FEATURES

An Overview of the Red Cross and Disaster Mental Health

 

If you or your family were impacted by a disaster, would you have everything you need? Where would you go if you needed to leave your home? What about food, water and prescription medications? Your family pets? Would you or your family members need emotional support to cope with what you had witnessed and experienced? Often, people are unable to answer these questions with any certainty or haven’t spent time preparing for the “what ifs” of a disaster. That’s where the American Red Cross comes in.


Founded by Clara Barton in 1881, the Red Cross helps to prevent and alleviate human suffering in the face of emergencies by mobilizing the power of volunteers and the generosity of donors. This work is guided by seven fundamental principles: humanity, impartiality, neutrality, independence, voluntary service, unity and universality.

Many people think of the Red Cross as the provider of food and shelter for individuals and communities impacted by a large-scale disaster, however the majority of Red Cross responses are home fires that occur in communities across the United States on a daily basis. In fact, the Red Cross responds to an average of more than 60,000 disasters every year—the majority of which are home fires. In addition, the Red Cross responds to hundreds of larger disasters each year including earthquakes, wildfires, tornadoes, hurricanes, floods, transportation disasters (e.g., plane, train) and mass casualty incidents.  The Red Cross relies on volunteers with specialized skills whose roles can range from responding to a call about a home fire to driving an emergency response vehicle to distribution of necessary emergency supplies to provision of necessary health services, plus many other opportunities in between. It truly takes a village to carry out a Red Cross disaster response.

Disaster Mental Health

The Red Cross began providing Disaster Mental Health  services in 1992. Today, with approximately 3,000 licensed mental health volunteers, the Red Cross is able to assist those who are coping with the impact of a disaster that may be felt long after the immediate danger has passed—including from our own Red Cross disaster workers. These specialty trained volunteers respond to immediate emotional distress, mitigate long-term consequences, and help augment a community’s mental health resources, rather than replacing them. This team also serves the community with preparedness activities and recovery programs.

Assumptions of Disaster Mental Health:

  • Most reactions to disaster are common and expected, and many people will naturally return to their pre-disaster level of functioning
  • Most people are resilient and will recover on their own
  • Disaster Mental Health interventions can help facilitate recovery and mitigate long-term psychological challenges including, but not limited to, PTSD, depression, and anxiety
  • Some people require more significant emotional support during and after a disaster

Disaster Mental Health workers, like MFTs, provide approved interventions to support people affected by disasters and the Red Cross workforce. They do not provide psychotherapy, formal mental health evaluations or diagnosis, individual psychological debriefings or long-term trauma therapy. Those needing longer term interventions are referred to appropriate community resources. While it is difficult to describe a typical Disaster Mental Health intervention, often the focus is on crisis de-escalation, problem solving, facilitation of coping skills and/or task-centered activities to address basic needs and stress reduction.

The people served by the Red Cross come from all walks of life, and everyone is welcome to our services regardless of race, religion, gender identity, sexual orientation, age or citizenship status. Cultural competence is a key component that guides our approach, and all interventions respect an individual’s right to privacy and are kept confidential. Disaster Mental Health workers operate according to their discipline’s code of ethics and maintain responsibility for reporting child or elder abuse or neglect according to the laws of the state or territory where the service is being provided.

Red Cross Disaster Mental Health services are provided wherever people in need are. This could include shelters, temporary services centers established in community settings, as well as through door-to-door outreach in communities or over the phone.

Working with people affected by disasters can be stressful. Hours may be long, surroundings may be unfamiliar and challenging, and repeatedly listening to survivors’ stories can be difficult. But the rewards are many, and often speak to the reasons for pursuing a mental health career—to help those who need assistance with life’s challenges. Red Cross Disaster Mental Health volunteers support one-another and their fellow volunteers by listening, being a compassionate presence and by sharing advice and tips regarding the importance of self-care in order to help prevent compassion fatigue.

Reactions to human caused vs. natural disaster

While the following is not an exhaustive list of the differences in reactions to human-caused versus natural disasters, there can be differences between these two types of events in terms of their impact on survivors. Human-caused events (e.g., mass shootings) often have a more devastating psychological impact on a community than natural disasters, though either type may create profound human and material losses. Human-caused events can seem incomprehensible and senseless; some may view them as uncontrollable and unpredictable, while others may view them as preventable. Natural disasters with warnings (e.g., hurricanes) increase a sense of predictability and controllability. Human-caused disasters may alter one’s assumptions about humanity; individuals no longer feel that the world is secure, just and orderly, and survivors are confronted with the reality that bad things can happen to good people and that anyone can be in the wrong place at the wrong time. These feelings may also be shared by survivors of natural disasters. It’s also important to note that natural disasters tend to have a greater impact on people with fewer economic resources because they typically live in lower-cost, structurally vulnerable residences in higher-risk areas.

Phases of survivor responses to disaster

Disasters and the aftermath can be categorized into five phases, and Red Cross Disaster Mental Health volunteers can be present to support individuals and communities during each phase. During the warning or threat phase, many people feel vulnerable, apprehensive and experience a sense of loss of control. Others may feel invincible and can fail to adequately prepare. During the rescue phase, people are in “fight or flight” mode, rushing to save themselves or others, protecting possessions, finding a place of safety or engaging in community activities such as sandbagging.  The honeymoon phase may involve a sense of relief to have made it through the crisis with accompanying feelings of thankfulness, empowerment and bonds with the impacted community.

The disillusionment phase sets in over time, and people begin to realize the true impact of the event and are now facing the reality of how much they need to do to recover. People also discover the extensive steps they must go through to find help, and the limitations of what agencies and organizations can do to assist them. Media coverage may drop off, and individuals may begin to feel abandoned, angry or depressed. Eventually, people move on to reconstruction and recovery and begin to come to terms with their circumstances and the necessary tasks before them. However, emotional recovery and reconstruction of homes and livelihoods may continue for years.

Red Cross response during COVID

The mission of the Red Cross did not change due to the pandemic, as disasters continued to occur, but the approach to how we delivered our mission underwent some necessary modifications. For example, many of our volunteers engaged virtually instead of being on the ground, and non-congregate shelters (e.g., hotels) were used to help protect everyone. Our workforce was also diligent in following social distancing protocols, wearing masks, performing health screenings and using enhanced cleaning procedures. Due to these efforts, we saw no significant spread of COVID-19 after disasters among our workforce or in our shelters. 

For 2021, we plan to open group shelters in most cases. However, in some communities, hotels may be more appropriate if the risk of COVID-19 is particularly high. To help keep our workforce and the people we serve safe, we plan to keep in place many of the additional safety precautions implemented in 2020 including masks, health screenings, enhanced cleaning procedures and encouraging social distancing. And, as we have throughout the pandemic, we’ll continue to follow the safety guidance of the CDC and OSHA.

Interested in becoming a Red Cross Disaster Mental Health volunteer?

The Red Cross is continually recruiting new volunteers to help support people affected by disasters in your local community and across the country. Your time and talent can make a real difference in people’s lives.

The following master’s level licensed mental health professionals are eligible to volunteer as part of Red Cross Disaster Mental Health: social workers, psychologists, professional counselors, marriage and family therapists, psychiatrists, school psychologists and school counselors. In addition, psychiatric nurses with a minimum of two years of experience working in a psychiatric setting are eligible, as are retired mental health professionals who meet certain eligibility requirements. There are many opportunities, and include being part of a team to support people impacted by home fires, educating school-age children about how to prepare for a disaster, teaching Psychological First Aid to interested community groups, or traveling to a disaster-impacted community in order to directly support those affected. Time commitments vary depending upon the nature of the assignment, and can be as little as a few hours, to as long as several weeks. Contact your local Red Cross chapter for further information about eligibility and training requirements, or visit us at redcross.org/volunteer.

Koski

Karen H. Koski-Miller, LCSW-C, is Disaster Mental Health lead at the Red Cross. email: Karen.koskimiller2@redcross.org

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