How to Provide Psychological First Aid? 

Have you heard about psychological first aid (PFA)? Do you think only professionals can do it? If you look at the news nowadays, you can see a lot of suicide cases each day. You can also see social media posts regarding mental health accompanied by such incidents. Some people may feel regretful for being unable to recognize the warning signs of their loved ones. This is where you need to learn about PFA. 

What is PFA? 

Before going to the explanation of PFA, you need to understand what stress and distress are. You experience some kind of pressure or strain while you are attending an exam or interview. The state of pressure or strain you experience here is called stress. Everyone experiences stress and it is a part of our daily lives. It helps you prepare and perform well in such important activities. However, some stress can be negative and difficult to deal with. They are called distress and affect your daily lives. They lead to emotional and physical discomfort. 

Psychological first aid involves providing first-hand support to people in distress. You need to learn certain skills to offer PFA. These skills will help you to identify and give proper support to distressed people around you. PFA skills include: 

• Assessing a situation 
• Understanding common reactions to crises 
• Knowledge about how to approach someone in distress 
• How to calm someone in distress 
• Knowledge on providing emotional support and practical help. 

What is not PFA? 

Several of you may think PFA can only be done by professionals. In fact, it is not. PFA is a kind of primary support that can be provided by anyone. Just like doing first aid for physical injuries. You also need to understand that providing PFA is not professional counseling or therapy. PFA does not mean pressuring the individual in crisis to explain the details of it. You don’t compel them to analyze the situation and to provide details about their feelings and reactions. Your duty is to address their basic needs and enable access to information, services, and social support. 

Who needs PFA? 

You can provide PFA to people with distress. Not everyone in distress needs PFA. Some can cope with it by themselves. Some find it difficult and need help. It can be useful to people who go through personal crises like social or health challenges. This can also have significant importance in situations like disasters, conflict, violence, forced migration, etc. Depending on the severity of the situation, you can’t help the person only through PFA. Understand your limitations and help people to connect to professionals. 

Read More: Know about the link between natural disasters and mental health?

When do you provide PFA? 

PFA is provided after an immediate crisis. You can provide PFA in the first encounter with the person after a crisis. It may also be provided days or weeks after the event, depending on the severity and impact of the situation. 

Where is PFA provided? 

PFA can be provided anywhere which seems safe and comfortable. Sometimes it may be the person’s home, crisis place, health centers, or shelter homes. Always ensure privacy in such places so that it won’t lead to any further harm to the persons affected. This is very essential in cases such as abuse. 

How to help responsibly? 

• Respect safety, dignity, and rights of people. 
• Be aware of your own culture and biases. Set them aside while dealing with people from a different cultural background. Try to adapt to the culture of those in need that facilitate providing PFA better. 
• Be aware of the emergency response measures. 
• Look after yourself 

Providing PFA 

Good Communication 

Individuals in crisis may be upset, anxious or confused. So, try to be calm, actively listen and understand them. Some people are okay with sharing their story with you whereas some are not. If they are not comfortable with sharing, don’t pressure them to open up. Give them their space. Sometimes you just need to quietly sit with them to ensure you are available to provide help. Just assist them with giving a glass of water or meals. Once they feel safe they will be comfortable in communicating their needs. Be aware of your body language and make it adaptable to the person’s culture so that they feel more comfortable with you.

Prepare 

• Learn about the crisis event. Understand in detail about the crisis event, when and where does it happen, how many are affected and who they are. 
• Keep data of the available services and supports. 
• Learn about the safety and security concerns 

Action Principles of PFA 

Three action principles of PFA include look, listen, and link. 

Look 

Before entering into the situation, take some time to look at the situation. By this, you can be calm, safe, and think before action. 

• Ensure safety: If the crisis site is not safe, then help the persons from a safe distance.
• Look for those who have urgent needs: be aware about your role and limitations. For people who need special assistance, enable access to such emergency and professional services. 
• Check who is in most distress: understand who needs PFA and how you can help them the best. 

Here are a few sudden responses to crises: 

• physical signs like headaches, body aches, shivers, loss of appetite, and extreme tiredness. 
• Crying, sadness, despair, melancholy 
• Feeling scared, restless, anxious, or overly alert. 
• Anxiety about an unwelcome occurrence 
• Agitated and ashamed sleep, including feeling guilty for not being able to save certain people, losing sleep over it, wondering why on earth I did not take action.
• Being emotionally numb or detached, while feeling a sense of unreality or being in a dazed state of mind. 
• Noticing things being far too quiet or tranquil in comparison to my headspace.
• Not engaging with other people at all. Not talking, and at times not remembering where they or even their name. 
• Not being able to provide for yourself or your children like deciding what they would like to eat or drink. 

The intensity of distress may vary among individuals. Most persons in distress will recover as time passes and with proper support such as PFA. However, some need professional support apart from PFA. Do you know who needs special attention? These include: 

• Children who are separated from their caregivers and are vulnerable to abuse.
• Individuals with physical and mental health issues. This includes old-age people, pregnant women, people with mental disorders, or people with sensory difficulties.
• People at risk of discrimination

Listen 

Listening is an important skill to understand the present condition of people in distress and to identify their immediate concerns. This includes: 

1. Approach people who may need support 
   • Respectfully approach people in distress by considering their cultural differences.
   • Introduce yourself by name and organization. 
   • Ask if you can provide help. 
   • Try to find a safe and quiet place to talk. 
   • Make the person comfortable (e.g., offer water if you can.) 
   • Try to keep the person safe. 
     • Protect the person from immediate threats as much as possible 
     • Protect the person from the media exposure and ensure privacy and dignity. 
     • For those in extreme distress, make sure there is support available.
2. Ask about people’s needs and concerns 
   • Apart from visible basic needs, ask them about their other necessary concerns.
   • Prioritize their different concerns and work on the most important at the moment.
   • Listen and help them to feel calm 
3. Stay close to the person. 
   • Do not pressure the person to talk. 
   • Listen to them when they want to talk about what happened. 
   • Support them to feel calm and ensure that they are not alone. 

How to help them to feel calm? 

When speaking to someone in distress, use a calm and gentle tone, ensuring your words provide comfort rather than alarm. Acknowledge cultural differences with respect and sensitivity, maintaining soft and reassuring eye contact to create a sense of connection. Let them know that you are there to support them and that they are safe, but avoid making any false promises.

If they express feelings of being disconnected or unreal, gently guide them back to the present moment by encouraging them to notice their surroundings, engage their senses, or focus on their breathing. Your presence and understanding can help them feel grounded and reassured.

You can do this by guiding them to: 

• Place their feet on the floor and make them feel it. 
• Tap their fingers or hands on their lap. 
• Aware of some non-distressing things in their environment, such as things they can see, hear or feel. 
• Let them tell you what they see and hear. 
• Encourage the person to focus on the breath, and make it slow. 

To provide PFA effectively, you need to know what are the frequent needs people have in face of crisis. Some common needs are:

• Fundamental needs, such as shelter, food, water and sanitation. 
• Health services for injuries or assistance with long-term medical conditions.
• Accurate information on the event, family members, and existing resources.
• Being able to communicate with family members, relatives, and other sources of support.
• Access to support that relates to one’s culture or religion. 
• Consultations and participation in important decisions. 

Link

The third important part of PFA is linking people to different services and professionals depending on their basic needs. You know that PFA is a short-term intervention and you are supporting them to be capable of dealing with their problems with themselves. So, linking involves: 

1. Support people to address their basic needs and accessibility to services
   • As soon as possible after a crisis situation, attempt to assist the distressed person in addressing their immediate needs, such as food, water, housing, and hygiene. 
   • Identify what specific assistance these persons may require, such as healthcare, clothes, or items for feeding infants, such as cups and milk bottles, and try to connect them to the available resources. 
   • Ensure that these groups of people, including the elderly, disabled, and very young children, are not hidden. 
   • If a promise is made to follow up with people, ensure this is done. 
2. Help people cope with problems 
   • Assist people in recognizing sources of support, such as family members or friends who can provide help in the current situation. 
   • Provide practical suggestions to address self-sufficiency for instance, like guiding a person on how enroll for food or material aid. 
   • Ask them to remember how they overcome difficult situations in the past, and affirm their ability to cope with the current situation 
   • Ask what helps them to feel better. Encourage using positive coping strategies and avoiding negative coping strategies 

Positive coping strategies 

• Take care of yourself and ensure you are sleeping enough. 
• Eat regularly and drink enough fluids like water. 
• Spend time with your loved ones, whether that involves a conversation or simply being in their presence. 
• Communicate your concerns with someone you trust. 
• Engagement in relaxing activities such as taking a walk, singing, praying, or playing with children is something you should consider doing. 
• Go through physical activities like jogging or lifting weights. 
• Assist others who are experiencing difficulties in safe manners and join in community projects. 

Discourage Negative coping strategies 

• Refrain from drug use, smoking, or drinking alcohol.
• Avoid sleeping excessively. 
• Stop overworking yourself without taking breaks. 
• Avoid withdrawal from interaction with loved ones and friends. 
• Maintain basic hygiene. 
• Avoid resorting to violence. 

Give information 

In the aftermath of a crisis, individuals require detailed information about the event, including what happened and its consequences. They seek updates on their loved ones and others impacted by the situation to ensure their well-being. Personal safety becomes a priority, as people need to understand any ongoing risks and protective measures. Additionally, they must be informed about their rights in the context of the event, helping them navigate legal or social implications. Access to essential services such as food, shelter, and medical aid is also crucial, as individuals strive to meet their basic needs and recover from the crisis.

Connect with loved ones and social support 

Support efforts should focus on keeping families together and ensuring that children remain with their parents or other relatives. Facilitating communication is essential, enabling individuals to contact friends or family for assistance, such as by providing access to phone calls. For those who require religious support, offering opportunities for prayer and guidance from religious practitioners can provide comfort and strength.

Additionally, fostering a sense of community is crucial—bringing people together to support one another, enlisting volunteers to care for the elderly, and connecting individuals who lack family with supportive community members can help create a network of care and resilience.

Ending your help 

Ending your help depends on the severity of the crisis, your role, and the person’s needs. Based on your judgment you can decide when to stop the PFA by understanding the ability of the person to cope with the situation. Inform them that you are leaving and explain it to them. If someone else is taking your role, introduce them to the person. If you connect them with someone, then make sure the availability of services and provisions to follow up. 

Looking after yourself 

It’s common for you to become distressed while helping others. So, you should take care of yourself both physically and emotionally. You can apply the action principles you learnt to yourself. 

• Look 
  • Observe your actions and behaviours 
  • Be able to identify signs or symptoms indicating excessive stress or exhaustion.
• Listen 
  • Listen what the outcome of that reaction is to you 
  • Acknowledge your feelings 
  • Try to work out what is affecting your reactions so that you can decide how to manage or cope better. 
• Link 
  • Link with other people. Seek help from them, both at work or at home.
  • Engage in activities that can help to protect your well-being. 

Conclusion 

Learning PFA is very relevant nowadays. We all know the rise of different mental health crises in today’s world. Your awareness of PFA can help many and save lives of a lot of people you can’t even imagine. Many are struggling in silence. Lack of our understanding about their warning signs make us fail to identify their concerns. Remember, you can’t become a professional by learning and offering PFA but you can connect them to the services they need which are difficult for them to reach in the face of distress. 

FAQs 

1. Who can provide Psychological First Aid? 

Anyone can provide PFA, including first responders, healthcare workers, teachers, community leaders, and even family members. No professional mental health training is required, but understanding the basic principles of PFA is important. 

2. What are the core principles of Psychological First Aid? 

• Look: Assess the situation and observe those in distress. 
• Listen: Provide a calm, compassionate presence and let them express their emotions. 
• Link: Connect them to further support and resources if needed. 

3. How do I approach someone in distress? 

Approach them with respect and patience. Introduce yourself, explain that you are there to help, and ask if they want support. Avoid forcing conversation—some may need time before talking. 

4. What if someone refuses help? 

Respect their decision, but let them know you are available if they change their mind. You can gently encourage them to seek support later if needed.

5. How do I support children in crisis? 

Use age-appropriate language, provide comfort, and reassure them that they are safe. Engage them in normal routines and activities to help restore a sense of stability. 

6. What should I avoid when providing PFA? 

• Do not force people to talk. Let them decide when to share. 
• Avoid giving false reassurances. Instead of saying, “Everything will be fine,” say, “You’re safe now, and we will work through this together.” 
• Do not diagnose or counsel. PFA is about immediate support, not therapy. 

7. When should I refer someone for professional help? 

If they show signs of severe distress, such as suicidal thoughts, inability to function in daily life, prolonged anxiety, or signs of trauma, encourage them to seek professional mental health support.