Making an immediate difference in supporting affected people.

What is Psychological First Aid (PFA)?

Psychological First Aid (PFA) is an acute intervention to help children, adolescents, adults, and families in the immediate aftermath of disaster, terrorism, and other emergencies. PFA can also be provided to police, fire, and other emergency responders. Psychological First Aid is designed to reduce the initial distress caused by traumatic events and to foster short- and long-term adaptive functioning and coping. PFA meets four basic standards. It is:

1. Consistent with research on risk and resilience following trauma
2. Applicable and practical in field settings
3. Appropriate for developmental levels across the lifespan
4. Culturally informed and delivered in a flexible manner

PFA does not assume that all individuals will develop severe mental health problems or long-term difficulties. Instead, it is based on an understanding that survivors and others affected by such events will experience a broad range of early reactions (physical, psychological, behavioral, spiritual). Some of these reactions will cause enough distress to interfere with adaptive coping, and recovery may be helped by support from compassionate and caring providers.

Is PFA an Evidence-Based Intervention?

PFA is supported by behavioral health experts as the “acute intervention of choice” when responding to the psychosocial needs of children, adults and families affected by disaster, terrorism, and other emergencies.

This model still requires systematic empirical support. However, because many of the components have been guided by research, there is consensus among experts that these evidence-informed strategies provide effective ways to help survivors, responders, and others manage distress and adversity and to identify those who may require additional services.

PFA’s Five Evidence-Informed Principles

Research indicates that many individuals experience fear, anxiety, a need to connect with others, a sense of being overwhelmed, and/or hopelessness immediately after an event, and that addressing these issues is related to improved recovery. In order to address these survivor needs, PFA’s 5 basic principles are:

1. SAFETY

Survivors may be concerned about their own safety, the safety of their loved ones and that of their community. Promotion of safety includes providing clear risk messages; addressing safety concerns; monitoring media reports/social messaging and addressing misinformation or distressing reports; and supporting family reunification, cohesion, and communication.

• CALMING

Disasters may cause fear, distress, and anxiety. Act in a calm manner to reduce others’ distress. Help survivors identify coping skills they have used in the past and new ones they may need to feel calmer.

• CONNECTEDNESS

Disasters often separate families, friends, and community members, and shatter the connectedness people share with one another. Help people reconnect with loved ones, or if that isn’t possible, connect them with those nearby in similar circumstances (same neighborhoods, faiths, families with young children). Help families and communities understand that recovery will be different for everyone and set up a tolerant environment for these differences.

• SELF AND COMMUNITY EFFICACY

After a disaster, individuals may feel overwhelmed and vulnerable. Nevertheless, every survivor and community has strengths upon which to draw. Help survivors to identify and apply their strengths, learn new strategies to cope with their situation, and begin to rebuild their lives and their communities.

• HOPE

When survivors feel that their world is falling apart and everything is hitting them at once, make every attempt to promote a sense of hope. Help them to engage in proactive activities and promote positive expectations that things will work out as best they can in the next hour, day, and week, even if they feel overwhelmed.

Who Delivers PFA?

PFA is designed for delivery by mental health and other response workers who provide early assistance to affected children, families, and adults as part of an organized response effort.

These providers may be embedded in a variety of response units, including first responders, governmental officials, health, public health, and mental health professionals, school staff, spiritual providers, media, social services staff and volunteers.

Where Should PFA Be Used?

PFA is designed to be adapted for any setting including shelters, schools, field hospitals and medical triage areas, family reception and assistance centers, acute care facilities, respite centers for first responders or other relief workers, emergency operations centers, crisis hotlines, disaster assistance service centers, homes, businesses, and other community settings.

Basic Objectives of PFA

Tailor your actions to the needs and priorities of each person you make contact with. Each encounter should include only those actions that are relevant, choosing from a combination of the following objectives:

• Establish a human connection in a non-intrusive, compassionate manner.
• Enhance immediate and ongoing safety and provide physical and emotional comfort.
• Calm and orient emotionally overwhelmed or distraught individuals.
• Help survivors tell you specifically what their immediate needs and concerns are and gather additional information as appropriate.
• Offer practical assistance and information to help address their immediate needs and concerns.
• Connect survivors as soon as possible to support networks, including family members, friends, neighbors, and community helping resources.
• Support adaptive coping, acknowledge coping efforts and strengths, and empower survivors. Encourage adults, children, and families to take an active role in their recovery.
• Be clear about your availability and your role, and (when appropriate) link the survivor to another member of your response team or to local community resources.

Professional Behavior and PFA

In the chaotic aftermath of an event, it is especially important to maintain professional behavior, including:

• Operate only within the framework of an authorized response system.
• Model healthy responses: be calm, courteous, organized, and helpful.
• Be visible and available.
• Maintain confidentiality as appropriate.
• Remain within the scope of your expertise and your designated role.
• Make appropriate referrals when additional expertise is needed or requested by the survivor.
• Be knowledgeable and sensitive to issues of culture and diversity.
• Pay attention to your own emotional and physical reactions, and practice self-care.

Preparing to Deliver PFA

Planning and preparation are important, so keep the following in mind:

• Stay up-to-date on the latest training and research on disaster/trauma mental health.
• Take additional courses on incident command systems, working with children, older adults, and other vulnerable populations, adapting PFA in different settings, situations, and populations.
• Participate regularly in drills or trainings to maintain skills.
• Educate yourself about the event, the current circumstances and those impacted by it before responding.
• Assess your readiness to respond by assessing your comfort level with this type of work, your current health, your family and work circumstances, and your ability to engage in self-care.
• Providing care and support in the immediate aftermath of disaster can be an enriching professional and personal experience that enhances life satisfaction through helping others. It can also be physically and emotionally exhausting. The following sections provide information to consider before, during, and after engaging in disaster relief work.
• In deciding whether to participate in disaster response, you should consider your comfort level with this type of work and your current health, family, and work circumstances. These considerations should include a variety of topics that are covered in the rest of this section.

Personal Considerations

Assess your comfort level with the various situations you may experience while providing PFA:

• Working with individuals who are experiencing intense distress and extreme reactions, including screaming, hysterical crying, anger, or withdrawal
• Working with individuals in non-traditional settings
• Working in a chaotic, unpredictable environment
• Accepting tasks that may not initially be viewed as mental health activities (e.g., distributing water, helping serve meals, sweeping the floor)
• Working in an environment with minimal or no supervision or, conversely, being micromanaged
• Working with and providing support to individuals from diverse cultures, ethnic groups, developmental levels, and faith backgrounds
• Working in environments where the risk of harm or exposure is not fully known
• Working with individuals who are not receptive to mental health support
• Working with a diverse group of professionals, often with different interaction styles

Health Considerations

Assess your current physical and emotional health status, and any conditions that may influence your ability to work long shifts, including:

• Recent surgeries or medical treatments
• Recent emotional or psychological challenges or problems
• Any significant life changes or losses within the past 6 to 12 months
• Earlier losses or other negative life events
• Dietary restrictions that would impede your work
• Ability to remain active for long periods of time and endure physically exhausting conditions
• Availability of enough medication for the total length of your assignment plus some extra days

Family Considerations

Assess your family’s ability to cope with you responding to a disaster:

• Is your family prepared for your absence, which may span days or weeks?
• Is your family prepared for you to work in environments where the risk of harm or exposure to harm is not fully known?
• Will your support system (family/friends) assume some of your family responsibilities and duties while you are away or working long hours?
• Do you have any unresolved family/relationship issues that will make it challenging for you to focus on your duties/responsibilities?
• Do you have a strong, supportive environment to return to after your assignment ends?

Work Considerations

Assess how taking time off to provide PFA might affect your work life:

• Is your employer supportive of your interest and participation in disaster work?
• Will your employer allow “leave” time from your job?
• Will your employer require you to utilize vacation time or “absence-without-pay time” to respond as a disaster worker?
• Is your work position flexible enough to allow you to respond to a disaster assignment within 24-48 hours of being contacted?
• Will your co-workers be supportive of your absence and provide a supportive environment upon your return?

Personal, Family, Work, Life Plan

If you decide to participate in disaster response, take time to make preparations for the following:

• Family and other household responsibilities
• Pet care responsibilities
• Work responsibilities
• Community activities/responsibilities
• Other responsibilities
• In providing PFA, it is important to recognize common and extreme stress reactions, how organizations can reduce the risk of extreme stress to providers, and how best to take care of yourself during your work.
• In providing PFA, it is important to recognize common and extreme stress reactions, how organizations can reduce the risk of extreme stress to providers, and how best to take care of yourself during your work. Common Reactions
• Extreme Stress Reactions Organizational Care Provider Self-Care

Common Stress Reactions

You may experience a number of common stress responses, including:

• Increase or decrease in activity level
• Difficulty sleeping
• Substance use
• Numbing
• Irritability, anger, and frustration
• Vicarious traumatization in the form of shock, fearfulness, horror, helplessness
• Confusion, lack of attention, and difficulty making decisions
• Physical reactions (headaches, stomach aches, easily startled)
• Symptoms of depression or anxiety
• Decreased social activities

Extreme Stress Reactions

You may experience more serious stress responses that warrant seeking support from a professional or monitoring by a supervisor. These include:

• Compassion stress: helplessness, confusion, isolation
• Compassion fatigue: demoralization, alienation, resignation
• Preoccupation or compulsive re-experiencing of trauma experienced either directly or indirectly
• Attempts to over-control in professional or personal situations
• Withdrawal and isolation
• Preventing feelings by relying on substances, becoming overly preoccupied by work, or making drastic changes in sleep (avoidance of sleep or not wanting to get out of bed)
• Serious difficulties in interpersonal relationships, including domestic violence
• Depression accompanied by hopelessness (which has the potential to place individuals at a higher risk for suicide)
• Unnecessary risk-taking

Organizational Care of Providers

Managers can reduce the risk of extreme stress by putting supports and policies in place. These include:

• Limiting work shifts to no more than 12 hours and encouraging work breaks
• Rotating providers from the most exposed assignments to lesser levels of exposure
• Mandating time off
• Identifying enough providers at all levels, including admin, supervision, and support
• Encouraging peer partners and peer consultation
• Monitoring providers who meet certain high-risk criteria (e.g., personally impacted by the disaster, multiple stresses, pre-existing conditions)
• Establishing supervision, case conferencing, and staff appreciation events
• Conducting trainings on stress management practices

Provider Self-Care

Activities that promote self-care include:

• Managing personal resources
• Planning for family/home safety, including making childcare and pet care plans
• Getting adequate exercise, nutrition, and relaxation

Using stress management tools regularly, such as:

• Accessing supervision routinely to share concerns, identify difficult experiences, and strategize to solve problems
  • Practicing brief relaxation techniques during the workday
  • Using the buddy system to share upsetting emotional responses
  • Staying aware of personal limitations and needs
  • Recognizing when one is Hungry, Angry, Lonely or Tired (HALT), and taking the appropriate self-care measures
  • Increasing activities that are positive
  • Practicing religious faith or spirituality
  • Spending time with family and friends
  • Learning how to “put stress away”
  • Writing, drawing, and painting
  • Limiting caffeine, tobacco, and substance use

Provider Self-Care Do’s

As much as possible make every effort to:

• Self-monitor and pace your efforts
• Maintain boundaries: delegate, say no, and avoid working with too many survivors in a given shift
• Perform regular check-ins with colleagues, family, and friends
• Work with partners or in teams
• Take relaxation/stress management/bodily care/refreshment breaks
• Utilize regular peer consultation and supervision
• Try to be flexible, patient and tolerant
• Accept that you cannot change everything

Provider Self-Care Don’ts

Avoid engaging in:

• Extended periods of solo work without colleagues
• Working “round the clock” with few breaks
• Negative self-talk that reinforces feelings of inadequacy or incompetency
• Excessive use of food/substances as a support
• After Relief Work, expect a readjustment period upon returning home. You may need to make personal reintegration a priority for a while.
• Organizational Care
• Provide Self-Care Do’s and Don’ts

Organizational Care of Providers

Managers should:

• Encourage time off for providers who have experienced personal trauma or loss
• Institute exit interviews to help providers with their experience. This should include information about how to communicate with their families about their work
• Encourage providers to seek counseling when needed and provide referral information
• Provide education on stress management
• Facilitate ways providers can communicate with each other by sharing contact information, or scheduling conference calls
• Provide information regarding positive aspects of the work

Provider Self-Care Do’s

Make every effort to:

• Seek out and give social support
• Check in with other relief colleagues to discuss relief work
• Increase collegial support
• Schedule time for a vacation or gradual reintegration into normal life
• Prepare for worldview changes that may not be mirrored by others in your life
• Participate in formal help to address your response to relief work if extreme stress persists for greater than two to three weeks
• Increase leisure activities, stress management and exercise
• Pay extra attention to health and nutrition
• Pay extra attention to rekindling close interpersonal relationships
• Practice good sleep routines
• Make time for self-reflection
• Practice receiving from others
• Find activities that you enjoy or that make you laugh

Provider Self-Care Don’ts

Make every effort to avoid:

• Excessive use of alcohol, illicit drugs, or excessive amounts of prescription drugs
• Making any big life changes for at least a month
• Negatively assessing your contribution to relief work
• Worrying about readjusting
• Even the best trained among us can’t always provide PFA because of a variety of life circumstances. Are you ready and able to respond?

General Guidelines for Delivering PFA

PFA is designed to be used only with those survivors who need it, not everyone you encounter. It is meant to be practical, tailored to the immediate needs and priorities of survivors, and conversational rather than clinical or formal. Therefore, it is important to:

• Observe first, to avoid being perceived as intruding in an effort to “help.” Most survivors will be able to handle the situation with their own resources, so take care not to undermine survivors’ own resources. Initiate contact only after you have observed the situation and have determined that contact is not likely to be intrusive or disruptive.

Focus your attention on how people are reacting and interacting in the setting. Individuals who may need assistance include those showing signs of acute distress, including individuals who are:

• Disoriented
• Confused
• Frantic or agitated
• Panicky
• Extremely withdrawn, apathetic, or “shut down”
• Extremely irritable or angry
• Exceedingly worried
• The best way to make contact is to provide practical assistance (food, water, blankets).

Engaging Survivors

Once you make contact:

• Ask simple respectful questions to determine how you may help.
• Maintain a calm presence. People take their cue from how others are reacting. By demonstrating calmness and clear thinking, you can help survivors feel they can rely on you.
• Be prepared that some survivors may either avoid you or flood you with contact.
• If survivors want to talk, be prepared to listen. When you listen, focus on hearing what they want to tell you and how you can be of help.
• Give information that directly addresses their immediate goals and clarify answers repeatedly as needed.
• Acknowledge the positive features of what they have done to keep safe.
• Speak calmly. Be patient, responsive, and sensitive.
• Speak slowly, in simple concrete terms; don’t use acronyms or jargon.
• Give information that is accurate and age-appropriate for those you are speaking to.
• When communicating through a translator or interpreter, look at and talk to the person you are addressing, not at the translator or interpreter.

Behaviors to Avoid

Your focus should be on providing practical, pragmatic support that is respectful and tailored to the immediate needs and priorities of survivors. With this in mind, behaviors to avoid are:

• Making assumptions about what survivors are experiencing or assuming that everyone will be traumatized.
• Assuming that all survivors want to talk or need to talk to you.
• Labeling reactions as “symptoms,” or speaking in terms of “diagnoses,” “conditions,” “pathologies,” or “disorders.”
• Talking down to or patronizing the survivor, or focusing on his/her helplessness, weaknesses, mistakes, or disability.
• “Debriefing” by asking for explicit details and reactions to what happened.
• Speculating or offering possibly inaccurate information. If you cannot answer a question, do your best to learn the facts.

Entering the Setting

Successful entry to the setting involves working within the framework of an authorized Incident Command System (ICS), in which roles and decision-making are clearly defined. Remember to:

• Establish communication and coordinate all activities with authorized personnel or organizations that are managing the setting.
• Learn as much as you can about the setting (e.g., leadership, organization, policies and procedures, security, and available support services).
• Get accurate information from authorized sources about what is currently happening, what services are available, and where they can be found. Such information is critical to reducing distress and promoting adaptive coping.

Using PFA for Groups

PFA can be offered in different types of group settings (e.g. classrooms, families, security briefings, child play areas).

When meeting with groups, keep the following in mind:

• Provide current information about the event.
• Attempt to dispel rumors and clarify any misunderstandings.
• Identify resources/services currently being offered.
• Discuss what steps are being taken to recover from the situation.
• Address safety concerns and safety procedures being implemented.
• Identify the group’s shared needs and concerns.
• Problem-solve strategies to address immediate needs and concerns. Do not let discussion lapse into complaints.
• Discuss ways the group members can help each other.
• Provide psychoeducation about a range of responses individuals can have after events.
• Describe coping strategies that others have found effective.
• Discuss the role of reminders and how to manage them.
• Identify where individualized services are being offered.

Be Sensitive to Culture and Diversity

Be sensitive to cultural, ethnic, religious, racial, and language diversity, and attempt to:

• Be aware of your own values and prejudices, and how these may agree with or differ from those of the community being served. Before providing services, training in cultural competence can facilitate this awareness.
• Help to maintain or reestablish customs, traditions, rituals, family structure, gender roles, and social bonds to help survivors cope with the impact of the current situation.
• Meet with cultural brokers/leaders to learn about the community being served, including how emotions and other psychological reactions are expressed, attitudes toward government agencies and receptivity to counseling.
• Ask those you’re serving what traditions or rituals are important to them.

Be Aware of At-Risk Populations

Be aware of individuals at special risk, including:

• Children, especially those:
  • separated from parents/caregivers
  • whose parents/caregivers, family members, or friends have died
  • whose parents/caregivers were significantly injured or are missing
  • involved in the foster care system
• Those who have been injured
• Those who have had multiple relocations and displacements
• Medically frail children and adults
• Those with serious mental illness
• Those with physical disabilities, illnesses, or sensory deficits
• Adolescents who may be risk-takers
• Adolescents and adults with substance abuse problems
• Pregnant women
• Mothers with babies and small children
• Disaster response personnel
• Those with significant loss of possessions (home, pets, family memorabilia)
• Those exposed firsthand to grotesque scenes or extreme life threat
• Economically disadvantaged groups who may be prone to mistrust, stigma, and fear
• Those living in disaster-prone regions or who have experienced prior trauma

Working with Children and Adolescents

• When working with young children, sit or crouch at the child’s eye level.
• Help school-age children verbalize their feelings, concerns and questions; provide simple labels for common emotional reactions (mad, sad, scared, worried). Do not use extreme words like “terrified” or “horrified” because this may increase their distress.
• Listen carefully and check in with the child to make sure you understand him/her.
• Be aware that children may show developmental regression in their behavior and use of language.
• Match your language to the child’s developmental level. Younger children typically have less understanding of abstract concepts like “death.” Use direct and simple language as much as possible.
• Talk to adolescents “adult-to-adult,” so you give the message that you respect their feelings, concerns, and questions.
• Reinforce techniques taught with the child’s parents/caregivers to help them provide appropriate emotional support to their child

Working with Older Adults

• Not all older adults are at risk. Many older adults have additional strengths from acquiring effective coping skills over a lifetime of dealing with adversities. It may be that only frail, injured or medically/functionally impaired older adults are likely to be at risk.
• For those who may have a hearing difficulty, speak clearly and in a low pitch.
• Don’t make assumptions based only on physical appearance or age. For example, don’t assume that a confused elder has irreversible problems with memory, reasoning, or judgment. Reasons for apparent confusion may include: disaster-related disorientation due to change in surroundings; poor vision or hearing; poor nutrition or dehydration; sleep deprivation; a medical condition or problems with medications; social isolation; or feeling helpless or vulnerable.
• An older adult with a mental health disability may be more upset or confused in unfamiliar surroundings. If you identify such an individual, help to make arrangements for a mental health consultation or referral.

Working with Survivors with Disabilities

• When needed, try to provide PFA in an area with minimal noise or other stimulation.
• Address the person directly, not the caretaker, unless direct comms is difficult.
• If communication (hearing, memory, speech) is impaired, speak simply and slowly.
• For those individuals who need interpretation, make sure you know how to access providers with these skills.
• Take the word of a person who claims to have a disability–even if the disability is not obvious or familiar to you.
• When you are unsure of how to help, ask, “What can I do to help?” and trust what the person tells you.
• When possible, enable the person to be self-sufficient.
• Offer a blind or visually impaired person your arm to help him/her move about in unfamiliar surroundings.
• If needed, offer to write down information and make arrangements for the person to receive written announcements.
• Keep essential aids (such as medications, oxygen tank, respiratory equipment, and wheelchair) with the person.
• Facilitate the specific needs that some individuals may need (e.g. video phone, materials in Braille, risk messages in closed caption).

What you should have in your Emergency Psychological Kit

1.	Psychologist’s workbook	1 pc.
2.	Blanket	1 pc.
3.	Herbal tea set (melissa, mint).
4.	Thermos	1 pc.
5.	Instant coffee	10 disposable bags.
6.	Disposable cups (glasses)	25 pcs.
7.	Disposable teaspoons	25 pcs.
8.	Disposable handkerchiefs	2 packs of 10 pcs.
9.	Soft children’s toys (for girls and boys)	2 pcs.
10.	Set of colored pencils	1 set.
11.	Album for drawing	2 pcs.
12.	Pens	5 pcs.
13.	Lumpy sugar	1 package.
14.	Flashlight (with a set of spare batteries)	1 pc.
15.	Cards for topping up a mobile phone account.
16.	Cigarettes	2 packs.
17.	Matches	2 boxes.
18.	Soft ball	1 pc.
19.	Power bank
20.	Transparent plastic bag for carrying various things	2 pcs.
21.	Personal hygiene products (soap, shampoo, etc.)
22.	Reflecting vest
23.	Badge with photo and logo of organization

This kit must also contain standard medical first aid kit which includes tourniquets and gloves.

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During the first days after the war started, we received several requests from different companies which had their branch offices in Ukraine. They were keen and ready to evacuate their employees, but people simply refused to leave their home towns. They refused to leave their country, this, in spite of coming under regular fire.

In the first instance we all know what patriotism feels like. However, if there is not a choice to join the army or a volunteer group, if there is not a choice to be helpful in support of the country, then a person must think of a very solid reason to stay in what is a warzone.
It may well be, simply a natural reaction. Many people have described their state of mind at this point like a form of shock and we know that this is the first stage of a typical brain response to crisis events.

Now, four months after the war began, and after hundreds of meetings, training and interviews with refugees from all over the Ukraine (including Mariupol, Irpen and Gostomel) there is a clear sense of tendencies of how our psyche works in such situations.

Of course all these stages are well known and studied but it is worth mentioning them in order to understand how we can best utilize these studies for use by organisations to provide a better response in the future.

Shock is what was being described by survivors. ‘I felt like it was a nightmare and wanted to wake up’. Some of them described their condition during the first hours. ‘I felt like I was a character in a bad movie. Sometimes I watched it in black & white. Time seems to be frozen or passing very slowly’. This is what is known as derealization. Some of them said ‘It seems like it was happening not to me but to someone else.’ This is what is called depersonalization symptoms. Both are dissociative symptoms which are quite common to a person under severe stress. Then many people described their thoughts like ‘It can’t have happened, just because it can’t have happened because it’s impossible’. This is how we go from shock to the denial stage. People are seeking for disproving facts and alternative information to convince themselves that the events are not true. This is a normal reaction to an abnormal situation. Of course, shock and denial are being followed by a number of emotions. For example, fear, horror, frustration and aggression. Knowledge about these stages is crucially important for crisis responders and for those who want to better cope in critical situations. The two primary stages can be really dangerous. They tend to make people freeze or doubt, instead of taking decisions and acting on those decisions. Sometimes, the cost of freezing, is life itself. The imperative, is to understand the stage where you are. This enables you to say to yourself, ‘this is how my stress works. I need to ACT rather than freeze.

Then you enter the realisation stage. A point at which we begin to understand that this is actually happening and it is happening to myself. Later on, there is an acknowledgement stage when the brain accepts the situation for what it is. It will then start to try and work a way out of the situation. To find a way out. This ultimately takes us to the adaptation stage.

Adaptivity is the main feature of any human being, and many other creatures for that matter, who are able to survive any circumstance or situation. The main challenge is to accept any given situation, and live through it. Our resilience and survival is in action, not in freezing.

In the current crisis, to teach people to accept themselves as they are, and to learn these strategies and coping mechanisms, Alexander Dimitrevich (GoCrisis Mental Health Associate) created and delivered a series of training programs for their clients, and their employees, delivered in English, Ukrainian and Russian. We also provided a program of one-to-one support to those who needed it. This ultimately gave a considerable number of learning outcomes which can be utilized in the future. For those involved, the training and other support showed a very positive therapeutic effect. People began to manage to understand themselves, to accept themselves, to understand that this is the normal reaction to a given situation. They also learned to understand their colleagues, their loved ones, and others. They had an excellent opportunity to articulate how they felt in a safe environment, seeing that they are not alone, and share common issues with others. It soon became obvious to them that through shared experience, their thoughts and feelings were in common with each other. This created a group cohesion, and a good basis for the creation of peer support within the groups and beyond.

From the point of view of the company’s management, the provision of these opportunities shows a considerable duty of care towards staff. It is an investment in their welfare in the here and now, and also moving forward.

Such training provides the perfect toolkit for mitigation of social stigma of mental health disorders, because people talk openly about stress, potential trauma and different hardships. This training has become a bridge from pyscho-education and practical knowledge, to support, counselling and therapy where needed.

Also, the GoCrisis team within a framework of this training was able to explain how GoCrisis’ crisis response hotline works. The provision of multi lingual responders enables us to ensure callers can express themselves in their own language. A must in a critical situation, and a way to reduce immediate stress. In real time, GoCrisis provided many fully qualified Ukrainian psychologists working remotely or at the scene. In doing so, it has proven its ability to deploy an effective communication option for its clients, with the capability to expand as required and provide call handlers with language skills that match those in need of support.

Confidentiality is of course of paramount importance, but we have a considerable number of learning points about how such work can be better structured in the future. This would apply to many different incidents, and would affect the way we manage them.

In many cases, we have emphasised the need for welfare officers who work with the company staff structure. This would facilitate and speed up decision making processes.

While any crisis provides people’s tragedies, training and studies helps a company mitigate any future impact on its people. It also enables the organisation to provide a higher standard of response.

There have been many excellent examples from recent clients who organised the evacuation and relocation of their staff. They provided mental health support for their staff also, and we hope that in the future, this will become the norm for all companies who fully understand the need to offer support to their most valuable asset, the people who work for them.

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In today’s “always on” media landscape, an organisation’s ability to communicate quickly and effectively in a fast-moving crisis requires activating all online and offline channels to ensure a consistent and integrated response across every touchpoint. This is particularly important after an event which causes loss of life, when the organisation needs to quickly acknowledge and react to the human tragedy and to demonstrate genuine empathy and compassion for those affected.

This includes both the language used in public statements and the visual branding which appears on the website or on social media platforms such as Twitter, Facebook or (in China) Weibo. As news begins to spread of an airline accident, for example, one of the first places families and friends of passengers will probably look for information is the airline’s website or social media pages, or alternatively to news sites which may in turn link to the website or Twitter feed. If it is already confirmed that this was a major accident with fatalities, families should not be confronted with colourful promotional messaging or photos of smiling faces on the landing page.

IATA’s “Best Practice” guidelines on Crisis Communication recommend that airlines immediately change their online branding to monochrome after an accident with fatalities, an approach which has now become standard in other sectors such as hospitality. After the terror attacks in the Sri Lankan capital Colombo on Easter Sunday 2019, two of the three hotels struck by suicide bombers greyed out their home pages and posted factual information about what had occurred, together with numbers which families could call for information. The third hotel, maintained its normal colourful branding and images of a property which was by now badly damaged in the explosion. Even then, one of the hotels which had changed its website overlooked its Facebook and Twitter pages, which continued to show the usual photos of smiling guests, employees and pristine hotel facilities, including the restaurant attacked by the bomber.

This reflects the difficulty of ensuring a consistent response across multiple touchpoints when ownership of communication channels may be fragmented, particularly in a complex or dispersed organisation. For many consumer-facing businesses, the website is an essential sales platform, and is usually “owned” by the commercial team, whose priority is to continue generating revenues, whereas the concern of the communications department is to protect brand and reputation. Resolving these conflicting priorities requires careful planning and coordination before the crisis strikes. Similarly, organisations which maintain multiple market-specific websites should have a procedure for over-riding the local administrator from head office in an emergency. This ensures that all sites associated with the organisation can be changed to appropriate branding simultaneously, as Lufthansa Group did after the Germanwings tragedy in 2015.

When Southwest Airlines suffered the first fatal event in its history in April 2018, it quickly executed a plan known internally as “Code Blue”, changing the visual branding on every online touchpoint, including its mobile booking app, to monochrome blue. The accident was caused by an uncontained engine failure which killed a passenger sat next to a window shattered by engine debris, the first fatality on a US airline in nine years. Southwest was acutely aware of how quickly an event like this could escalate on social media, and had carefully planned an online-first communication response. In the event, a passenger used the onboard wifi service to broadcast live footage from the aircraft cabin on Facebook Live – the first time live images of an aviation emergency had been streamed on the internet.

Southwest’s ability to mobilise its online channels as the primary source of information emphasized the importance of preparation, particularly in developing a “dark site” which can be activated immediately in an emergency. This does not replace the entire website, which can still be used to make bookings.  But the usual landing page is overlayed with a new screen, usually in grey scale, which omits any promotional messages or images and contains information about the accident, together with links to further information. As the response develops, updated statements can be posted to the new home page, with links to other material such as video statements from the CEO posted on YouTube.

The website should also be used to signal the gradual transition back to “business as usual”, but this must be done sensitively and in stages to avoid creating a perception that the organisation is rushing to “move on” from the crisis. Companies such as Lufthansa, FlyDubai and Air Asia each took several weeks to transition back to their normal online branding after fatal events. Following the loss of an Air Asia Indonesia Airbus A320 in 2014, AirAsia Group monitored the extent of media coverage and social media sentiment country by country before it slowly transitioned its country-specific websites back to their normal branding, starting with unaffected markets (countries such as Japan, which had no citizens on board flight QZ8501) before eventually restoring the website for Indonesia and the group website hosted in Malaysia. Southwest transitioned its online branding over the course of a week, having lost one passenger on flight 1380. Even then, the airline consulted with the victim’s family and monitored social media sentiment carefully to ensure it was transitioning sensitively and with utmost consideration.

Ensuring that the organisation is ready to mobilise its online communication channels, including the website, as part of a coordinated and holistic response to a crisis is now an essential part of crisis planning and preparation. In the worst case, failure to acknowledge the human tragedy by continuing to show colourful promotional messages or smiling faces on the main website is likely to offend families who have lost loved ones, and leave the organisation open to accusations of being insensitive or disrespectful.

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