preparing and responding to major accidents and disasters

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This article was downloaded by: [McMaster University] On: 21 November 2014, At: 06:41 Publisher: Taylor & Francis Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK International Journal of Injury Control and Safety Promotion Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/nics20 Preparing and responding to major accidents and disasters Katharina Purtscher a Crisis Intervention Team Styria, Department of Child and Adolescent Psychiatry , Mental Health Hospital Sigmund Freud Graz , Wagner-Jauregg-Platz 1, A-8053, Graz, Austria Published online: 16 Feb 2007. To cite this article: Katharina Purtscher (2005) Preparing and responding to major accidents and disasters, International Journal of Injury Control and Safety Promotion, 12:2, 119-121, DOI: 10.1080/17457300500102955 To link to this article: http://dx.doi.org/10.1080/17457300500102955 PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http:// www.tandfonline.com/page/terms-and-conditions

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Page 1: Preparing and responding to major accidents and disasters

This article was downloaded by: [McMaster University]On: 21 November 2014, At: 06:41Publisher: Taylor & FrancisInforma Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House,37-41 Mortimer Street, London W1T 3JH, UK

International Journal of Injury Control and SafetyPromotionPublication details, including instructions for authors and subscription information:http://www.tandfonline.com/loi/nics20

Preparing and responding to major accidents anddisastersKatharina Purtschera Crisis Intervention Team Styria, Department of Child and Adolescent Psychiatry , MentalHealth Hospital Sigmund Freud Graz , Wagner-Jauregg-Platz 1, A-8053, Graz, AustriaPublished online: 16 Feb 2007.

To cite this article: Katharina Purtscher (2005) Preparing and responding to major accidents and disasters, InternationalJournal of Injury Control and Safety Promotion, 12:2, 119-121, DOI: 10.1080/17457300500102955

To link to this article: http://dx.doi.org/10.1080/17457300500102955

PLEASE SCROLL DOWN FOR ARTICLE

Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) containedin the publications on our platform. However, Taylor & Francis, our agents, and our licensors make norepresentations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of theContent. Any opinions and views expressed in this publication are the opinions and views of the authors, andare not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon andshould be independently verified with primary sources of information. Taylor and Francis shall not be liable forany losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoeveror howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use ofthe Content.

This article may be used for research, teaching, and private study purposes. Any substantial or systematicreproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in anyform to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/terms-and-conditions

Page 2: Preparing and responding to major accidents and disasters

Preparing and responding to major accidents and disasters

KATHARINA PURTSCHER*

Crisis Intervention Team Styria, Department of Child and Adolescent Psychiatry, Mental Health HospitalSigmund Freud Graz, Wagner-Jauregg-Platz 1, A-8053 Graz, Austria

(Received 31 July 2004; in final form 31 August 2004)

After major incidents and disasters psychosocial support for the people affected is urgent

and sometimes predominant. To plan and train staff for psychosocial intervention

European and national guidelines have been developed. The European Policy Paper

‘‘Psychosocial support in situations of mass emergencies’’ offers guidance for policy-

makers and health-planners. The quality and time of early psychosocial interventions

after a traumatic event are important factors for the coping capacity of the people

affected. To meet the needs of those affected crisis intervention teams for psychosocial

acute care have been established and trained in almost all federal provinces of Austria

acccording to the principles of the Policy Paper.

Keywords: Psychosocial care; Crisis intervention; Traumatic event; Major incidents;

Disasters

1. Introduction

After major incidents such as natural disasters, mass

emergencies, technical disasters and severe accidents, in

addition to medical and technical assistance the need for

psychosocial support for the people affected is urgent and

sometimes predominant.

The nature and extent of psychosocial needs in cases of

mass emergencies are as such that they may exceed the

immediate coping capacity of the affected individuals and

the community as a whole. The necessary response in the

different areas of intervention requires a special approach

that is essentially collective and preventive, although

curative care can be necessary as well.

In almost every member state of the EU some kind

of psychosocial intervention is initiated after mass

emergencies. There is however a striking variety in

activities, methods and approaches to the provision of

psychosocial support, depending upon prevailing the-

ories, economic resources, culture and situational

characteristics. Gradually the idea has emerged that

psychosocial interventions need to be prepared and

trained in advance and must be effectively coordinated

and structured during the different phases of the

intervention (Seynaeve 2001).

In this context public authorities have an undeniable

responsibility to make sure that preparing, planning and

evaluating psychosocial intervention is part of a compre-

hensive response management. To structure the training

and capacity building for emergency responders in the field

of psychosocial support, European and national guidelines

have been developed.

2. European Policy Paper ‘Psychosocial support in situations

of mass emergency’

This Policy Paper (Seynaeve 2001) offers guidance for

policy-makers concerning psychological support and social

accompaniment for those involved in situations of mass

emergencies. In the Policy Paper general principles and

methodological guidance for preparing psychosocial inter-

ventions in the aftermath of major accidents and disasters

*Corresponding author. E-mail: [email protected]

International Journal of Injury Control and Safety Promotion, Vol. 12, No. 2, June 2005, 119 – 120

International Journal of Injury Control and Safety PromotionISSN 1745-7300 print/ISSN 1745-7319 online ª 2005 Taylor & Francis Group Ltd

http://www.tandf.co.uk/journalsDOI: 10.1080/17457300500102955

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Page 3: Preparing and responding to major accidents and disasters

are established. It offers decision-makers a methodological

guide and a coherent model for psychological and social

support in situations of mass emergencies. Given the

urgency and the relative shortage of available resources in

cases of mass emergencies a hierarchy of needs – from the

perspective of those involved – does exist.

Priorities must be set according to the following.

To rescue and maintain the vital functions, including

basic and advanced life support, assistance to meet basic

needs, such as shelter, drinking, eating, sleeping and

hygiene, and providing information and social commu-

nication.

To provide psychosocial support to enable people to go

on with their personal and family activities with regard to

their privacy, dignity and liberty.

To maintain or regain physical, mental, emotional and

social well-being.

The Policy Paper points out different phases of reactions to

a traumatic event, each with specific psychosocial needs.

The time line of the phases comprises an acute phase, a

transition phase and a long-term phase. According to the

specific nature of each major incident it is difficult to state

the duration of each phase in terms of hours, days, weeks,

months or years.

The preparation and training for psychosocial support in

cases of mass emergencies comprises the management

during the acute phase by establishing the Reception,

Information and Support Centre and psychosocial follow-

up coordination in the transient and long-term phase.

The specific approach to planning and preparing for the

provision of psychosocial support must be integrated in the

general management and response planning of rescue

organizations and public authorities in general.

Specific training should improve personal knowledge

about stress and trauma reactions, skills to meet the

psychosocial needs of individuals and groups of people

affected, with special emphasis on vulnerable groups such

as children and adolescents.

To ensure the quality of the training, standards should be

developed to provide sound knowledge according to the

state-of-the-art and supervised experience in the field.

3. Austrian guidelines

To meet the psychosocial needs in terms of psychosocial

assistance and prevention of post-traumatic disorders in

almost all federal provinces of Austria, crisis intervention

teams or teams for psychosocial acute care have been

established during recent years (Lueger-Schuster et al.

2003).

There are four key areas that need to be considered in

terms of preparing the psychosocial response.

1. Planning and preparing a general intervention plan.

2. Training of staff; preparing for the specific needs in

situations of traumatic incidents and mass emergen-

cies.

3. Evaluation of all interventions during the different

phases of interventions (acute, transient and long-

term).

4. Information management.

To provide full preparation for all members of the crisis

management teams, training guidelines were developed and

adopted within the organizations of disaster protection of

several federal provinces and the Austrian Red Cross.

All members of the crisis intervention teams join the

training voluntarily and are selected by questionnaire and

personal interviews. Standards for the training have been

developed in international and national expert groups. The

different training modules comprise several short-term

teaching seminars, practical experience in the field of rescue

organizations and psychosocial support organizations, such

as mental health offices or emergency call offices, and

training in first aid.

4. Discussion

In the immediate aftermath following the exposure to a

traumatic event, the majority of people affected may

experience a short period of distress with somatic symp-

toms or changes of behaviour and psychological effects,

such as fears, anxiety or depressed emotions (Schnyder and

Moergeli 2003). To meet these needs and to prevent further

distress, several types of early interventions are provided by

individuals and organizations. However, there is a great

difference in the type as well as in the time and frequency of

the interventions. In a recently published meta-analysis of

risk factors for post-traumatic stress disorder in trauma-

exposed adults (Brewin et al. 2000), risk factors that

already existed before the traumatic event and risk factors

that were operating during and/or after the trauma were

investigated.

There is growing evidence that the quality and time of

early psychosocial interventions after a traumatic event are

important factors in determining whether those affected

will develop maladaptive psychological states or trauma-

related disorders.

Given the currently available evidence concerning the

effects of early interventions after trauma, one must

carefully look at the person’s natural course of the recovery

process and enhance the individual coping capacity. It is

important that helpers are able to recognize – on the basis

of training and experience – when the process requires

additional support actions in order to ensure an optimal

outcome.

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References

BREWIN, C.R., ANDREWS, B. and VALENTINE, J.D., 2000, Meta-analysis of

risk factors for post-traumatic stress disorder in trauma exposed adults.

Journal of Consulting and Clinical Psychology, 68, 748 – 766.

LUEGER-SCHUSTER, B., PURTSCHER, K., ALFARE, M., CHRISTOPH, R. and

KALCHER, K., 2003, Psycho-soziale Akutbetreuung. (Wien: Leitfaden

Steiermark-Vorarlberg).

SCHNYDER, U. and MOERGELI, H., 2003, The course and development of

early reactions to traumatic events: baseline evidence from a non-

intervention follow-up study. In Reconstructing Early Intervention after

Trauma, R. Orner and U. Schnyder (Eds) (Oxford: Oxford University

Press).

SEYNAEVE, G.J.R. (Ed.), 2001, Psycho-social Support in Cases of Mass

Emergency. European Policy Paper concerning different aspects of

psychological support and social accompaniment for people involved in

major accidents and disasters. (Brussels, Belgium: Ministry of Public

Health).

Responding to major accidents and disasters 121

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