Recommendations for persons with mental disabilities

Prevention phase

  • Raise awareness within the community of people with mental disabilities
  • Training of helpers in psychological first aid, first responders and first aid personnel
  • Design emergency plans and construct intervention teams in housings for people with mental disabilities
  • Organization of trainings for caregivers
  • Promote local inter agency cooperation/networking between different care organizations
  • Implementation of local teams for intervention in disasters

Response phase: Psychological First aid

First contact to persons with mental disabilities:

  • Ensure security and orientation according to the degree of understanding
  • Pay attention to nonverbal signals and respond to these if possible
  • Verbally explain each action you make even though there might be a lack of speech comprehension
  • Use a simple, slow, but no infantilizing language
  • Be careful in the case of physical proximity (caution: Individuals with disabilities might fear medical interventions)

Ensure basic needs:

  • Assess needs depending on the developmental state (e.g. restricted communication possibilities or obsessions of certain concerns (toy/mother))
  • Permit stereotyping or automutilitative behavior to a certain degree (reduction of tension and calming down)

Enhance feeling of protection, safety and stabilization:

  • Involve trusted individuals, familiar environment, belongings, activities; contact to persons of trust (e.g. parents)
  • Implement security by providing distance or proximity (individual differences) 
  • Promote the feeling of self-efficacy and independence as much as possible
  • Be aware of group thinking and group behavior (calming group behavior)

Involvement of caregivers:

  • In most cases caregivers are affected by the disaster themselves and restricted in their actions; they cannot care for more individuals at the same time, therefore: Cooperate with caregivers, help them to help or include other capable persons of trust; inhibit the restriction of trusted individuals
  • Support and advocate rights of caregivers
  • Instruct trusted people to help

Information dissemination:

  • Focus on few key points and concrete information (support via gestures)
  • Use a clear and guided communication
  • Seek information from family members
  • Involve local caregivers and institutions
  • Ensure counselling for housing establishments for persons with disabilities

Respond to self-harm and harm towards others:

  • Pay attention to the safety and protection needs of the helpers
  • Act in an effective and in a most harmless manner
  • In severe cases contact the medical personnel to support with medical treatment
  • Permit grief

Recovery phase

  • Support in restructuring daily activities; help to regain normality
  • Refer to therapy if needed
  • Criteria for additional care: Prolonged or intermitting distress (despite medication), sleeplessness, restlessness, no ingestion, dissociation, lacking involvement in group behavior, lacking of understanding or acceptance
  • Give mental health care if needed and appreciate work of caregivers
  • Provide counselling for housing facilities with special needs to ensure long term recovery

References

Ballan, M. S., & Sormanti, M. (2006). Trauma, Grief and the Social Model: Practice Guidelines for Working with Adults with Intellectual Disabilities in the Wake of Disasters. Review of Disability Studies, 2(3). Available at www.rds.hawaii.edu/ojs/index.php/journal/article/view/339.