The tornadoes in the southern and central U.S were severe and wide-spanning, leading to billions of dollars in damages and claiming nearly a hundred lives across six states. The tornadoes also caused extreme disruption and distress for communities, adding to challenges of the ongoing COVID-19 pandemic (resources can be found here). Below are brief and easy-to-read education fact sheets with recommended actions to protect the mental health and well-being of individuals, communities, and organizations following the tornadoes.
Grief is a near universal experience for those directly impacted by an extreme natural disaster, such as a tornado. In the immediate aftermath, loss of home, possessions (such as pictures, keepsakes and other items which comprise our lives) cause feelings of grief. Loss of control, life routines, as well as familiar people and places often compound feelings of grief. Community leaders and those leading disaster management efforts, and healthcare providers can help by proactively and respectfully inquiring about, acknowledging and then allowing individuals to process grief. Grief support also involves addressing feelings of loss, mourning losses, and fears about the future. Anxiety about the future is best managed through “problem solving” (supporting people in connecting with practical help when available). Being sensitive to the need for rituals, such as memorial and funerals, to support expressions of grief allow for healing, which ultimately strengthen communities. The following resource(s) address this topic in further detail:
FACT SHEET: Grief Leadership in the Wake of Tragedies
FACT SHEET: Leadership in Disasters & Lessons Learned
Evacuation centers can support these efforts by training personnel in the principles of PFA which can significantly reduce distress of occupants displaced from their homes. Interventions at evacuation centers which promote PFA principles include: keeping children with primary caregivers, creating “school like” activities that involve routine for kids (obtain volunteer “teachers” and create “activity centers”), and accommodating pets when possible. In addition, creating “communities” which encourage formal and informal support and connection among residents. It is important to help those in significant distress with one-on-one interactions as having residents retell their distressing stories in great detail can unnecessarily increase distress in others around them. Creating and maintaining connections with healthcare support systems is important to address inevitable acute (lost medications, active illnesses, etc.) and chronic (insulin for diabetes, dialysis for kidney disease, etc.) health concerns that will inevitably arise and, when unaddressed, often diminish health and compound distress.
Common responses to disasters include distress reactions (insomnia, irritability, loss of safety, social isolation, blaming and scapegoating) and health risk behaviors (increased use of alcohol and tobacco, reduced attention to health care). For healthcare personnel, being alert to these reactions and behaviors, promptly identifying them, and providing interventions can reduce distress and improve functioning and may decrease the likelihood of ultimately developing mental disorders. The following resource(s) address this topic in further detail:
FACT SHEET: Helping Communities After Disasters
Vulnerable populations may be at increased risk for adverse mental health effects after a disaster and warrant unique considerations. Children have developmental limitations in their understanding and ability to respond as well as from the distractions that occur for parents. Women who are pregnant or postpartum have increased risk during these physiologic states. Cognitively and mobility impaired as well as dependence on system of care may increase risk for elderly as and those with pre-existing mental illness. First responders and public health emergency workers (including volunteers) may be both responder and victim and have increased risk for exposure to death, dying, human remains, and considerable suffering. Marginalized populations (low socioeconomic status, migrants and refugees, LGBTQ persons, racial and ethnic minorities) may have limited access to resources, previous negative experiences using government services, and fear retaliation or reprisals by government and related organizations, ultimately leading to disparities in access and utilization of critical post-disaster resources. Community-based interventions can help address the unique needs of these (and other) populations by addressing vulnerabilities and reducing barriers to care. The following resource(s) address this topic in further detail:
FACT SHEET: How Families Can Help Children
FACT SHEET: How Schools Can Help Students
Health risk and crisis communication is a critical behavioral health intervention following a community disaster. For those leading disaster management efforts, understanding what to say and what not to say, when and how to say it are important elements. Basic principles include being clear and succinct; stating what is known and unknown; indicating when you do not know the answer, committing to following up at a specific time and then doing so; and avoiding misleading or being overly reassuring as these erode trust. Effective communication following a disaster can reduce distress and enhance well-being for affected communities. The following resource(s) address this topic in further detail:
FACT SHEET: Risk and Crisis Communication for Leaders
Workplace management following a disaster is an important part of restoring community functioning. In addition to financial support, the workplace often provides a sense of meaning and social connectedness. Though workplaces may be understaffed during disasters, overworking remaining personnel leads to diminished functioning and demoralization. Effective support for personnel in the workplace can enhance functioning for both the individuals and the organization. The following resource(s) address this topic in further detail:
Exposure and contamination can occur when chemical, biological, radiological or nuclear (CBRN) facilities are damaged during tornadoes or other large-scale disasters. Events involving actual or potential CBRN exposure and contamination often increase distress for community members. The novelty, potential imperceptibility, and uncertainty around prevention or treatment heighten concerns. Somatic symptoms are common responses and healthcare organizations are advised to anticipate increased utilization of services in affected communities. Health risk and crisis communication (see below) can help decrease distress for individuals, which may subsequently reduce unnecessary consumption of healthcare and related services. The following resource(s) address this topic in further detail:
Additional detailed resources can further knowledge about effective preparedness, response, and recovery measures. Some are brief while others are more detailed. Working with more detailed resources, such as books or online training, during an actual disaster response is not typically feasible. These more in-depth treatments of key topics may be helpful as the initial response slows and serve to inform later response and recovery efforts as well as enhance preparedness for future events. Links to additional websites, fact sheets, articles, training, and books can be found below:
Additional free fact sheet resources at the Center for the Study of Traumatic Stress.