PRE-DEPLOYMENT BRIEFING : MENTAL HEALTH

By:

MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT SERVICES(MHPSS), MOH

Sector of Mental Health, Substance Abuse and Violence Injury Prevention Disease Control Division

Ministry of Health

PRE-DEPLOYMENT BRIEFING : MENTAL HEALTH

PREPAREDNESS FOR FIRST LINE RESPONDERS

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MENTAL HEALTH IMPACT IN CRISIS/ OUTBREAK

01

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DEPLOYMENT AND MENTAL HEALTH PREPAREDNESS

02

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COPING SKILLS AND

MENTAL HEALTH CARE OF RESPONDERS

03

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• Crisis / Outbreaks / Disaster inflicts psychological burden

• Aftermath may bring major life changes and uncertainty about future life

Psychological Trauma Grief, Loss, Anger, Guilt Social and Lifestyle Stress

Mental Health in Disaster

overwhelmed confused fearful anxious numb detached

mild/ severe reactions

Communities can be severely affected in many ways.

Patients are

separated from their loved ones, due to illness or death.

Those associated with COVID -19 can be vulnerable to social stigma, worsening their distress & isolation

Health workers / frontliners need to deal with a high workload & a lot of stress.

people experience a

wide range of reactions eg:

Exposed to long hours of work Poor / Horrible conditions Dangerous / Life threatening Lack of Information

Lack of Coordination Fear of unexpected

Any Individual may be affected emotionally

Everyone reacts or responds differently to stressful situations

WORRY

FeAR Helpless Anxious

BOREDOM

LONELY

ANGER

CATEGORIES OF RESPONDERS IN CRISIS

• Fire fighters, Rescue and Emergency workers

• Medical doctors and Nurses

• Mental Health Professionals

• Police Officers

• Local Government Officers / Private Sectors

• Soldiers

• Volunteers from different background

 Relief work

Service provided to the individuals in need, especially in an emergency context such as disasters/crisis.

 Relief worker, the service provider

Anyone with or without experience involving in a disaster but preferably someone with specific training or

knowledge.

AN EFFECTIVE RESPONDER

• Willingness to undergo training

• Able to care and be empathetic

• Able to work in a team and accept different views and opinions of others ( TEAMWORK ⁾

• Able to follow instruction from higher

management

DEPLOYMENT MISSION : COVID-19

• Uncertainties

• What to expect next?

• What happens when you come back?

• Need to quarantine?

• Need to test… swab?

Deployment

Pre

• Before the mission

Intra

• During the mission

Post

• After the mission

PRE- DEPLOYMENT (1)

This stage refers to the preparation phase before going for a mission

1.

Pre-deployment Briefing

– Anticipation of the mission

• the event

• scope of service

• target groups

• length of service

• availability of updated information

• relevant training

PRE- DEPLOYMENT (2)

2. Mental Health Preparedness

(i)

Personal Consideration :

- Assess your comfort level with the various situations you may experience - Working in environments where the risk of harm or exposure not fully known

(ii) Health Consideration

- Recent emotional or psychological challenges

- Enough medication available for the total length of assignment plus some extra days

(iii) Family consideration

- Family prepared with your absence

- Do you have a strong supportive environment to return to after your work assignment ?

Intra- DEPLOYMENT

This stage refers to the management and maintenance

during

a mission

1. Pre-incident education and discussion on mobilization

• Update about the current status of disaster/crisis condition

• Discuss job scope and responsibilities

• Report writing, discussion or group briefings 2. On-site group dynamic

• Team spirit, communication, trust, peer supervision and support

13

Intra- DEPLOYMENT

 Thus, it is important for us to constantly monitor the following aspects

 Keeping updated with current status

- Emergency contacts, changes of situation and mission

 Personal care and safety

 Ensure proper PPE at workplace

 Good personal hygiene: hand washing

 Healthy diet i.e. vitamin and mineral supplements, Avoid taking excessive caffeine

 Comfortable accommodation i.e. clean tent, sufficient toiletries

 Appropriate workload i.e. reasonable work shift, time off

 Availability to contact with loved ones

14

Intra- DEPLOYMENT

 Good team dynamic

 peer supervision and support

 mutual understanding

 Emotional management

Stress management, monitor stability of mood, motivation level

Be able to identify potential symptoms of acute stress condition

Spiritual empowerment

Allow time for personal spiritual restoration if needed

Relaxation practice

15

Intra- DEPLOYMENT

Every mission is a new exposure and experience to any relief worker.

You may experience on-going stressors associate with the nature

of disaster/crisis work

16

Volunteers may experience horrific or dangerous situations that leave them tormented by strong stress reactions

Need to be readily prepared in terms of

–

Physical well being

_√

–

Mental well being √

17

Physical

Dry mouth

Tremor

Headaches

Sleep difficulty

Change of appetite

Fatigue

Body aches

Palpitation

Rapid breathing

Stomach ache

Diarrhoea

Restless

Easily agitated

Low motivation

Worry

Poor concentration

Forgetful

Self-defeating

Low self-esteem

Anxiety

Loss of interest (Anhedonia)

Feel bored

Low mood

Psychological

How to recognize Stress in Yourself?

Behavioural

Execessive smoking

Inappropriate drug and alcohol used

Change of appetite

Aggressive behavior i.e.

bully, vandalism

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Mental Health Self Check

Easily anxious

Extremely sad/hopeless/helpless

Feeling guilt

Easily irritated / angry

Extremely tired

Difficulty in sleeping

Crying without any specific reasons

19

Intra- DEPLOYMENT

 Identify affected worker who presented with:

Preference not to talk

Refrain from group activities during off time

Tired of continual interaction with other individuals

Tendency of isolation / social withdrawal

20

End of Mission?

Post- DEPLOYMENT

 This stage refers to completion of mission

 Post-deployment briefing

 Updated with current status

 Announced completion of mission

 Thought sharing and passing over of duties

 Make necessary referral to local health care provider if needed

 Psychosocial management

 Assessment for mood and stress level

 Aware of potential mood instability

22

Post- DEPLOYMENT

 Take a break !

 Quarantine if required

 Enjoy a few days off

 Rest to restore energy

 Spend quality time with family and friends

 Readiness of job resume

 Return to work station

 To maintain healthy mentally

23

Coping Skills

and Mental Health Care Of

Responders

Developing healthy coping skills

and learning to be resilient may help you during times of high stress.

Resilience is the ability to adapt well to stress, adversity, trauma or tragedy

25

HOW TO COPE…

• TALK to someone you trust to share upsetting

emotional responses and strengthen support system

• Recognize HALT

– Hungry, Angry, Lonely, Tired

• Allowing time off or breaks during deployment

• Suitable level of humour

• Constant communication with the loved ones helps prevent sense of alienation

26

Personal Care

• Practise good hygiene: hand washing

• Maintain regular meal intake

• Have regular physical activity

• Schedule time for yourself

– Leisure activities, activities of interest

• Maintain good sleep hygiene

• Avoid drug and alcohol use

• Seek out social support

27

•

A type of relaxation

•

Expansion of abdomen instead of chest

• Benefits:

•

Relaxation

•

Release tension

•

Manage pain

•

Improve digestive

system

•

Mentally Present!!

28

Inhale through nose and

 expand your belly

 (1..2..3..4..) Hold for a while

 (1..2..)

Exhale through mouth and

 empty your belly

 (1..2..3..4..5..6..) Hold for a while

 (1..2..)

29

Expect a readjustment period upon returning home.

You may need to make personal reintegration

a priority for a while

30

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IF SYMPTOMS PERSIST AND DISTRUPTS LIFE

SEEK MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT FROM MHPSS PROVIDERS / SEEK

PROFESSIONAL HELP

33

Mental Health Alert Card

34

35

Public Health Physicians

Family Medicine Specialists

Medical

Practitioners

MHPSS PROVIDER

Resource Person:

Medical Social Workers trained in mental health Paramedics

trained in mental health

Registered

counselors from NGOs/ Trained Volunteers

Psychiatrists

Psychology Officer

or click the following link: https://tinyurl.com/INFOMHPSS1

PSYCHO-EDUCATION MATERIALS FOR HEALTH CARE WORKERS AND OTHER RESPONDERS

Scan this QR Code:

THANK YOU

TERIMA KASIH

ACKNOWLEDGEMENT

TWG PEACE (Technical Working Group for Psychosocial Empowerment & Crisis Education): LEP 2.0 JICA –

Psychosocial Response to Disaster