Disaster Mental Health for First and Second Responders: Self-Care

Xiomara A. Sosa, XAS Founder

First responders to disasters are emergency managers, law enforcement, firefighters, medical personnel, the military, etc.

Second responders to disasters are mental health professionals, social workers, humanitarian workers, etc.

First and second responders to disasters need to employ habits of self-care such as regular exercise, support networks, healthy nutrition, proper sleep habits and time for family. Disaster responses can deplete their reservoir of resources — coping strategies, emotional and physical energy, and support systems at home and at work. Taking time, no matter how brief, for meals, breaks, walks, supervision and after-hours discussions with fellow workers will provide a respite and refill their reservoir of resources.

Defusing and debriefing are essential before first and second responders return home, where the transition back to family routine may be very stressful. Problems with intimacy or relationships with family members and co-workers may threaten the support system needed for validation and recovery.

When symptoms of compassion fatigue or burnout appear, all responders need therapeutic opportunities to tell their stories and transform the experience. On the other hand, some responders returning from a disaster site may surprise relatives and co-workers with a positive benefit of deployment — increased positive feelings and the ability to let go of the small stuff and deal with what’s really important.

Interventions responders can use to help protect themselves against the symptoms of compassion fatigue and burnout are:

1. Learn and practice the skills necessary for self-regulation. Pay attention to your arousal level and try to minimize it with relaxation, meditation, music and exercise. Self-regulation is essential for the responder’s effectiveness and well-being.

2. Remain within yourself as a responder. Do not be concerned with results and specific outcomes. You don’t need people to express gratefulness for your work. This is referred to as self-validated care giving.

3. Try to maintain as healthy a lifestyle as possible, especially when experiencing extreme conditions. Eat well (avoid the doughnuts and sugary foods that are sometimes staples at disaster sites), rest whenever possible and recenter yourself. Exercise if you have the chance. This is probably similar to what you would recommend for others.

4. Share your experiences. It is helpful to offload your traumatic images and talk about your experiences. This can help to remove “psychic plaque.” Again, this is something that responders would encourage their clients to do.

5. Appreciate the experience you are engaged in and pace yourself. Try to remember that you are in a marathon and not a sprint. Also remember that what you are engaged in is a humbling experience.

Spend as much time as possible with family and friends during times of extreme stress. This will help responders to maintain a therapeutic balance in their lives. Accessing social support networks has proved to be the most effective way of coping with the stress of disasters.

13 Signs of First and Second Responder Burnout:

1. Chronic fatigue – exhaustion, tiredness, a sense of being physically run down
2. Anger at those making demands
3. Self-criticism for putting up with the demands
4. Cynicism, negativity, and irritability
5. A sense of being besieged
6. Exploding easily at seemingly inconsequential things
7. Frequent headaches and gastrointestinal disturbances
8. Weight loss or gain
9. Sleeplessness and depression
10. Shortness of breath
11. Suspiciousness
12. Feelings of helplessness
13. Increased degree of risk taking

American Counselors Association (ACA)

American Red Cross (ARC)