How to support after the Whakaari / White Island volcanic eruption

As details emerge about what unfolded on Whakaari / White Island two days ago, my thoughts go out to all the families affected by this terrible event. My thoughts are also with the first responders who worked in perilous circumstances to assist and protect those affected. Both local and wider international communities are affected, and will continue to be affected as the facts of the event are revealed and the repercussions of loss, understanding, and meaning-making extend out into the future.

When thinking about how to deal with the consequences of such a tragic event, it’s important to understand what we have learned already about how such events affect people, and how to help. Though each event brings its own challenges and circumstances, there is knowledge that can be applied effectively to assist when one feels like it is a struggle to know what to do. 

In this short article, I want to go over some of the principles of what helps in supporting people through emergency events and disaster, and what we need to bear in mind when dealing with the special case of first responders, and those in the emergency and welfare services who are tasked to serve and protect in times of crisis and distress. These principles form part of the NZ Ministry of Health’s Framework for Psychosocial Support in Emergencies document, updated in 2016; a project which I worked on with my colleagues.

All those involved in an emergency are likely to benefit from some form of psychosocial support. This may be informal through the support received from family and friends, or more formally through health and welfare services. For many, the evidence is that the distress they experience can be eased with the care and support of families, whānau, friends and the community. For some, this will be much more difficult than for others. And for those who really struggle, it is worth remembering that these struggles and distress are common experiences in extraordinary and terrible circumstances. Some people will need more formal or professional interventions and a smaller proportion of this group will be likely to need the expert help of specialised mental health services. 

We are just starting the process of piecing together and understanding exactly what happened in the minutes and hours after eruption on Whakaari / White Island on 9 December 2019. The processed of recovering the bodies still on the island is yet to begin at the time I published this piece, and the established view is that there is very little likelihood that anyone on the island remains alive. We are just at the start of a very personal and soul-wrenching journey of grief and loss for the families, friend and communities affected. 

There is also a wider process of psychosocial recovery that is also only just beginning. The primary objectives of assisting in community and individual psychosocial recovery are to minimise the physical, psychological and social consequences of an emergency and to enhance the emotional, social and physical wellbeing of individuals, families, whānau and communities who are affected. This is be no means an easy task, especially if we understand that psychosocial recovery is not about returning to normality. It is about positively adapting to a changed reality. What this reality may look like in the future is already starting to be debated, as well as trying to understand the circumstances that led up to this event happening.  

From what we have heard already, we can be certain that the physical injuries that people have sustained will take much care and healing to recover from. Most people do also recover from psychological and social impacts with time. But this path to psychosocial recovery is likely to be a long one, and may last for an indeterminate period, from weeks to decades. It’s a difficult message to hear, but one that is only too important to acknowledge if we are to try to assist in an informed way.

First responders at disaster events have a very particular type of exposure to potential harm when involved in emergencies and disasters. If they have had training in crisis response, and are embedded in an organisation that is well-rehearsed in supporting their staff and volunteers through such events, their risk of lasting consequences is certainly reduced but not removed. And even if they do work in such organisations and have had training, they still may never have been confronted with the conditions that they faced that day, or experienced what it was like to work in them. It’s still critically important for these people to understand their likely reactions and their tendency to possibly minimise their distress compared to those that they have assisted, meaning that they may actually delay seeking help themselves. Organisations equally need to remain aware of this possibility and design ways to support and assist that acknowledge these risks.

For those first responders who perhaps have had no training, and do not belong or agencies or organisations who do this kind of work on a regular basis, we need to pay special attention to their needs. It is not uncommon for people to be left with lingering thoughts of what happened on the day, in those few minutes of the event itself – doubting whether they did enough, or could have made different decisions.

These comments above apply equally to the health and welfare professionals who have started giving their accounts of harrowing experiences in the immediate hours after the eruption: of their work and the continuing impact it is having on them.

People who have experienced such events often recount recalling sounds, smells, and other experiences that suddenly re-appear days and weeks later, if not for longer. Most people report some kinds of experience like this, and most people cope ok with the support of family and friends. But if this affects you or someone that you know for more than a few weeks, and / or you are experiencing nightmares, loss of sleep, or re-experiencing what happened to you that day, then I would strongly urge you to seek professional assistance and assessment to see if you might benefit from more formal assistance. 

If you have found yourself in this position, remember; you are likely to have done extraordinary things in awful circumstances. You may need help in adjusting to life afterwards. Just as everyone would, in some shape or form. 

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