D

isasters result in bitter memories. Psychological suffering manifests instantly and, if left unaddressed, may leave lasting scars. Simple measures can go a long way toward giving minds a healing touch.

The earthquake and tsunami that struck Central Sulawesi remind us how quickly disasters can tear lives apart and leave thousands homeless. Almost 2,000 people have been confirmed dead. Officials warn the death toll may increase, as nearly 5,000 people have been reported missing.

Indonesians have a long history of dealing with earthquakes and other disasters, including the catastrophic Indian Ocean earthquake and tsunami in 2004. Consistent efforts have been made to reduce disaster risks, improve preparedness and build resilient communities. Life-saving aid flows in immediately after a disaster. Yet, while the military, government, volunteers and humanitarian organizations are adept at dealing with survivors’ physical needs, they can miss invisible needs, such as mental health and psychosocial support, especially for children.

How do disasters impact the mind?

There’s only so much a person can take, literally. Liken the mind to a balloon: If you keep pumping air into it and don’t relieve the pressure, something has to give. People affected by the tsunami, earthquake and other disasters experience great distress. Anxiety levels go up, as do levels of sleeplessness and, often, nightmares. Aftershocks amplify human anxieties. During my work in Japan following the disasters that hit Sendai, Fukushima and neighboring areas, I came across stories of children scared to flush toilets, as the sound and sight of the flowing water reminded them of a tsunami.

At the community level, people disengage and are withdrawn. Research in post-disaster settings around the world found significant increases in depression, anxiety levels and psychological distress amongst adults. Children affected by disasters may face various mental health and psychosocial problems. This may also cause adults to feel confused or nervous, especially when they see children display responses such as regressing to earlier behaviors (e.g., bedwetting) or when they engage in sociodramatic play related to the disaster or conflict. Some survivors turn to substance abuse or alcohol.

It is possible and necessary to reduce the suffering and beat long-term trauma through activities in the early stages of disaster response. Emotional care and psychosocial first aid also help to instill a sense of hope and speed up recovery efforts.

So what can survivors, teachers, volunteers and health workers do?

Promoting a sense of safety, calm and senses of self- and community efficacy, connectedness and hope are important for coping in difficult situations. Reliable and useful information about relatives, friends and about relief supplies is a key stress-buster. Urging normal and routine activities, including group, cultural and social activities, helps to bring about a sense of normalcy.

Participation in community activities and family-support activities help survivors to recover more quickly, especially children. Good social networks help normalization and healthy child development. Having stable caregivers and caring adults around children help their mental health and psychosocial well-being.

Education and recreational activities are key elements that support children’s mental health and psychosocial well-being. Children will have many questions when schools reopen, so preparing teachers to answer students’ questions and reduce their anxieties is key. Teachers who are trained to be sensitive to such questions are best placed to help children overcome their anxieties.

The World Health Organization’s Psychological First Aid: Guide for field workers recommends “a humane, supportive response to a fellow human being who is suffering and who may need support”. It recommends simple and pragmatic measures such as keeping children safe, recreational and play sessions for children and listening sessions for adults.

Community-based care and support models are gaining momentum worldwide. They are cost effective, contextual and demonstrate ownership. Save the Children’s Psychological First Aid program and guidelines is based on the WHO program, but is also designed to be more aligned for direct use with children as well as providing guidance to parents and caregivers on recognizing “when to worry” signs among their children, and how to help them deal with their own distress.

The media can also play a critical role in spreading key messages on healing and recovery. Positive stories would help to inspire other disaster survivors to get back on their feet. The media can help to demystify matters of the mind and make it part of popular conversation and science.

Psychologists and mental health experts alone can’t beat trauma in post-disaster settings. The human mind is too important to be left to technical experts. Film stars, sports stars, musicians, magicians and theater artists can all make a huge difference by spreading messages of solidarity and collaboration through their respective mediums. Such efforts help turn victims into survivors as well as active agents of recovery and social change.
_________________________