What is Psychological First Aid?
Psychological First Aid (PFA) is defined as the humane and supportive response offered to the person who is suffering or in need of support and assistance.
What topics does Psychological First Aid include?
• Provide practical care and support that does not force people
• Identifying needs and concerns
• Helping people meet their basic needs (such as food, water, information)
• Listening without forcing people to speak
• To help them relax and calm down
• Provide assistance for people to obtain information, access services and social support.
• To protect people from possible future harm.
Who is Psychological First Aid for?
PID is for stressed people who have recently been exposed to a serious crisis situation. PFA can be applied to both children and adults. However, not everyone who has experienced a crisis may need or want psychological first aid. Don’t force people who don’t want help in these situations, just be readily available when they ask for support.
There may be situations where PFA alone is insufficient and the person needs further support. At this point, the PFA provider should know his or her limits and direct those needed – such as medical staff, colleagues or other people in the field, local authorities, community leaders and religious leaders – to the most appropriate resource.
PEOPLE WHO NEED MORE URGENT ADVANCED SUPPORT:
» Serious life-threatening casualties in need of emergency medical care,
» People who are so sad that they cannot take care of themselves and their children,
» People who can harm themselves,
» People who can harm others
When is the PI given?
Although people’s need for help and support persists long after the stressful event, PFA aims to help people affected by the crisis event immediately. You can provide psychological first aid as soon as you first come into contact with people under stress. This assistance is usually provided during or immediately after the disaster. However, this assistance can sometimes be offered for days or weeks, depending on how long the event lasts and its type.
Where is PY offered?
PFA can be offered anywhere safe enough. This is generally recommended at the scene of the incident/accident or facilities where aid is provided, such as health centres, shelters, camps, schools, and food. Efforts should be made to deliver the PFA in a private place where facilities are available. Particular attention should be paid to ensuring privacy in order to respect the dignity and confidentiality of the person who is exposed to certain types of crisis situations, such as sexual violence.
What are the PY principles?
Safety: Avoid behavior that poses a risk of harm to individuals. Make sure the children and adults you help are safe and protect them from physical or psychological harm.
Reputation: Behave respectfully, taking into account the cultural and social norms of those you help.
Rights: Make sure people can access help fairly and without discrimination. Help people to assert their rights and get appropriate support. Act with the best of minds for the person you are helping.
How should citizens behave in a crisis (natural disaster, accident, terrorist incidents, etc.)?
» Follow the explanations of the relevant authorities managing the crisis.
» Find out how the emergency response, if any, is organized and what help resources are available.
» Do not interfere with search-and-rescue personnel or emergency medical personnel.
» Know your mission and the limits of your mission.
It is not necessary to have a psychosocial background to offer PFA. However, it is recommended that you work with an organization or community if you want to help with crisis work. If you act on your own, you may be putting yourself at risk, negatively impacting the coordination of efforts, and not being able to provide crisis-affected people with the resources and support they need.
How is Psychological First Aid Service Provided?
1) Effective communication:
The way you communicate with people under stress is very important. People in crisis situations can be very sad, anxious or confused. Some people may blame themselves for things that happened during the crisis. Being calm and understanding helps people under stress feel more secure, understood, respected and cared for. Don’t talk too much, give time for silence. Being quiet for a while will give the other person the space and courage to share with you if they want.
2) Preparation
» Learn about the crisis event.
» Find out about available services and support.
» Learn about safety and security problems.
3) PIY Principles: WATCH, LISTEN AND BAGKUR
Three basic PFA principles; watching, listening and connecting. These principles of action will guide you on how to look at a crisis situation and enter the field with confidence, how to approach affected people, understand their needs, and provide them with practical support and information.
What are the issues that health workers should pay attention to when meeting with a person who needs Psychiatric First Aid who has a risk of harming himself/herself/environment?
• If it is known or suspected that the person has a sharp object on the person, the police should be asked for help.
• The presence of other dangerous objects in the environment should be investigated (knives, iron / wooden sticks, etc.) and removed from the environment.
• The patient should be interviewed in a closed, quiet environment with little stimulation.
• As far as possible, the interview should not be entered alone, the door should be left open when it is necessary to enter alone, and the assistant health personnel should be easily accessible.
• Punch and kick distance should not be entered.
• Do not turn your back on the aggressor.
• Hands must always remain uncovered and visible.
• Speech should be well organized and rational. Sequences in official documents (eg, filling in the questions in the call form in order) are not very useful in this case. Mutual conversations in the field should be kept very short. The conversation should be in a way that is appropriate for your condition and receives information that will be useful in your treatment. If the patient gives you more spontaneously, try to benefit from that information.
• The questions you ask during the conversation should be open-ended, you can ask them directly or indirectly. You can allow the patient to lead the conversation, except in cases of depression, suicide, or those with little response. However, the speech should be of the quality to reach the information you want. If the patient does not want to answer some of your questions, do not force them, otherwise the patient will close and may not give any information. Take as much time as necessary to gather information; neither more nor less. If the patient’s condition requires urgent transport or poses a danger to his environment, do not waste time seeking information. Despite all the information you have obtained (observation, information gathered from the patient and the environment), avoid making firm decisions about the patient’s behavior and responses.
• It is thought that the following guideline information will make your conversation with the patient more effective:
- Introduce yourself to the patient, express that you are there to help.
- Move the patient away from the scene of the problem, remove disturbing people or objects.
- With good intervention, you can prevent the patient’s family, friends or people from reacting with excessive anxiety. Ask the appropriate people to remove the curious or disturbing people around you (make sure to choose people who can do it politely, not violently)
- If necessary, provide the help of acquaintances who provide support and comfort to the patient
- Absolutely avoid behaviors that will increase the patient’s anxiety. Try to establish a friendly relationship with the patient before performing a head-to-toe examination. Respect the patient’s privacy, protect your professional boundaries (your professionalism) and be effective.
- If the patient is overly agitated or refuses treatment, explain each procedure carefully and in language that he or she will understand.
- Communicate with confidence, act with maturity required by the patient and the event (be reasonable), be honest.
- Make rules; For example, “You can cry, but I will not let you hurt yourself or others”.
- If the patient is distorting the facts, it doesn’t matter whether you accept his thoughts or not. The important thing is that you understand that these distortions are the patient’s facts (eg, “spiders on the wall are attacking me”).
- Encourage (encourage) the patient to sit down and relax
- Encourage the patient to express their situation in their own words
- Do not interrupt the patient’s words as much as possible, unless he is jumping from branch to branch or speaking nonsense.
- Do not be afraid of prolonged periods of silence, be relaxed but careful
- If the patient begins to cry or laugh, do not interrupt this spiritual demonstration with speech.
- Allow the patient to tell his/her story (here, not the disease story!) as he/she wants and encourage him/her to continue by nodding, “Yes, I understand, you can tell more”
- If the patient’s thoughts are confused or the situation seems too complicated for him; steer the conversation in such a way that it feels less complicated (or organized).
- Do not argue with the patient (do not try to prove things)
- Never ask closed-ended questions when you want to keep the conversation going. (For short, questions with “yes” or “no” answers are called closed-ended questions)
- Your stance should not be in a way that will frighten (intimidate) the other person.
- Be cool-headed, this way you reduce the patient’s anxiety and relax
- Do not yell at the patient who is already anxious
- Never touch the patient if the patient does not allow
- Do not judge the patient’s actions or condition! Let the patient think that you are impartial (you already have to be impartial as a healthcare professional)
- Do not decide without trying that it is impossible to talk to the patient (even the most severely psychotic patient can provide invaluable information about the history of the illness, unless they have memory impairment)
- Do not lie or cheat.
- Don’t get sick between you and the exit! If you need to run away when the patient becomes aggressive, your escape route should be in your immediate vicinity.
