In this guest blog for World Mental Health Day, David Trickey talks about the importance of psychological first aid, especially in helping children and families who have experienced traumatic events.
Today is World Mental Health Day and we join the Heads Together campaign in focusing on psychological first aid. One in 10 children and 1 in 4 adults will experience mental health difficulties at some time in their lives. At such times, we all need the confidence and tools to look after our own mental health and help others, just as we do with first aid for physical health problems.
The Duke and Duchess of Cambridge, who are spearheading the Heads Together campaign alongside Prince Harry, have been meeting people from across the country at a lunch today at the London Eye to hear the stories of those who have responded to others in their times of crisis. Later tonight, the Eye will be lit up purple, connecting Heads Together with the worldwide movement to end stigma around mental health.
I am a consultant clinical psychologist, specialising in working with children and families who have experienced traumatic events. These range from having someone close to them killed or take their own life, being involved in frightening or tragic accidents, witnessing extreme violence or experiencing abuse.
I am often asked by schools or other adults close to the children and families about the best things to do after such events have taken place. Here are some tips that are based on my 16 years of specialising in trauma, and which draw heavily on the work of Professor Stevan Hobfoll and many collaborators who worked together to learn what the research indicates is most likely to help.
Help those affected to feel safe and supported
The first thing is to make sure that people are safe and that they feel safe. This means initially making sure that they are not exposed to further danger. Although people may need to access some information, for example, from the news, in order to help them understand what happened, repeatedly watching media broadcasts of the event might make people focus on the frightening and dangerous aspects of what happened, in turn making it harder for them to feel safe. So it is better to limit and monitor what children and young people watch.
We all feel safer when things are predictable and we know what to expect. The event might have made people think that everything is now unpredictable, so it can be helpful to ensure that some structures and routines are retained, and that people know what to expect.
School or college can provide a useful return to a sense of normality for children and young people, and familiar, caring teachers and tutors can help children to feel safe and secure.
Spending time with friends and family (and even pets) can also help people to feel calm. Some children may need help to work out which friends are likely to be most helpful – if they are going to ask lots of questions or make unfriendly comments, they might not be the best option.
Help those affected to understand what happened
If children and young people are not given sufficient information to understand the event, they may try to fill in the gaps using their imagination, and this might be worse than the reality. Any misunderstandings may make things worse, so it is important to give children an honest explanation of what happened and to answer any questions that they may have. They may need to know that it is OK for them to ask questions and you will do your best to answer them honestly.
A common protective response from parents and carers is to try to avoid causing further distress by not talking about what happened. Some hope that by keeping quiet the person will forget about the event, but generally they benefit from talking about it as and when they are ready to do so. Don’t force them to talk about it – just follow their lead.
Help those affected to feel as if they have some control over things
The event might have made people feel as if they have no control over things that happen to them. Giving them some choices and helping them to do things rather than doing everything for them can help them to realise that the event does not change everything in their world.
Look after yourself as well
Seek support for yourself if you are affected by what has happened. Often, if you are worried, the person you are supporting may sense this and therefore find it harder to be reassured by your care.
Look for the light
Sometimes events can shatter a person’s view of everything. It can be helpful to explore their thoughts further so that they are able to evaluate the event realistically and helpfully, rather than catastrophically.
Hobfoll SE, Watson P, Bell CC, Bryant RA, Brymer MJ, Friedman MJ & Maguen S (2007) Five essential elements of immediate and mid–term mass trauma intervention: empirical evidence. Psychiatry 70(4) 283-315.