A house that was destroyed by forest fires in Altadena, California.
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Survivors of Hurricane Helene floods and the Los Angeles fires have something in common: the help of front -line workers trained in something called Psychological first care.
It is a mental health intervention designed to combat a therapeutic deficit exposed by other terrible events – such as the bombing of the federal building of Alfred P Murrah in Oklahoma City. Nineteen children were one of the 168 people who died that day in 1995. It is still the deadliest act of domestic terrorism.
Robin Gurwitch was a young psychologist at Oklahoma City at the time, and she quickly found herself to deal with the consequences. His customers were the people who survived.
“It was my community,” said Gurwitch. “Being in child care (center), the YMCA, which was destroyed on the other side of the street, even less that of the building,” she said, “it was like” OK, I have Need to know more about the best support and helps. ‘”
But Gurwitch’s training had not equipped it to deal with collective disasters and generalized trauma. Desperated with information, she started calling experts across the country.
“There were very few,” she recalls.
The event would define the course of Gurwitch’s career because it would help to create A new set of best practices for early treatment for trauma that are now used by millions – including people affected by Los Angeles fires in January and Hurricane Helene in September.
RCR for mental health
Gurwitch is now an authority on the fight against collective trauma – especially for children – at Duke University in North Carolina. His expertise includes an emphasis on psychological first care, therapy that helps fight trauma and mitigate the risk of post-traumatic stress disorder.
The practice was launched by a group of researchers who – recognizing the need for new ways to treat trauma – met 20 years ago to create an approach focused on evidence.
“After 9-11, there was a real need to think about how we really help the primary survivors, victims with the immediate consequences of a mass disaster,” explains Melissa Brymer, who directs terrorism and programs disaster of the National Center of UCLA for the traumatic child stress.
Events such as Oklahoma City bombings had given rise to new approaches to trauma, but some of the therapists of therapeutic strategies were leaning at the time of The attacks of September 11 aggravated the trauma of people – forcing them to relive the events before being ready, explains Brymer.
For the inhabitants of Los Angeles with the immediate consequences of the fire, for example, Brymer says that “the unimaginable has just happened to them. And it is so crushing that people do not even know what should be their first step . “
Using other evidence that they had through the experience of therapy, Brymer and his colleagues have designed a new practice, the one that would change attention in these times to listen to people and meet their immediate needs.
Miriam Brown, assistant director of the Los Angeles mental health department, supervised the crisis centers, where people moved by fires could obtain psychological first aid.
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“Part of what we do in the training is to help people not watch in the long term, but what is the next step they have to take so that we can help them start this trip to healing” , explains Brymer.
Experts like Gurwitch were essential to its dissemination with millions of people.
Often described as a kind of RCR equivalent to mental health, psychological first aid is a Training Any person can follow. He relies on four principles: preparing to provide help, watching the situation and the need, actively listen to the person to understand his feelings and connect them to the services.
Experts say it is easy to compose more shocks and trauma by assuming someone’s needs.
“Number, we want to make sure people don’t say,” I have to go back to the fire. “Or that they return to an area that is not considered safe, what we call a hot area,” explains April Natural, clinical social worker and vice-president of disaster services at Dynamic emotional health – An organization that frequently sends the first mental health stakeholders to disasters.
Natural says that in crises, even formed clinicians can become psychologically deregulated, unstable and unable to control their emotional responses. They may have trouble making good decisions: “I went to situations with mental health professionals, who worked in difficult areas where there was a lot of death, or scary things like fire – They often do not recognize that they “I don’t think clearly.”
Psychological first care provides a base on which falling back into these moments of deregulation which can persist for weeks or months after an event.
Los Angeles quickly opened three crisis centers, while fires were still burning and endowed them with mental health respondents trained in psychological care to help the victims.
“We are just trying to put them at ease, trying to locate them, trying to orient them towards what is necessary,” explains Miriam Brown, deputy director of the Los Angeles Mental Health Department, who supervised the centers crisis. “Help them to face anxiety and shock from this traumatic experience.”
Brown says these first -line mental health agents have seen hundreds of people in the centers in the first days after the return of fires.
Psychological first care for all
Cheryl Antoncic – A restaurant owner in Asheville – followed Gurwitch’s class after Hurricane Helene brought catastrophic floods in western North Carolina.
“It’s like you think to support someone, you have to be a mental health professional or an advisor,” said Antoncic. “This is not the case.”
Cheryl Antonon has Bear’s Smokehouse in Asheville, NC, she was trained in psychological first aid and helping free food distribution by World Central Kitchen.
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Antoncic has long been in his own interest in mental health; His non-profit organization Linked4life helps to promote the well-being of the community. When Helene struck Asheville, Antonicic has teamed up with the charity World central kitchen Reserve and distribute tens of thousands of meals to the survivors of the floods. Its restaurant has become a hub for recovery. Sometimes meals were delivered by helicopter to people blocked in the mountains of the Appalachians.
Antoncic helped organize Gurwitch to go to Asheville to teach people like his psychological care. A large part of the course is based on the importance of listening to people at the time of the crisis – asking them their needs rather than guessing.
“Just sitting with someone, you know, and offering them something to eat, offering them water – it’s going very far,” said Antoncic.
Asheville, NC, on September 28, 2024, when massive precipitation from Hurricane Helene flooded areas that are generally not flooded.
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It may seem common sense, but it can be difficult to invoke common sense in the midst of trauma.
“The trend of some people is to reach out and try to hug someone when they are in distress,” said Antoncic. “This can be something that you should ask first – like:” Would it be for me to hug you? “”
Since the storm, Antoncic has put his training to use, nourishing tens of thousands of survivors. One day in December, she was standing next to gigantic paella Cuisers who held hundreds of gallons of beef chili. “Comforting food,” she says, “they will serve this with a piece of corn bread on the side.”
The science of trauma is still young
While practice assessments have shown Promising advantages For people treated with psychological first care, researchers would like to see it studied more rigorously. It is difficult to measure mental well-being before and after an event. Gurwitch claims that there is still so much to learn about the whole field of trauma and disasters.
Almost three months after Hurricane Helene, massive cleaning continued in Swannanoa, NC, near Asheville.
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“We learned from Oklahoma City, we learned from Katrina, we learned from 9 to 11,” she said. “We learned the lessons of Sandy Hook that could help Marjory Stoneman Douglas.”
Gurwitch says it is important to study these horrible tragedies. She is still working today with the people she met in the Oklahoma City attack.
“It’s been 30 years,” she said. “I have never stopped working with them.”