Disaster Medical Assistance Teams: What Psychosocial Support is Needed?

AbstractObjective:The objective of this preliminary study was to evaluate the perceptions of internationally deployed Disaster Medical Assistance Team (DMAT) personnel regarding the psychosocial support needs of these teams.Methods:The DMAT questionnaire was sent to 34 members of Australian medical teams involved in deployments to the 2004 Southeast Asian tsunami and the 2006 Java earthquake. Twenty personnel (59%) completed this survey, which reviewed key deployment stressors, specific support strategies, and the support needs of team members, their families, and team leaders. A key aspect of the survey was to determine whether the perceived psychosocial needs would be supported best within with existing provisions and structures, or if they would be enhanced by further provisions, including the deployment of mental health specialists.Results:There was strong support for brief reviews of stress management strategies as part of the pre-deployment briefing, and access to written stress management information for both team members and their families. However, more comprehensive provisions, including pre-deployment, stressmanagement training programs for personnel and intra-deployment family support programs, received lower levels of support. The availability of mental health-related training for the team leader role and access to consultation with mental health specialists was supported, but this did not extend to the actual deployment of mental health specialists.Conclusions:In this preliminary study, clear trends toward the maintenance of current mental health support provisions and the role of the DMAT leader were evident. A follow-up study will examine the relationship between teamleader, psychosocial support strategies and team functioning.

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Scope for Psychosocial Treatments in Psychosis: An Overview of Collaborative Therapy

Australasian Psychiatry ◽

10.1046/j.1039-8562.2003.00555.x ◽

2003 ◽

Vol 11 (2) ◽

pp. 220-224 ◽

Cited By ~ 17

Author(s):

Monica Gilbert ◽

Kathryn Miller ◽

Lesley Berk ◽

Velma Ho ◽

David Castle

Keyword(s):

Mental Health ◽

Psychotic Disorders ◽

Psychosocial Support ◽

Controlled Trial ◽

Psychosocial Needs ◽

Psychosocial Treatments ◽

Mental Health Consumers ◽

Collaborative Therapy ◽

Modular Treatment ◽

The Impact

Objectives: The psychosocial needs of people with psychotic disorders are not being addressed adequately. The present paper outlines a proposed framework that will help to meet some of this deficit and deliver psychosocial treatments for these individuals, as part of routine clinical practice. Conclusions: The recent Australian study on low prevalence (psychotic) disorders found that, although most Australians (91%) with a psychotic illness were taking medication, few were receiving adequate psychosocial support from mental health services; fully 47% of these saw the need for a particular type of service that was not able to be accessed by them, either because of it simply not being available or not being affordable. The programme described herein will develop, evaluate and disseminate comprehensive modular treatment packages addressing the psychosocial needs of people with psychotic disorders. It is novel in terms of the comprehensiveness of the approach, the rigour of the evaluation (using a controlled experimental design), and the extent of intersectoral and multidisciplinary involvement in mapping needs, developing the interventions, and dissemination. The potential impact for mental health consumers with psychosis is enormous because currently there is no coherent and consistent approach to addressing their psychosocial needs. The impact for the scientific community will be great because there is currently very little by way of controlled trial data in this important area of activity.

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Improving mental health and psychosocial wellbeing in humanitarian settings: reflections on research funded through R2HC

Conflict and Health ◽

10.1186/s13031-020-00317-6 ◽

2020 ◽

Vol 14 (1) ◽

Author(s):

Wietse A. Tol ◽

Alastair Ager ◽

Cecile Bizouerne ◽

Richard Bryant ◽

Rabih El Chammay ◽

...

Keyword(s):

Mental Health ◽

Psychosocial Support ◽

Scale Up ◽

Lessons Learned ◽

Research Projects ◽

Psychosocial Needs ◽

Knowledge Gaps ◽

Humanitarian Settings ◽

Wide Range ◽

The Impact

Abstract Major knowledge gaps remain concerning the most effective ways to address mental health and psychosocial needs of populations affected by humanitarian crises. The Research for Health in Humanitarian Crisis (R2HC) program aims to strengthen humanitarian health practice and policy through research. As a significant portion of R2HC’s research has focused on mental health and psychosocial support interventions, the program has been interested in strengthening a community of practice in this field. Following a meeting between grantees, we set out to provide an overview of the R2HC portfolio, and draw lessons learned. In this paper, we discuss the mental health and psychosocial support-focused research projects funded by R2HC; review the implications of initial findings from this research portfolio; and highlight four remaining knowledge gaps in this field. Between 2014 and 2019, R2HC funded 18 academic-practitioner partnerships focused on mental health and psychosocial support, comprising 38% of the overall portfolio (18 of 48 projects) at a value of approximately 7.2 million GBP. All projects have focused on evaluating the impact of interventions. In line with consensus-based recommendations to consider a wide range of mental health and psychosocial needs in humanitarian settings, research projects have evaluated diverse interventions. Findings so far have both challenged and confirmed widely-held assumptions about the effectiveness of mental health and psychosocial interventions in humanitarian settings. They point to the importance of building effective, sustained, and diverse partnerships between scholars, humanitarian practitioners, and funders, to ensure long-term program improvements and appropriate evidence-informed decision making. Further research needs to fill knowledge gaps regarding how to: scale-up interventions that have been found to be effective (e.g., questions related to integration across sectors, adaptation of interventions across different contexts, and optimal care systems); address neglected mental health conditions and populations (e.g., elderly, people with disabilities, sexual minorities, people with severe, pre-existing mental disorders); build on available local resources and supports (e.g., how to build on traditional, religious healing and community-wide social support practices); and ensure equity, quality, fidelity, and sustainability for interventions in real-world contexts (e.g., answering questions about how interventions from controlled studies can be transferred to more representative humanitarian contexts).

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Mental health and psychosocial support needs among people displaced by Boko Haram in Nigeria

Global Public Health ◽

10.1080/17441692.2019.1665082 ◽

2019 ◽

Vol 15 (3) ◽

pp. 358-371 ◽

Cited By ~ 2

Author(s):

Bonnie N. Kaiser ◽

Cynthia Ticao ◽

Jeremy Boglosa ◽

John Minto ◽

Charles Chikwiramadara ◽

...

Keyword(s):

Mental Health ◽

Psychosocial Support ◽

Support Needs ◽

Boko Haram

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Migrants in Austria and their understanding of mental health issues

European Journal of Public Health ◽

10.1093/eurpub/ckz186.019 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

M Weigl ◽

S Gaiswinkler ◽

H Wolf ◽

H Haider

Keyword(s):

Mental Health ◽

Health Services ◽

Support Services ◽

Psychosocial Support ◽

Reference Group ◽

Health Issues ◽

Psychosocial Needs ◽

Migrant Communities ◽

Mental Health Issues ◽

Wide Range

Abstract Psychosocial needs are common among migrants but their use of mental health services is not. Little is known about the understanding of mental health issues by migrants and their perception of mental health services. The study aims to provide a basis for further developments of the mental health system to contribute to health equity in the long term. Qualitative research: literature review, semi-structured interviews and focus groups. 54 migrants from Afghanistan, Somalia, arabic-speaking countries and Turkey and 16 experts were involved. Access was gained through cooperating with an institution offering various health services in different languages and well-known by migrant communities. Migrants from Turkey with long residence in Austria and linked to psychosocial services were chosen as reference group. There are many similarities among socio-economically disadvantaged people in terms of their understanding of mental health and their willingness to seek and accept support. However, differences can also be observed which are related to country of origin or gender, but also to acculturation status, current life situation or previous experiences within the home or the receiving country. The Turkish reference group shows, that mental health issues are given higher priority in the course of time. To quicken this process, targeted measures for the promotion of health literacy are decisive, but also integration possibilities and the social climate. With a wide range of access and psychosocial support options, attitudes like openness, impartiality and flexibility among health professionals, it is possible to reach migrants with psychosocial needs. A stronger exchange on how people with a migration background and psychosocial needs are perceived and reached is needed. But also activities to increase the diversity of support services and to carry information about mental health issues as well as the existing services into the migrant communities Key messages Specific activities can improve the knowledge about mental health issues within migrant communities. A wide range of access and psychosocial support services is needed to address the diversity.

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Leadership and Use of Standards by Australian Disaster Medical Assistance Teams: Results of a National Survey of Team Members

Prehospital and Disaster Medicine ◽

10.1017/s1049023x12000489 ◽

2012 ◽

Vol 27 (2) ◽

pp. 142-147 ◽

Cited By ~ 11

Author(s):

Peter Aitken ◽

Peter A. Leggat ◽

Andrew G. Robertson ◽

Hazel Harley ◽

Richard Speare ◽

...

Keyword(s):

National Survey ◽

Leadership Training ◽

Strong Support ◽

Evidence Based ◽

Medical Assistance ◽

Team Members ◽

Tsunami Disaster ◽

Australian Health ◽

Clear Identification ◽

Measures Of Effectiveness

AbstractIntroductionIt is likely that calls for disaster medical assistance teams (DMATs) will continue in response to international disasters.ObjectiveAs part of a national survey, the present study was designed to evaluate leadership issues and use of standards in Australian DMATs.MethodsData was collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 Asian Tsunami disaster.ResultsThe response rate for this survey was estimated to be approximately 50% (59/118). Most of the personnel had deployed to the Asian Tsunami affected areas. The DMAT members were quite experienced, with 53% (31/59) of personnel in the 45-55 years of age group. Seventy-five percent (44/59) of the respondents were male. Fifty-eight percent (34/59) of the survey participants had significant experience in international disasters, although few felt they had previous experience in disaster management (5%, 3/59). There was unanimous support for a clear command structure (100%, 59/59), with strong support for leadership training for DMAT commanders (85%, 50/59). However only 34% (20/59) felt that their roles were clearly defined pre-deployment, and 59% (35/59) felt that team members could be identified easily. Leadership was identified by two team members as one of the biggest personal hardships faced during their deployment. While no respondents disagreed with the need for meaningful, evidence-based standards to be developed, only 51% (30/59) stated that indicators of effectiveness were used for the deployment.ConclusionsIn this study of Australian DMAT members, there was unanimous support for a clear command structure in future deployments, with clearly defined team roles and reporting structures. This should be supported by clear identification of team leaders to assist inter-agency coordination, and by leadership training for DMAT commanders. Members of Australian DMATs would also support the development and implementation of meaningful, evidence-based standards. More work is needed to identify or develop actual standards and the measures of effectiveness to be used, as well as the contents and nature of leadership training.Aitken P, Leggat PA, Robertson AG, Harley H, Speare R, Leclercq MG. Leadership and use of standards by Australian disaster medical assistance teams: results of a national survey of team members.Prehosp Disaster Med.2012;27(2):1-6.

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Mental health in humanitarian settings

Oxford Handbook of Humanitarian Medicine ◽

10.1093/med/9780199565276.003.0006 ◽

2019 ◽

pp. 101-132 ◽

Cited By ~ 1

Author(s):

Vanessa Cavallera ◽

Lynne Jones ◽

Inka Weissbecker ◽

Peter Ventevogel

Keyword(s):

Mental Health ◽

Health Workers ◽

Psychosocial Support ◽

Basic Knowledge ◽

Psychosocial Needs ◽

Humanitarian Emergencies ◽

Humanitarian Settings ◽

Cultural Considerations ◽

Presenting Symptoms ◽

Clinical Conditions

This chapter provides the basic knowledge about mental health and psychosocial support that all health workers in humanitarian emergencies should have and includes descriptions of the presenting symptoms and management of common clinical conditions encountered. In addition to detailed approaches to specific conditions, including recognition and management, this chapter also emphasizes an understanding of the humanitarian context in which these conditions occur, including social and cultural considerations, and the necessity of collaboration with non-health actors to address the psychosocial needs of patients.

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Rapid Support for Older Adults during the Initial Stages of the COVID-19 Pandemic: Results from a Geriatric Psychiatry Helpline

Geriatrics ◽

10.3390/geriatrics6010030 ◽

2021 ◽

Vol 6 (1) ◽

pp. 30

Author(s):

Anna-Sophia Wahl ◽

Gloria Benson ◽

Lucrezia Hausner ◽

Sandra Schmitt ◽

Annika Knoll ◽

...

Keyword(s):

Mental Health ◽

Older Adults ◽

Rating Scale ◽

Psychosocial Support ◽

Psychiatric Symptoms ◽

Psychological Impact ◽

Psychiatric Disease ◽

Depression Symptoms ◽

Psychosocial Needs ◽

Health Crisis

Background. The COVID-19 pandemic and governmental lockdown measures disproportionally impact older adults. This study presents the results from a psychiatric helpline for older adults in Mannheim, Germany, during the lockdown, set up to provide information and psychosocial support. We aim to elucidate the needs of older adults, their reported changes, and the psychological impact during the initial stages of the health crisis. Methods: A total of 55 older adults called the psychiatric helpline between April and June 2020. Information on demographics, medical and psychiatric history. as well as changes in daily life due to the pandemic was collected anonymously. Mental health status was assessed using the 7-Item Hamilton Depression Rating Scale (HAMD-7) and the Hamilton Anxiety Rating Scale (HAM-A). Results: Most callers were women, older adults (M = 74.69 years), single, and retired. In total, 69% of callers reported new or an increase in psychiatric symptoms, with anxiety and depressive symptoms being the most common ones. Age was significantly negatively correlated to higher levels of anxiety and depression symptoms. Individuals with a previous diagnosis of a psychiatric disease reported significantly higher levels of depressive and anxiety symptoms than those without a diagnosis. Conclusion: In older adults, the perceived psychological impact of the COVID-19 crisis appears to ameliorate with age. Individuals with a history of psychiatric disease are most vulnerable to negative mental health outcomes. Rapid response in the form of a geriatric helpline is a useful initiative to support the psychosocial needs of older adults during a health crisis.

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Towards Practical Guidelines for Mental Health and Psychosocial Support after Emergencies in the Western Pacific Region

Prehospital and Disaster Medicine ◽

10.1017/s1049023x19001560 ◽

2019 ◽

Vol 34 (s1) ◽

pp. s71-s72

Author(s):

Hans Te Brake ◽

Relinde Reiffers ◽

Charlie Steen ◽

Michel Dückers

Keyword(s):

Mental Health ◽

Psychosocial Support ◽

Action Plan ◽

Stakeholder Involvement ◽

Well Being ◽

Western Pacific ◽

Pacific Region ◽

Psychosocial Needs ◽

Western Pacific Region ◽

The Western Pacific

Introduction:The Western Pacific Region, comprised of 37 diverse countries and areas, is one of the world’s areas most prone to be affected by disaster. Seven of the top ten countries most at risk of a natural disaster are in this region. The Regional Agenda for Implementing the Mental Health Action Plan 2013-2020 in the Western Pacific identifies mental health in disasters and emergencies as a priority area and calls for a social movement for action on mental health and well-being. To increase understanding of and need for mental health and psychosocial support in emergency situations, regional guidelines are necessary. It is unclear to what degree international guidelines are applicable in this region.Aim:To synthesize the contents of available evidence-based guidelines and assess their potential to address the mental health and psychosocial needs of people in emergency settings in the Western Pacific Region.Methods:A systematic literature review of existing guidelines for mental health and psychosocial support in disasters and emergencies was conducted. Using the Appraisal of Guidelines for Research and Evaluation II instrument, the quality of each guideline was determined covering the following: (1.) scope and purpose, (2.) stakeholder involvement, (3.) rigor of development, (4.) clarity of presentation, (5.) applicability, and (6.) editorial independence.Results:The results provide an overview of the quality, number, and specificity of available guidelines. A framework was developed to categorize these guidelines on each stage of the disaster management cycle (prevention, preparedness, response, and recovery) while considering their guidance regarding coordination, monitoring, communication, human resources, and connection with regular health services.Discussion:The framework and its implications for further research and development are presented at the conference. We will specifically focus on the question, “What is needed to move from a reactive to a more proactive stance in policy and practice?”

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