preparing and responding to major accidents and disasters
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This article was downloaded by: [McMaster University]On: 21 November 2014, At: 06:41Publisher: 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
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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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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).
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