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A large number of emergency personnel were involved in the response to the May 2004 storms that devastated a 52 mile swath of Southeast Nebraska. Emergency workers who responded the night of the storm were exposed to bad weather, darkness, and uncertainty about their own safety. Later, they were asked to work alongside survivors and neighbors who had lost everything amidst widespread destruction of farms, homes, and businesses. Some, but not all of the emergency personnel were offered formal psychological support services like critical incident debriefing to assist with the emotional processing of the event.
The research literature is mixed regarding the type of psychological support that is best for emergency response personnel after they respond to a disaster. This has resulted in some confusion on the part of practitioners about the most effective way to offer support services to emergency workers. The Lincoln Metropolitan Medical Response System was interested in understanding how local service structures could be better utilized to support responders after large scale events like the May 2004 storms. Rather than rely on the literature alone, an exploratory study was completed to discover what emergency workers relied upon to support psychological or emotional health after the storms and how they preferred to experience that support.
Thirteen in-depth interviews and four focus groups were held with emergency personnel who responded to the May 2004 storms. An on-line survey was also administered but the response rate was quite low (eight responses). The interviews and focus groups were conducted a little over a year after the storm. The information was analyzed using qualitative research methods with the aid of the software program Atlas.ti.
Formal debriefing service was highly thought of by many responders. They reported feeling better as a result of being in a debriefing. Some responders appreciated unobtrusive service of mental health and faith professionals who offered water and assistance at the disaster site. Most emergency responders said they relied on peers for informal support. Participants reported positive effects of going through this response experience. They said it brought them closer together as a team, made them appreciate what they had, and strengthened their knowledge and confidence related to responding to such events.
The research resulted in several practical recommendations based on the preferences and experiences of responders. First, respondents indicated that they might have taken advantage of more formal support services if they had been offered rather than relying on department heads to request them. Responders were very concerned about maintaining the confidential nature of their work and tried not to talk to their families about the event or their personal experiences. This left peers as the primary audience for any discussion of the event. A second practical recommendation is to equip responders to provide appropriate psychological support to each other since this is the preferred way to get emotional support for many of the responders. Although it requires no formal training to be a friend, it may be beneficial to equip responders with psychological first aid skills so they are more comfortable facilitating referrals to professionals when a peer needs more formal support. A third recommendation is to increase communication about the importance of self care. Most responders participating in the study reported that they did not heed the advice of experts regarding self care. This was particularly true of physical care (exercise, diet, avoiding alcohol).
The overall conclusion of this study was that Nebraska responders are well trained and confident of their collective ability to respond to disaster. They rely on each other for support more than they rely on formal support systems. This could be because of the limited access they have to these systems and because it is more natural to turn to peers for such support. As a result of this research, Nebraska’s Critical Incident Stress Management Program is studying ways it can increase accessibility to services after disaster. It may be beneficial to consider equipping peers to appropriately support each other and to care more prudently for themselves after disaster response. Using mental health and faith professionals in unobtrusive support roles during the disaster response increases their acceptance by responders. Educating these professionals about the advantage of adopting a consultant model as part of their service to emergency responders may increase their effectiveness with this population.