete destruction of houses, the recovery process is usually slow and extremely painful to go
through. People must find temporary housing, food and clothing, and receive psychological
counseling. Many people also run into issues with their jobs and need to find further assistance,
and businesses must recuperate from their losses and attempt to restart themselves with what
As discussed, there are several aspects in which natural disasters impact different groups
of people, communities and populations as whole, homes and structures, and the lives of people
and their livelihoods. Although there are many more aspects that could be addressed in regards to
the effects of natural disasters, the psychological and economic effects are very prominent and
make the biggest impacts on individuals, with the economic effects also not limited to the lives
of those in poverty, children and youth and their education, and the physical effects on homes
and infrastructure. The psychological and economic effects also inversely affect one another.
When individuals are experiencing mental issues, it can affect their education or their work, and
with economic strains such as financial instability and the overload of stress, their risk of
developing mental health problems increase. Therefore, disaster survivors that are negatively
impacted in these aspects are stuck in back and forth cycle of stress and struggle. With this said,
it is evident that natural disasters have the capability to cause massive damage and change the
lives of many, but now the question is: How can these people be helped?
Psychological First-Aid
Today, the term and concept of Psychological First-Aid is relatively new and is
immediate, practical mental health support to disaster survivors. It consists of a systematic set of
helping actions with the goal to reduce initial post-traumatic distress and supporting adaptive
PSYCHOLOGICAL FIRST-AID 16
functioning, short and long term. The belief that Psychological First-Aid implies the presence of
psychopathology is a common misconception. Its entirety does not consist of providing a formal
diagnosis or traditional forms of mental health care. Its overall purpose is to identify and respond
to immediate emergency situations and aid individuals involved. This is done by going through
specific tasks and using short-term practical interventions that have demonstrated their utility in
trauma response intervention that is on a larger and more comprehensive scale, as well as
collectively addresses a wide range of disaster-related problems and associated needs (Ruzek,
Brymer, Jacobs, Layne, Vernberg, & Watson, 2007). The basic goals of PFA are to reduce stress
of affected persons from trauma, direct them away from further traumatic stimuli, meet their
immediate needs, and to provide them a means of further recovery (Ditzler, Hastings, & Deleon,
2009).
compassionate and non-intrusive manner, providing emotional and physical comfort while
securing safety, offering practical information and assistance in order to address immediate
needs, calming individuals and helping to reduce their stress, connecting individuals to additional
help and support, encouraging positive coping means, and linking for further recovery (Ditzler et
al., 2009). More specifically, Psychological First-Aid consists of Eight Core Actions. These core
actions are Contact and Engagement, Safety and Comfort, Stabilization, Information Gathering,
Practical Assistance, Connection to Social Supports, Information on Coping, and Linkage with
Collaborative Services (See Appendix A for a table with an overview from the Psychological
Contact and Engagement. Affected persons may not seek out help from providers or
want it. This means the provider must assess situations by using their judgement to determine
how to initiate contact. Providers should be non-intrusive, compassionate, and helpful. Once they
are introduced they can should about any needs that need to be met immediately. This initial
interaction is very important because it gives the person affected a sense of connectedness,
making them more willing to trust the provider and accept further aid.
Safety and Comfort. The first steps to providing practical help consist of ensuring
immediate physical safety, promoting a sense of psychological safety, as well as physical and
emotional comfort. PFA providers may need to obtain assistance from a medical or security team
when it comes to persons that may be a potential threat to themselves and others. Assisting to
immediate physical safety means PFA providers should be alert to attend to critical medical
concerns and help to protect affected persons from further trauma. PFA providers should
encourage affected persons to be active, facilitate their reconnections with family members and
other affected persons, and inform them on accurate information on the event such as what is
currently known about the event and the services that are helping to aid survivors of the event.
Above all, it is especially important to judge every person’s situation properly in order to decide
how to approach their needs while protecting their privacy and respecting their wants at the same
time.
their stress. It isn’t necessary to stabilize expected expressions following traumatic events such
as expressions of strong emotion, but rather reactions that inhibit their ability to comprehend the
situation or respond to guidance. These reactions may consist of a person being unresponsive to
they cannot control. PFA providers have several ways in which they can take action, they can
comfort the distressed person by taking them aside or allow their loved ones to provide comfort
to them, giving them time alone, simply being present for support, or seeking other professional
assistance.
gathering information consists of identifying immediate needs and concerns and properly
tailoring means of intervention. This process is repeated as needed throughout the course of
disaster response. Meanwhile, the PFA provider should look for the needs for potential referral,
additional services, or follow-up contact. Relevant information that may be important to gather
would be pre-existing social support network, prior mental health treatment, and use of alcohol
or drugs. The PFA provider must use judgment while gathering information in order to
determine how much information that must be gathered, what questions must be asked and to
Practical Assistance. A central part of PFA is aiding affected persons and their current
or anticipated problems. Added problems following those of the disaster can contribute to even
more stress for affected persons Problem-solving, discussing immediate needs, and generating
ideas are helpful. With this, it is important to follow up with an active response. This can lead
into further assistance, which is where the next core action, Connection to Social Supports,
comes in.
important. One of the immediate duties of a PFA should be to locate and contact the loved ones
of an affected person. Doing this implements a sense of predictability and normalcy in the
disaster environment. If an affected person is not able to contact a form of social support, it may
PSYCHOLOGICAL FIRST-AID 19
be a good idea for them to engage in interactions with other survivors if appropriate in order to
to stress, ways to reduce their stress, and how to promote adaptive functioning. It may be helpful
to discuss positive and negative actions of coping. They should also educate on disaster-related
information such as what is known about the current event, what is being done to help survivors,
Linkage with Collaborative Services. Many affected person will require additional
services following PFA, making it important to link them with those needed services in order for
them to contact certain agencies or resources. It would be beneficial to involve local community
leaders or other indigenous authority figures that can be principal sources of support. When
making referrals, it is important to discuss all the needs of the affected person and give them
their options for referral. It may be necessary to physically aid them in getting to further
assistance or organizing a meeting with a community representative that can provide appropriate
referrals.
PFA can be provided by a wide range of individuals. Examples include caregivers from
traditional mental health fields, such as psychology, psychiatry, social work pastoral care, or
nursing. It can also be provided by trained paraprofessionals, usually community leaders, from
village elders and traditional healers to teachers and law enforcement or security personnel
(Ditzler et al., 2009). With the different types and levels of aid PFA involves, a variety of
qualifications must be met as well as receiving varying levels of training. Because the knowledge
and capabilities of members of different professions differ, the capacity in which they can
competently carry various interventions varies and which groups or individuals they can work
PSYCHOLOGICAL FIRST-AID 20
with too. Therefore, added consultation services and referral networks are available in order to
ensure quality and continuity of care, which helps to prevent adverse effects (Ruzek et al., 2007).
Several studies and experiments have been conducted dealing with Psychological First-
Aid. In South Korea, a preliminary evaluation was done in order to examine the training effects
of a didactic and simulation-based psychological first aid program in students and school
counselors. Recognition of the importance of aiding in psychological needs from disasters has
been increasing in Korea. This has especially occurred in response to recent disasters nationwide,
including the Sewol ferry disaster in 2014 and a series of earthquakes since 2016. The nation is
now more aware how important PFA is and the training that comes with it.
A study was conducted by Jong-Sun Lee, Sungeun You, Yun-Kyung Choi, Hye-young
Youn, and Hye Sook Shin to examine if a PFA program on knowledge and skills would
significantly impact training effects. They did so with thirty-seven students, undergraduates
studying psychology to obtain their Bachelor’s degree and graduates studying clinical
psychology to obtain their Master’s Degree. On August 30, 2016 the students participated in a
one-day workshop at Keimyung University. They took part in a 3-hour didactic lecture delivered
clinical psychologists. The study assessed their knowledge on PFA and perceived competence in
PFA skill.
This study provided results showing that a day of training for PFA with a didactic lecture
and a simulation-based practice yielded medium to large effect sizes. They found “a medium-
sized effect on PFA knowledge and perceived confidence to provide psychological assistance for
future disasters and large effects on perceived competence in PFA skills and perceived
preparedness” (Lee, You, Choi, Youn, & Shin, 2017). They concluded that using an evidence-
PSYCHOLOGICAL FIRST-AID 21
based PFA program to train qualified disaster mental health providers could lead to a well-
Another similar study was conducted by Suzanne Hawley, Gary Hawley, Theresa St.
Romain and Elizabeth Ablah, but in the state of Kansas in the United States. It assessed
perceived mental health preparedness knowledge following mental health preparedness training.
The participant consisted of 157 first and secondary response responders from public health
Preventive Medicine and Public Health at the University of Kansas School of Medicine-Wichita
on mental health emergency preparedness topics. Topics included stress reactions, mental health
and physical consequences from a disaster or terrorist event, factors of resilience, and the
preparedness knowledge from their pretests to their post-tests. On a 6-point Likert scale, from
pretest to post-test, there was an increase from 3.17 (“adequate”) to 4.63 (“good” to very good)
of mean perception of knowledge about typical stress reactions from terrorist or disaster events.
The study exhibits the potential mental health-related and non-mental related occupations have in
improving mental health preparedness knowledge through further training. The conductors of
These studies evidently provide support for the effectiveness of mental health preparedness
training to increase the knowledge of the topic for public health professionals and that have high
The Philippines has it’s long history of natural disasters, from Tropical Depression
November 2006 and Tropical Storm Washi in December 2011, and the Bohol Quake in October
2013 and Typhoon Haiyan in November 2013, the list goes on (See Appendix C for a transcript
of an interview with a Filipino Immigrant on natural disasters in the Philippines). With the
country being one of the most disaster-prone countries in the world, it is extremely important that
those in the country affected by natural disasters receive the Psychological First-Aid they need.
One of the major issues faced following traumatic disaster events are psychological.
However, mental illness is an issue that Filipinos still find difficult to understand. The
Philippines Daily Inquirer in Makati, the Philippines stated that Filipinos “feel uncomfortable
when discussing, for instance, depression, anxiety and bipolarism, or they tend to stigmatize
these illnesses-criticizing those who open up about their condition, calling them 'OA,' (meaning
they are overacting or being dramatic) or disregarding the seriousness of their condition.” It is
crucial that when people have been psychologically affected by an event that they are helped in
Along with psychological impacts, education is affected as well. There is a total of over
46,000 primary schools and 12,000 secondary schools in the Philippines. Over 20 million
students are enrolled in private and public schools. Because the country experiences natural
disasters frequently, education is often disrupted. School buildings are damaged, teaching
PSYCHOLOGICAL FIRST-AID 23
materials and school supplies are lost, teachers are unavailable for long periods of time, students
and teacher are injured or killed, and students often drop out (Ireland, 2016). The growth and
educations of the youth are put to a halt and their lives severely affected.
The country as a whole is still developing and still lacks and resources, technology, and
funding developed countries have. The recovery process can be slow and long due to the lack of
resources and aid. Those living in rural areas and in poverty especially may not have the
transcript of an interview with a Filipino Immigrant on the presence of PFA in the Philippines).
These difficulties and drawbacks make it evident that improved PFA is very much needed and
extremely crucial to have in the Philippines in order to manage the effects of natural disasters.
PFA has, however, improved in the Philippines on multiple occasions in past years. The
Government of the Philippines and the international community has done work to reduce the risk
of impacts of such disasters and alleviate them. The Philippines has created binding frameworks
and legislation, addressing disaster risks and response in a comprehensive manner, to improve its
coordinating the work of the large amount of government and non-government agencies and
The Mindanao conflict in the Philippines first began in the 1960s. The Muslim minority
began an armed struggle in order to regain their ancestral homeland in the southern island. Since
then, peace has been interchanged with clashes between the Bangsamoro rebel forces and the
Armed Forces of the Philippines (AFP). This has caused the displacement of tens of thousands of
people. In November 2008, the Medecins Sans Frontieres or MSF began working to provide
medical care for those displaced. Psychologists trained community health workers to be able to
PSYCHOLOGICAL FIRST-AID 24
identify and refer cases of mental disorders and epilepsy to the MSF mobile clinics. There, the
mental health team would provide persons with proper diagnosis and treatment. The Mindanao
project in the Philippines provides support that in an emergency humanitarian context, mental
health approaches, such as PFA, can be integrated into primary health care (Mueller, Cristofani,
In December 2013, Filipino health professionals were given the opportunity to learn how
to teach others to provide PFA in support of typhoon survivors of Typhoon Haiyan. The
Philippine Department of Health (DOH) with support from the World Health Organization
and community agencies to learn about PFA recommended by WHO. Filipino psychologists,
physicians, and psychiatrists used the train-the-trainer method to teach people in the community
how to perform PFA. This approach showed that anybody is capable of being of help during
crisis situations. “Filipinos, we are very compassionate. So it is kind of cultural for us to be warm
to people and aid someone who is seeking help. This makes the approach very conducive for our
local context” stated Dr. Criselda Abesamis, the Director of the Special Concerns Technical
Cluster at DOH.
Conclusion
Natural disasters result in various effects on people and their communities. Psychological
effects should be handled with great care due to their sensitive nature, and economic effects
should be focused on in order to build back up lives that have been broken down. Those in
poverty, children and youth and their education, homes and infrastructure, and access to
resources are aspects that are majorly impacted when it comes to natural disasters. People all
around the world every year, every month, and every day are suffering from their effects.
PSYCHOLOGICAL FIRST-AID 25
Psychological First-Aid helps to aid in all aspects and responds to immediate needs. It is the
most crucial first-step in aiding disaster survivors and provides for an easier, faster, and more
efficient recovery.
The Philippines faces many challenges dealing with natural disasters, especially with how
frequent they occur. It is evident that it experiences the major psychological and economic
effects commonly present following natural disasters. Poverty is still very prevalent, education is
still vulnerable to disruptions, and overall there is an absence of resources and financial support
in the country to go towards PFA so that all people, regardless of who they are or where they
live, are able to receive it. With the knowledge of what PFA is able to provide, the improvement
of it can be supported and should be implemented in order to lessen the damage done physically
and emotionally. The Philippines still remains a developing country and requires additional aid
in PFA among other aspects. Although, it is still important to acknowledge the successes the
Philippines has had with trying to advance PFA in past years. Psychological First-Aid and the
proper training for individuals to provide it should be a priority in the Philippines, because
although natural disasters can not be prevented, mankind still has the capability of ensuring that
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PSYCHOLOGICAL FIRST-AID 30
Appendices
Appendix A: Overview of Psychological First Aid from the PSYCHOLOGICAL FIRST AID
Field Operations Guide 2nd Edition
PSYCHOLOGICAL FIRST-AID 31
Appendix B: Key Elements of High-Quality Health, Behavioral Health, and Social Resources
and Services from the book Building Community Resilience to Disasters.
Appendix C: Transcript of interview with Aurea Reyes, a Filipino Immigrant from the
Q: Could you please give a little introduction of who you are and where you’re from?
A: My name is Aurea Reyes. I’m a 74 year-old Filipino Immigrant from the Philippines and I
lived in Asingan, Pangasinan in Central Luzon of the Philippines from my birth in 1943 to when
I immigrated to the United States in 1966.
Q: Did you ever experience effects from natural disasters during your life in the Philippines?
A: Yes, there were typhoons every single year where I lived, especially during the rice planting
season and rainy season, those were the months where there were a lot of typhoons. Every time
there was a typhoon we would have to stay inside the house because of the heavy rain and strong
wings that could last up to 24 hours. There would be a lot of damage to crops, the branches of the
trees fell down and some uprooted, and there would be flooding. There were usually no
casualties in my neighborhood because people knew to take precautions.
Q: Was there ever any type of aid that was provided to help those affected?
A: When natural disasters hit The Philippine Red Cross would come and help to provide aid,
food, water, and shelter.
Q: Can you describe the degree in which poverty exists in the Philippines?
A: When I was still living in the Philippines, for those families that were not educated and their
parents had no occupation, they depended on farming. My mother was a teacher and my father
was a farmer. Poverty was definitely worse before, it is still present in the Philippines today, but
now it has improved because education has improved. More people have jobs in the city, and
many are able to go abroad and make more money to send home.
Q: Do you think it would be beneficial to implement improved Psychological First-Aid for those
in the Philippines and why?
A: Now a days, there is available help known as Public Health Services, medical people like
doctors, nurses, and midwives go to the rural areas to deliver babies of pregnant women, give
immunizations, treat minor illnesses, and for major illnesses they take people to the hospital in
the city, but they can’t reach everyone. The U.S. is more developed because it has the money,
resources, and advanced technology to aid in the recovery from natural disasters, but in the
Philippines, there’s a lack of money and resources, so it’s harder for them. So I think it would be
beneficial to have better Psychological First-Aid so that they can provide the help people need
and get that help to them better.