Module 5 - Populations with Special Needs

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Learning Objectives

Identify and describe the characteristic reactions of vulnerable groups affected by disaster

Describe effective interventions to assist vulnerable groups

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Groups with Special Needs

Children Older persons Persons with disabilities (physical/mental

illness/substance abuse/developmental) People with past experience with war or

terrorism

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Groups with Special Needs (cont.)

Ethnic and cultural groups Parents with dependent children Bereaved spouses or partners Economically disadvantaged groups Socially disadvantaged groups First responders/disaster response

personnel

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Groups with Special Needs (cont.)

Individuals may overlap between groups Women & Vulnerability

• role of women as primary caregivers (overlap with parents, maybe economically disadvantaged)

• Women outlive men and thus may be alone and physically compromised as they age (overlap with older adults, socially isolated)

• Women may have a history of trauma or abuse (overlap with past trauma experience)

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Emotional Stress in Children

Listen/Observe/Respond• Changes in behavior, personality, outlook.

• Talk to the child and observe responses.

• Does the child appear upset or confused?

• Compare the child’s behavior to other children of the same age in the same setting.

• Does the child play appropriately?

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Children’s Typical Responses

Fear and anxiety “Childish” or regressive behavior Difficulty sleeping Physical reactions “Trigger” responses Difficulty concentrating or thinking

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Reactions Related to Age Groups

Birth to 2 years• Irritability, crying, clingy or passive behavior

Pre-school, 2-6 years• Intense fear or insecurity

• Play activities may involve aspects of the event

• Re-enactment of the event over and over

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Reactions Related to Age Groups (cont.)

School age, 6-10 years• Guilt

• Feelings of failure

• Anger

• Fantasies of playing rescuer

• Intensely preoccupied with the event

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Reactions Related to Age Group (cont.)

Preadolescence to adolescence, 11-18 years• Responses resemble adult reactions

• Irritability, rejection of rules and aggressive behavior

• Dangerous, risk-taking behavior

• Fearful

• Depressed

• May contemplate or attempt suicide

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Helping a Child

Help by helping the parents Keep familiar routines Pamper and care Talk about what happened (as

appropriate) Find opportunities for children to

participate in decision-making

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When a Specialist is Needed:

Suicidal or homicidal ideation/behavior• Younger children may say they wish they had

never been born

Hopelessness/helplessness Unable to stop thinking about the event Physical problems Alcohol or drug use

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Activity # 16 – Group Discussion

Helpers need to be prepared for their own emotional reactions when supporting children in crisis, and to be aware that their reactions are normal. • Brainstorm and list the “normal” reactions that can

helpers may have when working with children Many areas of Nebraska have very few mental

health services for children. • As a group, brainstorm and list all the mental

health services for children available in your community

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Older Persons

Especially vulnerable when:• Having co-occurring medical problems

• Having ambulation difficulties

• Living alone

• Lacking help and other resources

• Having to face the shock of losing all that they had attained in life• Home

• Family

• Security

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Older People’s Typical Reactions

Increased memories of past Wish to connect with past friends Increased dependence on family,

refusing assistance from authorities Fear of mortality Negative view of the future Regression

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Older People’s Typical Reactions

Feeling of multiple losses Disoriented as routine is interrupted Use of denial as a normal defensive

reaction Immediate fear response, followed by

anger and frustration Concentration and communication

difficulties Physiological responses

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Helping Older People

Ensure safety Give factual information Reassure by providing information about

normal reactions Be supportive and build confidence Identify secure attachments and relationships Talk about the event Be aware of cultural backgrounds

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Helping Older People (cont.)

Facilitate access to aid and support services Ensure that they are not isolated Establish Routine Provide opportunities for continuity, culture

and history Help them to maintain their sense of

community and preserve cohesion

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Persons with Disabilities (Physical/Mental Illness/Substance Abuse/Developmental)

May need assistance in negotiating the “second disaster”, applying for assistance from aid agencies

May need some accommodations within shelters

May need assistance in replacing lost prescriptions

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Persons with Disabilities Always link with existing services for their

disabilities Seek advice if these are evident or suspected:

• Suicidal ideation• Homicidal ideation• Depression lasts longer than two weeks• Active hallucinations or delusions• Rage• Aggression• Inability to care for self or carry out activities of daily

living

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Previous Experience with War/Trauma/Disaster

Previous, and especially repeated, exposure to death and injury may increase a person’s risk of developing psychological problems after a disaster.