MENTAL HEALTH MOMENT
MENTAL HEALTH MOMENT
November 3, 2000
* * *VOTE* * *
TUESDAY, November 7, 2000
Take a friend with you
"Education is when you read the fine print. Experience
is what you get if you don't." Pete Seeger
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For those of you in the Wyoming area, the following is
a website with state highway information. It also has
links to real-time camera shots of the I-80 summit between
Laramie and Cheyenne as well as I-25 near Cheyenne and
Walcott Junction near Rawlins. For those of you in the
rest of the country, take a look at our snowy highways.
If you have a similar link near you, send it to me via
email and we can share it.
http://wydotweb.state.wy.us
Click on the highway information link; then click on the
web cameras link; finally, click on the I-80 and other
sites links for the pictures.
* * * * *
The China Cultural Tour is tentatively scheduled for the
following dates:
https://www.angelfire.com/biz3/odocspan/china1.html
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TYPES OF MENTAL HEALTH PROBLEMS FOLLOWING DISASTERS
The following are the more severe and, therefore,
relatively uncommon responses among victims of a major
disaster. The criterion is relatively simple: When the
behavior indicates the victim is no longer able to
function appropriately in the situation, he/she should
be referred for professional assistance.
1. Psychosomatic - vomiting, diarrhea, insomnia,
loss of appetite, headaches, allergies, ulcers,
bladder problems, extreme tiredness and weakness,
rashes. These are some of the physical symptoms
commonly associated with or directly resulting from
emotional stress.
2. Loss - bereavement (loss of loved ones);
separation from loved ones (especially children);
loss of limbs due to trauma; loss of familiar objects,
possessions, lifestyle, memories; loss of independence;
loss of home or farmlands, livelihood, etc.
3. Social stresses - divorce, delinquency, alcoholism
reactivated, family discord. These reactions may not
appear immediately due to the priority of pressures
of coping with physical problems of adjustment to
the disaster. As these problems are overcome or
postponed, the emotional aftermath of stress may
surface in various forms of interpersonal and
socially negative behavior.
4. Sequelae of physical trauma - broken bones,
burns, pain toxicity, changes in body image caused
by disfigurement and invalidism, loss of memory.
Sudden and unexpected physical damage to the body
also very often leads to what is known as somatopsychic
disturbances, that is, emotional distress resulting
from physical injury.
5. Psychological - nightmares, unreasonable
anticipation of another disaster, difficulty
concentrating, severe depression, extended dazed
feeling, nervousness, crying spells, hopeless
feelings, irritability. More formal classifications
are:
A. Depression - severe sadness, feels hopeless,
can't get out of bed, won't eat, cries, is apathetic,
unable to engage in usual activities, sleep disturbance,
feelings of helplessness, unshakable feelings of
worthlessness and inadequacy, withdrawal from others,
does not respond to others;
B. Disorientation - Confused and doesn't know
where he/she is, what's happening, what time it is,
unaware of surroundings, memory loss, dazed;
C. Hysteria - uncontrollable crying and upset,
screaming, can't be left unattended, agitated, may
show paralysis or numbness of parts of the body;
D. Psychosis - complete personality change,
irrational thinking and highly unusual behavior,
may report sensations for which there is no cause,
and may have delusions of grandeur or persecution.
When the conclusion is reached that the person should
seek consultation with a professional, encourage the
person to avail him/herself of such services and offer
assistance, if needed, in locating competent help. It
may be helpful to enlist the assistance of family and
friends in persuaduing the person to accept treatment.
Sometimes a physician or clergyman is most useful. It
is best to work closely with a professional and to
develop free and open relationships with them which
will facilitate assistance with severe emotional
problems.
Role Playing As A Training Tool With Workers
Along with empathy comes the process of offering help.
This is not a simple process, because it requires
sensitivity to feelings, understanding of values,
awareness of cultural and ethnic aspects, and avoidance
of damage to pride. Again, the basic procedure is to
imagine oneself in the role of the victim. How would
you want to be treated? What characteristics of the
worker would be most helpful? (e.g. sympathetic,
understanding, supportive, ready to listen, warm,
competent, informed, personally interested, etc.). What
sort of helping behaviors would operate as a "turn off"
most quickly and cause resentment toward the person and
his/her agency (e.g. impatient, pitying, bossy, cold,
condescending, oversolicitous, non-listening, etc.)?
Role-playing is one method of learning. It asks the
participants to imagine themselves in an assigned role
and to "play the part" for a while. It gives all of
those involved an experience which is not too far afield
from the actual situation. Many people are anxious or
uncomfortable in the role-playing situation, feeling
exposed and awkward. Trainers can be of most help by
establishing a sense of trust and mutuality and by
stressing that it is a learning situation for everyone.
Critiques are non-hoatile and non-derogatory. If mistakes
are to be made, this is the time to make them because
all can profit from them.
Many trainees will already have first-hand knowledge of
the problems faced by disaster victims. Role playing
various kinds of helping situations will allow the workers
to see and to try out various styles and methods. Divide
the group into small subgroups and practice using some
of the following situations:
1. You are at the Evacuation Center
Hundreds of people have had to leave their homes and are
being given food and temporary shelter by the Red Cross.
You circulate through them and talk at length with one
family of five - a father, mother, and three small
children. You learn they have lost their house and are
wondering what to do next. Keep in mind the steps for
effective helping:
A. Rapport can be established through the art of
listening. Encourage the family to do the talking,
and ask questions in order to obtain information
about their most pressing concerns. Listen nonjudgmentally,
empathetically, and alertly. Establish trust through
your interest and concern.
B. Problem focusing - ask about the current
difficulties and other difficulties. Arrive at the
most immediate problems to be attended to and
establish priorities. Repeat back and summarize
information to be sure all understand and agree.
C. Evaluate - review the problems, the capabilities,
and the resources in your mind as you explore. Can
this be handled without additional help? Does it
require professional assistance?
D. Resources - learn what personal resources the
family has, e.g., other family, relatives, neighbors,
friends, and finances. Also determine what governmental
agencies and nongovernmental relief agencies may be
most helpful and in what order they should be visited.
Help the family to understand and overcome red tape,
if possible. Be willing to play the advocate role and
be alert to possible ways in which you can diminish
frustrations.
2. You Are At The "One-stop Center".
You have been asked by a Family Services official to
help an elderly woman of 65 who has lost her house and
all her possessions in a devastating tornado. She was
sitting dazed amidst the wreckage and was finally
persuaded to come to the center to get help. She has
been alone in her house for years with help from Social
Security and a daughter who lives in a small town 30
miles away. She has always been independent, but now
seems overwhelmed, almost "out ot it", by the
catastrophe.
A. Listening Can you get her to talk? What was
most important among the things she lost? Understand
the victim's grief over lost objects and the consequent
obliteration of memories. For many, these losses are
as important as the loss of loved ones because they
represent ties to life and symbolize a continuity
with the past.
B. Focus What will be the most important, the
most immediate, problem? Medication? Finances?
Eyeglasses? Shelter? Focus on the one that is both
immediate and most likely to be solved easily.
C. Evaluate Can the woman recover? Will she be
able to live alone again? What strengths remain?
How does she evaluate her problems? Does she see
them realistically? Can she regain her former
independence?
D. Resources Can the daughter help? Is the woman
willing to live with her? Does she get along with
others?
E. Plan When practical, try to present choices.
Agree with the woman on what to do first. Make sure
she understands. Determine what else you can do
and what the ensuing steps will be. Set a time, date,
and place for the next contact.
3. You Are Interviewing A Couple In Their Temporary
Mobile Home Supplied By FEMA
There are two children. Plans for rebuilding are progressing.
An additional concern is the youngest child, a 3-year-old
girl. She seems to have become unruly and "whiney". The
neighbors' children tease a lot, but the girl continues to
play with them. The mother doesn't feel happy about having
to live in such cramped quarters with an unhappy child for
another year. The child has been having frequent nightmares.
A. Listen There may be many other problems and
difficulties this young couple is having. They may still
be having nightmares of the evening of the disaster which
devastated their home.
B. Focus Which is the main problem - rebuilding the
house, the youngest child, or the continuing nightmares?
Which can you possibly help with?
C. Evaluation How serious are the problems? Is
professional help needed for anyone? For whom?
D. Resources Professional mental health agency for
therapy? Advocacy for insurance, low interest loans?
Moving the mobile home to another area? What agencies
will be needed? What resources does the family have to
help itself? Are they close, warm, involved?
E. Plan Mutual agreement on what to do first and how.
4. You Are Visiting The Mother Of A 6-year-old Boy.
The mother is puzzled by the boy's behavior in school and
at home. He is reluctant to play, has to be coaxed, and
follows her around all the time. She feels he no longer
cares for school, something he had always enjoyed before.
You agree to talk to the teacher to see what you can learn
about the boy's behavior in school. You learn that in school
he now has become a behavior problem. He doesn't mind and
is difficult to control. What can you do to help the teacher,
the mother, and the child?
5. You Have Been Asked To Be Available At The Temporary
Morgue.
Many of the victims who come in to identify dead members of
the family seem to be having difficulty adjusting to their
sudden loss. The thought was that having someone there from
mental health might be helpful. Are you able or willing?
Can you handle the circumstances surrounding death? Can you:
A. Help the survivor face the reality of the loss?
B. Help the survivor feel free to express grief (e.g., to
cry, reminisce, to feel the "normal misery" of the
mourning)?
C. Offer support and comfort?
D. Help in making arrangements for movement or burial?
E. Arrange for additional support as long as needed?
6. A neighbor has remarked that a woman across the
street seems to be having difficulties because her
eyeglasses were crushed during the disaster.
A. How do you approach the woman?
B. What resources can you offer?
C. Are eyeglasses the only problem, or are there more? How
do you find out?
7. The disaster occurred nearly 8 months earlier.
A young father is frustrated in his efforts to fill out
income tax forms. He needs advice. A friend told him you
might be able to help.
8. You are handling telephone inquiries of all sorts.
A call comes from a middle-aged woman who wants to know
the telephone number of welfare services. She seems upset.
You think she needs more than a telephone number, since
you know the phone lines to welfare services have been
jammed all day.
A. What can you offer your caller?
B. What are the limits on what should be offered?
C. How can you find out the best way to be of help?
Tapping Strengths In The Individual And The Community
There are opportunities for uncovering strengths in disasters
which go unnoticed or unrecognized. They can provide a
positive focus for discussions with clients. Some of these
are:
1. Recovery as a new purpose for life.
2. Experiencing the helpfulness and mutual aid of others.
3. Rebuilding to make desired improvements.
4. Sharing of severe stress leading to stronger relationships
with significant others.
5. Opportunity for community leadership to emerge and
reaffirm itself.
6. Opportunity to develop new strengths, new abilities to
cope. How can workers capitalize on these?
Groups - Therapy And Community
Special problems may suggest the formation of therapy groups
(under professional leadership). Children's fears and
anxieties are often helped when played out or discussed in
groups, giving the child a chance to see he/she is not alone.
Parents may find that a group situation is the best place to
discuss their children's problems, and, in the process, to
bring up their own.
Meetings of the affected population are helpful when factual
information can be disseminated. Later, group participation
in the decisions about rebuilding and reclamation is helpful
in restoring and maintaining community spirit. Opportunities
for recreational events, block parties, disaster anniversary
ceremonies, etc. should be taken advantage of, if possible.
Schools, social clubs, neighborhood councils, church groups,
etc. may serve as facilitators in such activities.
Governmental And Non-governmental Disaster Relief
Agencies
Following are listed some of the various relief agencies
which may provide services following a disaster:
If You Need... You Can Get... From...
FOOD Emergency meals at Red Cross,
shelter or mass Salvation Army
feeding stations
Food packages or Red Cross
emergency food orders
Food Stamps USDA Food &
Nutrition Service,
Community Action
Agency
_____________________________________________________________
CLOTHING Clothing or an Red Cross,
order for clothing Salvation Army,
which any store will Other
fill
Loans for replacing Small Business
Administration
Emergency clothing Community Action
Agency
_____________________________________________________________
HOUSING OR A place to sleep Red Cross,
HOME FURNISHINGS until housing can Salvation Army
be found
Temporary Housing State or Federal
Temporary Housing
Agency
Household furnishings Red Cross
Loans for household Small Business
furnishings Administration
Loaned furniture State or Federal
for those in Temporary Housing
temporary housing Agency
_____________________________________________________________
MEDICAL CARE Emergency medical Public Health
care and health Service, Veterans
service Administration
Help in getting Red Cross, local
medical care health agencies
Emergency medical Community Action
assistance Agency
_____________________________________________________________
EMERGENCY FUNDS Pay while jobless State employment
because of disaster security office
Social Security Social Security
Administration
Veterans Benefits Veterans Administration
Emergency Assistance Red Cross
Community Action
Agency
_____________________________________________________________
LEGAL ASSISTANCE Legal advice in Federal Disaster
solving disaster- Assistance Adminiostration
caused problems (for referral)
Community Action
Agency
_____________________________________________________________
EMPLOYMENT ADVICE Job help State Employment
Commission, Community
Action Agency
_____________________________________________________________
INCOME TAX Tax help for Internal Revenue
disaster victims Service
_____________________________________________________________
PROPERTY CLEANUP Help to clear Contact State
away disaster debris and local officials
from your property
Debris clearance Agricultural
from farm or other Stabilization and
rural property Conservation Service
______________________________________________________________
HOME REPAIR OR Loans to rebuild Small Business
your home and replace Administration
furniture Veterans Administration
Supplementary funds Red Cross
for repairing your
home
Help to repair your Mennonite Disaster
home Service
_____________________________________________________________
BUSINESS REPAIR OR Loans to repair Small Business
MAINTENANCE or replace your Administration
business
Loans to help keep Small Business
keep your business Administration
going
_____________________________________________________________
FARM REPAIR OR Loans to repair Farmers Home
MAINTENANCE or replace your Administration
farm and buildings,
fencing, equipment and
livestock
Emergency Agricultural
conservation measures Stabilization and
Conservation Service
Help in getting feed Agricultural
for your livestock Stabilization and
Conservation Service
_____________________________________________________________
MOVING ASSISTANCE Trucks and labor National Guard
_____________________________________________________________
OFFICIAL INFORMATION General public Federal Disaster
information and Assistance Administration
assistance
_____________________________________________________________
NOTE: Check locally to make sure that certain above groups
have a presence in your area.
Partial List Of Agencies Involved In Disaster Assistance
Federal:
Department of Health and Human Services
Public health and welfare functions
Federal Emergency Management Agency (FEMA)
Coordinates all Federal services in Presidentially
declared disasters; Arranges for temporary housing;
Liaison with local emergency management organizations.
Department of Labor
Unemployment insurance
Department of Agriculture
Farmers Home Administration (FHA)
Food stamps - food commodities - disaster loans
Small Business Administration (SBA)
Disaster loan program for homes and businesses
STATE
Department of Public Assistance
Assistance to welfare clients (Federal assistance program)
Department of Health
Immunization
Prevention health measures as necessary
Department of Mental Health (Referral of disaster victims
with mental health needs)
National Guard - except when called into Federal
service
Civil Defense
Assistance to communities on damage to public facilities
(some states have separate disaster preparedness agency)
LOCAL CITY/COUNTY GOVERNMENT
The local/county level counterparts of State Government
provide the following services:
City/County Government
Declaration by public proclamation of emergency when
situation cannot be handled by existing relief agencies,
ptivate and governmental, operating in the normal manner.
Civil Defense
"To prepare comprehensive plans and programs for the civil
defense in bothe enemy-caused and natural emergencies."
Establishes Control Center
Coordinates all efforts
Police Department
Suppression of criminal activity
Dispersal of crowds
Traffic control
Organization and control within the damaged area
Alerting people to emergency and evacuation
Fire Department
Alerting through telegraph section
Minimize or prevent the effects of fire
Assistance with water supply, street clearance, and
demolition
Associated General Contractors
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To search for and purchase books with further information
on this topic, go to:
https://www.angelfire.com/biz/odochartaigh/searchbooks.html
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Contact your local Mental Health Center or
check the yellow pages for counselors, psychologists,
therapists, and other Mental health Professionals in
your area for further information.
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