VIOLENCE
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action will depend on the context and the needs of those traumatized individuals who are being targeted for psychological first-aid( 15).
CORE ACTIONS
1. Contact and engagement- initiate contact the targeted individuals in a nonintrusive, compassionate and helpful manner.
2. Safety and comfort- enhance immediate and ongoing safety if any element of dangerousness still remains at the scene of a violent act or death and provide physical and emotional comfort.
3. Stabilization- calm and orient the emotionally overwhelmed or disoriented persons who have been traumatized by an event.
4. Information gathering- identify immediate needs and concerns, gather additional information, and tailor PFA interventions.( DO NOT ask for a detailed description of the traumatic event itself as this can prove to be counterproductive and actually worsen the psychological status of a traumatized person).
5. Practical assistance- offer practical help to those who have been traumatized in addressing immediate needs and concerns.
6. Connections with social support- help establish brief or ongoing contacts with primary support persons and other sources of support, including family members, friends and community helping resources.
7. Information on coping support- provide information about stress reactions and coping to reduce distress and promote adaptive functioning.
8. Linkage with collaborative services- link survivors with available services needed at the time or in the future.
Further information about the application of Psychological First- Aid can be obtained from the World Health Organization, the International Red Cross, the National Child Stress Network and the US National Center for PTSD.
Whether you are a health care provider, friend, family or just a concerned individual wanting to help people newly traumatized by the ongoing violence in Louisville, a knowledge of psychological first-aid may well be the difference between the development of a mental health disorder versus eventual psychological stabilization of the traumatized individual.
References
1. Louisville Metro Police Data. Year End Homicide Investigations
2. Rich, S, Mellnick, T, Kelly, K, et al.“ Murder with Impunity, Where Murders Go Unsolved.” The Washington Post, published online June 6 th, 2018.
3. Gillikin, C et al. Trauma Exposure and PTSD Symptoms Associated with Violence in Inner City Civilians. Journal of Psychiatric Research. Volume 83, 1 7.
4. Breslau N, Kessler R, Chilcoat H, et al. Trauma and Posttraumatic Stress Disorder in the Community: the 1996 Detroit Area Survey of Trauma. Arch Gen Psychiatry. 1998 Jul; 55( 7): 626-32.
5. Donley S, Habib L, Jovanovic T, et al. Civilian PTSD Symptoms and Risk for Involvement in the Criminal Justice System. J Am Acad Psychiatry Law. 2012; 40( 4): 522-9.
6. Prins, A., Bovin, M. J., Kimerling, R, et al. The Primary Care PTSD Screen for DSM-5( PC-PTSD-5). 2015.
7. Fu, C. and Underwood, C. A Meta-review of School-based Disaster Interventions for Child and Adolescent Survivors. Journal of Child & Adolescent Mental Health. 2015;( 161), 27.
8. McCabe OL, Perry C, Azur M, et al. Psychological First-aid Training for Paraprofessionals: a Systems-based Model for Enhancing Capacity of Rural Emergency Responses. Prehosp Disaster Med. 2011 Aug; 26( 4): 251-8. Epub 2011 Oct
9. Pekevski J. First responders and psychological first aid. J Emerg Manag. 2013 Jan-Feb; 11( 1): 39-48.
10. Bell, CC, Lessons Learned from 50 Years of Violence Prevention Activities in the African American Community. Journal of the National Medical Association. 2017; 109, 4,( 224)
11. Brymer M, Jacobs A, Layne C, et al.: Psychological First Aid: Field Operations Guide. 2nd ed. Washington, DC: National Center for PTSD, 2006.
12. World Health Organization: Psychological First Aid: Guide for Field Workers. Geneva: WHO, 2011.
13. Kulka, R. A., Schlenger, et al.: Trauma and the Vietnam War generation: Report of findings from the National Vietnam Veterans Readjustment Study.( 1990). New York: Brunner / Mazel.
14. Kang, H. K., Natelson, B. H., et al.: & Murphy, F. M. Post-Traumatic Stress Disorder and Chronic Fatigue Syndrome-like illness among Gulf War Veterans: A population-based survey of 30,000 Veterans. American Journal of Epidemiology, 157( 2): 141-148,( 2003).
15. Published on The National Child Traumatic Stress Network( https:// nctsn. org)
Dr. Bozeman practices at the UofL Hiram C. Polk, Jr., MD Department of Surgery
Dr. Campbell practices at the UofL Department of Psychiatry and Behavioral Sciences.
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