psychosocial preparedness for united nations critical staff
TRANSCRIPT
PSYCHOSOCIAL PREPAREDNESS FOR
UNITED NATIONS CRITICAL STAFF
Redefining Readiness: Effective Risk Communication
Impact of Pandemic on Critical Staff
Psychosocial Issues in Pandemic Influenza
Coping Strategies
Workforce Resilience
Scientists refer to it as a “quadruple reassortant” virus, meaning it is comprised of 4 flu virus genes: 1 human, 1 avian, and 2 swine
New influenza virus causing typical flu-like symptoms (fever, cough, etc.)
Human to human transmission through spread of the virus via typical respiratory means (coughing, sneezing)
Three Level Operational Framework:
Readiness Mode
Crisis Response
Emergency Mode
60% of the US public would not heed official instructions to get vaccinated during a smallpox outbreak
40% of the public would not heed official instructions to shelter in place during a dirty bomb incident
Lasker, RD. (2004). Redefining readiness: Terrorism planning through the eyes of the public. New York, NY: The New York Academy of Medicine.
Closer examination suggests what support the public would need to comply with official requests:
In the case of a smallpox outbreak, 55% indicated they needed more information before they could make a decision regarding vaccination
In the case of sheltering in place, the major reason for not following instructions was concern for the safety of family members. If assurances were given that family members were taken care of, compliance dramatically increased.
Findings emphasize critical importance of communication in a crisis
Provides guidelines for essential psychosocial human needs that must be met in a large scale crisis
Arms us with critical information regarding human decision-making processes in a crisis
U.S. Dept of Health and Human Services (2002). Communicating in a Crisis: Risk Communication Guidelines for Public Officials. Washington, D.C.: Author.
Potential increased risk of exposure Need to take special precautions Ethical dilemmas regarding competing
obligations to work and family Frustration regarding need/expectation
to maintain business as usual Compassion fatigue or burnout
Centers for Disease Control. Retrieved 4/30/09. Psychological and social support for essential service workers during an influenza pandemic. http://www.cdc.gov/swineflu/guidance
Fear
Anxiety/Worry
Anger
Loss/Separation
Fear is an expected response to a perceived threat to safety
Fear takes various forms and differs across individuals, groups and cultures
Some biological/physical aspects of fear are universal across cultures
Fear is often the underlying emotion that leads to panic – contagion aspect.
Popular misconception that panic will be a common reaction to an influenza pandemic
Although people may experience significant anxiety and even periods of fear, research indicates that panic is a relatively atypical in pandemics
Panic is most likely to occur when people feel ill-prepared to deal with scarcity of resources that may arise
Acknowledge fear as a normal reaction to threats to safety in yourself, staff and coworkers
Provide timely and accurate information
Limit large, unstructured group assemblies, as these often “feed” the fear response
Maintain regular contact/communication with staff
Address questions directly and honestly
Can be related to specific concerns – Economic security Health and safety
Can also be related to nonspecific concerns Uncertainty/fear of the unknown Lack of control is typically the most difficult
type of anxiety to tolerate
May continue for longer periods of time and lead to emotional exhaustion, OR improved coping methods if adequate support and opportunities for constructive action is provided
Provide regular updates Knowledge facilitates adaptive coping
Encourage active participation Doing something constructive alleviates
anxiety
Encourage healthy habits and coping resources A regular routine can ease excessive worrying
Anger has different sources
Some individuals/groups will express their fear through anger
Anger is a common response to helplessness and feeling out of control
Some anger may be “legitimate”, e.g. a rational response to poor communication, unequal access to resources, etc.
Diffuse the anger through listening “Understand first, seek to be understood
later”
Differentiate between anger and aggression Tolerate and empathize with anger (up to a
point . . .) Set immediate limits on aggression
Recognize anger is often a way of setting up a false “us/them” dichotomy Emphasize solidarity – “we are all in this together”
Redirect/channel strong emotions into productive activity that promotes group cohesion “What can we do together to help one another?”
The pandemic influenza crisis may result in multiple losses, of various types, and at various phases: Economic/financial Sense of predictability/routine Loss of mobility/freedom to travel Health and sense of safety General loss of feeling in control Separation from friends/family During later/more severe stages: Death of loved ones
(death of children particularly devastating issue in pandemics)
Empathize and validate the experience
Encourage seeking support from family, friends and coworkers
Support spiritual/religious beliefs and rituals
Provide adequate time off from duties for bereavement
Recognize the unique nature of loss in a pandemic crisis (e.g., issues of contagion,, sustained periods of uncertainty, alterations in burial rituals)
Fear
Anxiety/Worry
Anger
Loss/Separation
Social support reduces feelingsof uncertainty,
enhances positive coping
Illness and death among colleagues and family members
Fear of contagion/transmitting the illness to family members
Shock, numbness, confusion, disbelief Concern about children and family Constant stress to continue work
performance Concern about receiving vaccines or
retroviral drugs before or after others
Psychosocial adjustment of staff can be impeded by: Lack of information Rumors or misconceptions Loss of trust in institutions and leaders Belief that medical resources are unavailable or
are unfairly distributed Increased stress, particularly sleep deprivation Restrictions on civil liberties that are perceived
to be disproportionate to the level of risk Infection control procedures that severely limit
personal contact or hinder communication
Psychosocial adjustment of staff can be facilitated by: An environment that emphasizes
collective efficacy and enhanced team support
Adequate preparation Opportunity to participate in decision
making as appropriate Workforce resilience programmes that
support well-being
Critical staff may be frustrated, tired, worried, distressed and irritable when they return home
Increased workloads may make regular communication difficult
Family members may experience mixed emotions (pride, guilt, fear, etc)
Family members will experience stress of increased responsibilities at home
www.pandemicflu.gov/plan/individual/checklist.html
Maintain your regular routine as much as possible (sleep, exercise, diet, etc.)
Balance physical and mental activities Alleviate anxiety by focusing on
constructive activities that you can accomplish
Limit media exposure Rely on your spiritual beliefs that can
nurture you through the challenges
It is impossible to prepare for everything
Concern for family and friends must be addressed
Communicate, communicate, communicate
Resiliency can be learned and enhanced
Self-care plans and peer support are essential
The primary goal of the organization when in crisis is to protect its staff members
Two-pronged approach:
1) Organizational Factors Work shifts and recovery periods Maintaining a climate of safety Support for unfamiliar roles
2) Support Services for Staff
Monitor workforce needs for stress management and health care
Provide leadership, supervisory and management training
Improve perceptions of collective efficacy (i.e., ability to handle problems as a team)
Promote integrated health, safety and security culture (hardiness, resilience)
Implement continuity of information and communication systems
Ensure continuity of essential operations (organizational resilience)
Resilience facilitates recoveryResilience facilitates recovery
http://www.un.org/staff/pandemicGeneral information for all UN staff
http://staffinfo.un/int/Staff emergency site, such as
information regarding building closures
HOTLINE: 1-866-UNINFO1 OR 212-963-9800
