Tag Archive: mental health

Do No Harm: Embracing Core Humanitarian Standards

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Introduction

Technology has presented many opportunities and challenges for those involved in the emergency, humanitarian crisis and disaster relief fields.  Revolutionary advances have allowed support teams to evolve in many ways to assist operations on the ground from remote locations.  Disaster and humanitarian-related remote volunteers sometimes experience extremely high stress levels, compassion fatigue, lower priority of self-care, and vicarious trauma, alongside other physiological and psychological effects.  This post aims to discuss research related to health, volunteering in humanitarian and disaster response covering the concept “do no harm”, am humanitarian core standards.

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Manner of Response Determines Results

During response to disasters, volunteers become submerged in their work, feeling a duty to the people they are helping.  Under high stress levels, workers perform with all of their energy, working longer and longer hours.  Mixed motivational messages can occur when a team leader or facilitator continually recognizes achievements of volunteers while failing to maintain a healthy working environment.  A health-centered work environment has volunteers take regular breaks, promotes emotional well-being, advocates self-care, respects personal priorities, supports team members in building amicable relationships, and encourages a non-hostile working space.

Workers may ignore the red flags of overwork and fatigue.  In supportive environment, teaching the signs and symptoms of compassion fatigue, vicarious trauma, and toxic stress are now more commonly addressed.  Increased irritability, confusion, headaches, symptoms of cold/virus, or extreme exhaustion are glaring signs of overwork and toxic stress levels. These may go either unnoticed or simply pushed aside.

With little to no energy left from prolonged hours of work, basic needs and personal wants may begin to become neglected.  What a person loves to do: spending time with family and friends, playing with a pet, engaging in sports and physical activities, enjoying social outings or the luxury of relaxing and pursuing peace of mind… these aspects are usually sacrificed first in order to “finish up those details”.  These basic wants help contribute positively to health and emotional well-being and are unique for each person.  Even basic needs that we all share, such as: consumption of food and water, a healthy amount of sleep, regular practice of hygiene, exercise, and maintaining emotional well-being may become secondary.

 

Some of these items seem simple or extravagant considering the emergency at hand, but many of us have burnt out during emergencies.  It will sneak up on you – the stress and the rollercoaster.  You may downplay it.  This is why we share to remind you that digital contributors can become strained too.

-Heather Leson, President Humanitarian OpenStreetMap Team -heather.leson@hotosm.org

Overload vs. Sense of Coherence

Overworked responders’ stress can reach toxic levels, causing their coping mechanisms to fail.  Toxicity of stress goes largely undiscussed, and magnifies stress as it combines with encounters of highly distressing information.  Witnessing unbearable scenes with the haunting faces of destruction, death, and suffering is unfortunately a common occurrence in disaster response and humanitarian crises.  Toxic stress happens when “unsuccessful coping due to lack of adequate internal capacities as well as poor external support” happens, or if a worker’s neural architecture is simply unable to handle stressors (McEwen, 1998).

Increasing hours worked means increasing exposure to deeply tragic elements.  Elements that aren’t fun to talk about, aren’t faced with ease, and can leave within us incredibly charged emotions.  Suppression and plowing onwards serve only as temporary coping mechanisms. Lack of proper self-care and toxic stress may reach what feels like the point of no return.  In all cases, this “allostatic overload” is volatile (Dias-Ferreira, et al., 2009).  Allostatic overload eventually leads to physiological dysregulation. Physiological dysregulation may then cause physical or mental disease.  It is important to remember however, that jobs creating worker burnout and/or depression can happen in any line of work.

Observations have shown that volunteer participation in group collaborative activities gives each volunteer a “Sense of Coherence” or SOC.  SOC is significant in that it helps build and strengthen coping abilities for situational stressors when a volunteer identifies their experience within a group as “comprehensible, manageable, and meaningful (Haraoka, Ojima, Murata, Hayasaka, 2012).”  When a team encounters “collective stressors”, SOC is felt at very high levels.  “The present findings show that strength of SOC in a community links more with willingness to carry out collaborative activities with volunteers (Haraoka, et al., 2012).”  Mutual support within a responding volunteer community is vital for the group’s collective SOC to solve problems more effectively.

Embracing Core Humanitarian Standards

A volunteer collective that tackles obstacles together might be a new concept for coordinators. Practices that consider the well-being of each person in the organization must evolve to develop a healthy level of community SOC that benefits everyone.  Only then, can volunteers develop better stress coping abilities, and have their problem-solving capabilities strengthened.  The organization can offer greater impact when working as a cohesive unit. It is a collective responsibility to see that volunteers within every community treated with dignity and care.  Leaders too often add to factors of burnout and depression in workers, weighed with the truth that ultimately only the worker can follow through with self-care and maintenance.

Leaving sole volunteers to deal with problems during a crisis with no help from the rest of the community represents a harmful expectation.  It isn’t a healthy experience for volunteers to face stressors without leader and community support.  Additionally, members of a volunteer community may see this and experience a higher burden of stress themselves because of projected expectations.  The SPHERE Project’s Humanitarian Charter and Minimum Standards, particularly the 6th core standard, reminds leaders and organizations of the responsibilities and rights of their workers, “Equally, agencies are responsible for enabling aid workers to perform satisfactorily through effective management and support for their emotional and physical well-being (SPHERE Project, 2012).”

Common Sense: Do No Harm

I have heard time and again volunteers referred to as handy tools, free labor, time savers, and other disparaging terms when some organizational leaders and coordinators discuss affiliated volunteers publicly.  In these cases, there is little consideration of the volunteers’ well-being or SOC, collectively or individually.  Volunteers make the choice to dedicate time, often with specialized skill-sets.  I do not write to accuse, but rather to discuss, educate, and remind organizations of the positive or negative effects they have on volunteers.

Conclusion

If humanitarian and disaster response organizations continue to embrace the core humanitarian standards, and the principle “do no harm” to those they serve, it MUST be equally important to these organizations to avoid deleterious internal treatment and harmful practice to those who volunteer their time, intellect, and heart.  In the same way, if humanitarian and disaster volunteers wish to embrace and admonish “do no harm” and core humanitarian standards to those around them with equanimity, they MUST include care and treatment of self.  It is emotionally and physically essential for volunteers to consider that it is those around them, are directly affected by the personal decision to embrace, or deny their own well-being and self-care.  For responders, “do no harm” must stay a vital concern when considering those affected and in need due to humanitarian crises and disasters… the same must apply to themselves, and those closest in heart and home.

 


 

References

Ahola, K., Hakanen, J., Perhoniemi, R., & Mutanen, P. (2014). Relationship between burnout and depressive symptoms: A study using the person-centered approach. Burnout Research, 1(1), 29-37. Retrieved December 1, 2014, from www.sciencedirect.com/science/article/pii/S2213058614000060

 

Dias-Ferreira, E., Sousa, J., Melo, I., Morgado, P., Mesquita, A., Cerqueira, J., & Sousa, N. (2009). Chronic Stress Causes Frontostriatal Reorganization and Affects Decision-Making. Science, 325(4290), 621-625. doi: 10.1126/science.1171203.

 

Enman, N., Sabban, E., Mcgonigle, P., & Bockstaele, E. (2015). Targeting the neuropeptide Y system in stress-related psychiatric disorders. Neurobiology of Stress, 1, 33-43. Retrieved March 26, 2015, from www.sciencedirect.com/science/article/pii/S2352289514000083

 

Franklin, T., Saab, B., & Mansuy, I. (2012). Neural Mechanisms of Stress Resilience and Vulnerability. Neuron, 75(5), 747-761. doi: 10.1016/j.ynstr.2014.09.001.

 

Haraoka, T., Ojima, T., Murata, C., & Hayasaka, S. (2012). Factors influencing collaborative activities between non-professional disaster volunteers and victims of earthquake disasters. PloS one, 7(10), e47203. doi: 10.1371/journal.pone.0047203.

 

McEwen, B. (1998). Seminars in medicine of the Beth Israel Deaconess Medical Center: Protective and damaging effects of stress mediators. New England Journal of Medicine, 338(3), 171-179. Retrieved March 28, 2015, from www.nejm.org/doi/full/10.1056/NEJM199801153380307

 

McEwen, B., Gray, J., & Nasca, C. (2015). Recognizing resilience: Learning from the effects of stress on the brain. Neurobiology of Stress, 1, 1-11. Retrieved March 26, 2015, from www.sciencedirect.com/science/article/pii/S2352289514000022

 

SPHERE Project, The. (2012). Humanitarian Charter and Minimum Standards in Humanitarian Response. Retrieved May 1, 2015, from http://www.spherehandbook.org/en/core-standard-6-aid-worker-performance

 

WHO, War Trauma Foundation, & World Vision International. (2011). Psychological first aid: Guide for field workers. Retrieved May 1, 2015, from http://whqlibdoc.who.int/ 

 

Dealing With Disasters

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Dealing With Disasters

During disasters, it can be hard to know what to do, and how to deal with unimaginable tragedy, destruction and loss… this list has resources available on the Internet, for Adults, Adolescents, Children, with information on traumatic stress, stress in disasters, how to cope, how to talk to your family and children about a disaster.
Soon to be added, tips and resources to help pets, in field, international, and multilingual resources…

Red Cross: Searching for Family Members

During an emergency, letting your family know that you are safe can bring loved ones peace of mind. If you have a loved one in a disaster-affected area and are unable to contact them directly, please visit our Safe and Well service to see if your family member has registered. If no information is available, contact your local Red Cross chapter to request assistance.

Help for Military Families, Active Duty Service Members, Veterans

Find Your Local Red Cross Chapter by Zip Code

Resources on the Web:

General & Adult Resources

Coping with Traumatic Stress Reactions -from VA Webpage

Fact Sheet on Stress- National Institute of Mental Health -Webpage, and PDF available
PTSD Meetup Groups- Search in your local area
Coping With Traumatic Events- SAMHSHA webpage   
Taking Care of You Coping Guidelines – From American Red Cross  
Red Cross Trauma & Emotional Support – all pdfs, all languages for download  
Trauma Information on Mental Health & Coping- Webpage 
Coping with Traumatic Stress 
Coping With Stress– CDC- Webpage

Adolescent & Children Resources for Parents

Helping Children Cope with Disaster (from FEMA)  
Helping Children and Adolescents Cope with Violence and Disasters: For Parents  (From National Institue of Health)
Where to Get Help for PTSD: General, Family, Military -National Center for PTSD
Helping Children Cope in Unsettling Times: Tips for Parents and Teachers– NASP
What Community Members Can Do: Helping Children and Adolescents Cope with Violence and Disasters- National Institute of Mental Health -Webpage, and PDF available

National Help Hotlines For USA

Disaster Distress Helpline

“Feeling stressed? If you or someone you know has been affected by a disaster and needs immediate assistance, please call this toll-free number for information, support, and counseling. You will be connected to the nearest crisis center.”

1-800-985-5990 or
Text TalkWithUs to 66746

TTY for Deaf/Hearing Impaired:
1-800-846-8517

Also you can call:

Samariteens Emotional Support Hotline (For Teens)    800-252-8336

Samaritans Emotional Grief Support & Suicidal Hotline

877-870-4673

24 hours a day: 617-247-0220 and 508-875 4500

Other Resources:

Ready.gov on Recovering from Disasters:

Recovering from a disaster is usually a gradual process. Safety is a primary issue, as are mental and physical well-being. If assistance is available, knowing how to access it makes the process faster and less stressful. This section offers some general advice on steps to take after disaster strikes in order to begin getting your home, your community and your life back to normal.

 

This originally started as a spreadsheet and I wanted to make the list more publicly available in wake of the Boston Marathon Bombings, and more recently, the Texas and Oklahoma Tornadoes this month… Tragedies and disasters can be stressful and anxiety provoking. We are all human, we are all breakable. If you need help, don’t be afraid to ask for it, seek it out!

(Kelli Merritz)