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21 This following checklist contains the five essential interven- challenging, as the context and nature of the exposure may tion principles that Hobfoll et al. (2007) introduced and are not be evident. For example, providing information though further explained for the emergency planner to consider: radio contact with an aircraft prior to the crash may not give the individual the visual picture most people associate with 1. Promote a sense of SAFETY. a traumatic event, but the individual may experience symp- Negative post-trauma reactions persist under conditions toms that need support. of ongoing threats. If you are imminently involved with a disaster, a helpful Introducing a sense of safety reduces survival reactions initial process identified in the Hobfoll article, described over time. earlier in this chapter, may be of assistance in your initial The perception of safety is also important. response to victims, recovery and rescue workers, or others There are a number of cognitive interventions for decreas- who may be at risk. Actions to consider during emergency ing exaggerated perceptions of dangerousness. operations include the following: 2. Promote a sense of CALMNESS. Prolonged states of emotional arousal can cause: 1. Identify individuals at risk and their organizational super- Sleep, concentration, and decision-making dys- vision. function; While disaster victims and airport personnel directly Unrealistic perception of dangerousness; and involved in rescue operations are the immediate concern, Avoidance. also consider personnel from maintenance, security, Major criticism of psychological debriefing: dispatch, gate agents, baggage handlers, and air traffic Increases arousal at a time when restoring a sense of controllers to list a few. Remember small organizations calming in important. (e.g., contract maintenance or security) within large airports 3. Promote a sense of SELF-EFFICACY. may be forgotten and may not have support or policies to Self-efficacy: having a sense or belief that your actions assist them. are likely to lead to a positive or desired outcome "I can 2. Identify resources for mental health support. do this." Organizations that provide mental health support should Individual and be contacted as they may have specific guidance and/or per- Collective/grouporganizational. sonnel to support your operation, depending on the nature Following trauma, people are at risk of losing sense of and the scope of operations. These organizations may be competency to handle problems they face. within organizations (e.g., Employee Assistance Programs), Important to feel one can cope competently with the spe- contract groups or through mutual aid (Fire department or cific trauma-related events/tasks. affiliated airports). Development of a MHRP will list sup- Normalize emotions and port groups (Red Cross for victims/families, etc.) Solve problems. 3. Assess the needs of the affected community. 4. Promote CONNECTEDNESS. Identify the conditions and exposures of the teams Social support facilitates information sharing, problem working in the rescue, recovery, and investigation of the solving, normalization, and emotional support. disaster. Unique issues may need physical support that as- 5. Instill HOPE. sists coping, such as temperature management, lighting, or Trauma results in shattered world view, catastrophizing personal needs (food, communication with family, etc.). "all is lost" situation. Consider the challenges faced by individuals tasked with Instill a sense that outside sources will act benevolently. jobs outside their training and experience, such as mainte- Interventions to decrease exaggeration of personal re- nance personnel tasked with cleaning a fatal accident scene. sponsibility for causing event. 4. Initiate early supportive measures. Decrease catastrophizing. Prepare crews who will work with the recovery effort Normalize reactions. whenever possible, as this will help them focus their efforts Stress that most people recover on their own. and minimize uncertainty. Pairing crew members with Emphasize strengths of individuals and organization. someone experienced in the operations appears to be help- ful, as well as providing individuals to offer mental health support on site to workers as needed. Response to Actions to Assist Do not expect NTSB, FAA, or other groups to provide Psychological Recovery mental health support for your staff. While their assistance Psychological trauma results from the exposures people during operations does help your team members, the men- experience before, during, and after incidents occur. Iden- tal health support embedded in their organizations is not tifying individuals at risk for psychological trauma may be intended to support individuals external to their group.

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22 5. Identify high risk groups and individuals for additional This list is but a shell of the plan needed to support an support. organization, but as with operational disaster action plans, The ultimate goal of a team would be to self-monitor it must be tailored to the specific needs and resources of the individuals, supporting and relieving colleagues as the organization. Excellent examples of Mental Health needed. This was identified as a key element by a num- Disaster Recovery Plans are available to review and use ber of well-developed recovery and investigation teams. as a template to develop your individual plan. Please see the Education and support are needed to prevent additional New York State County Disaster Mental Health Planning trauma and provide additional supportive measures, such and Response Guide: A Guide for County Directors of as time off, counseling, etc. Mental Health and Community Services attached as a case 6. Continue to monitor personnel and effectively commu- study to this guidebook and available at http:/www.omh. nicate. Listen, and provide answers, to individuals involved in Lastly, there is "no one size fits all" approach, there- the recovery operations, as uncertainty was found to be a fore careful consideration of your employee's percep- significant factor in aggravating stressful work. Make lists tions and mental health regarding the incident, and the to keep concerns from being forgotten. organization structure, culture, and communication net- 7. Assess the intermediate and long term needs. work is critical in framing your response to the traumatic 8. Evaluate the effectiveness of the plan after each training event and realizing the best possible course of action for session and disaster. all involved.