1. Module 5 - Populations with Special Needs

2. Module 5 Populations with Special Needs 2 Learning Objectives Identify and describe the characteristic reactions of vulnerable groups affected by disaster Describe effective interventions to assist vulnerable groups

3. Module 5 Populations with Special Needs 3 Groups with Special Needs Children Older persons Persons with disabilities (physical/mental illness/substance abuse/developmental) People with past experience with war or terrorism

4. Module 5 Populations with Special Needs 4 Groups with Special Needs (cont.) Ethnic and cultural groups Parents with dependent children Bereaved spouses or partners Economically disadvantaged groups Socially disadvantaged groups First responders/disaster response personnel

5. Module 5 Populations with Special Needs 5 Groups with Special Needs (cont.) Individuals may overlap between groups Women & Vulnerability role of women as primary caregivers (overlap with parents, maybe economically disadvantaged) Women outlive men and thus may be alone and physically compromised as they age (overlap with older adults, socially isolated) Women may have a history of trauma or abuse (overlap with past trauma experience)

6. Module 5 Populations with Special Needs 6 Emotional Stress in Children Listen/Observe/Respond Changes in behavior, personality, outlook. Talk to the child and observe responses. Does the child appear upset or confused? Compare the child’s behavior to other children of the same age in the same setting. Does the child play appropriately?

7. Module 5 Populations with Special Needs 7 Children’s Typical Responses Fear and anxiety “Childish” or regressive behavior Difficulty sleeping Physical reactions “Trigger” responses Difficulty concentrating or thinking

8. Module 5 Populations with Special Needs 8 Reactions Related to Age Groups Birth to 2 years Irritability, crying, clingy or passive behavior Pre-school, 2-6 years Intense fear or insecurity Play activities may involve aspects of the event Re-enactment of the event over and over

9. Module 5 Populations with Special Needs 9 Reactions Related to Age Groups (cont.) School age, 6-10 years Guilt Feelings of failure Anger Fantasies of playing rescuer Intensely preoccupied with the event

10. Module 5 Populations with Special Needs 10 Reactions Related to Age Group (cont.) Preadolescence to adolescence, 11-18 years Responses resemble adult reactions Irritability, rejection of rules and aggressive behavior Dangerous, risk-taking behavior Fearful Depressed May contemplate or attempt suicide

11. Module 5 Populations with Special Needs 11 Helping a Child Help by helping the parents Keep familiar routines Pamper and care Talk about what happened (as appropriate) Find opportunities for children to participate in decision-making

12. Module 5 Populations with Special Needs 12 When a Specialist is Needed: Suicidal or homicidal ideation/behavior Younger children may say they wish they had never been born Hopelessness/helplessness Unable to stop thinking about the event Physical problems Alcohol or drug use

13. Module 5 Populations with Special Needs 13 Activity # 16 – Group Discussion Helpers need to be prepared for their own emotional reactions when supporting children in crisis, and to be aware that their reactions are normal. Brainstorm and list the “normal” reactions that can helpers may have when working with children Many areas of Nebraska have very few mental health services for children. As a group, brainstorm and list all the mental health services for children available in your community

14. Module 5 Populations with Special Needs 14 Older Persons Especially vulnerable when: Having co-occurring medical problems Having ambulation difficulties Living alone Lacking help and other resources Having to face the shock of losing all that they had attained in life Home Family Security

15. Module 5 Populations with Special Needs 15 Older People’s Typical Reactions Increased memories of past Wish to connect with past friends Increased dependence on family, refusing assistance from authorities Fear of mortality Negative view of the future Regression

16. Module 5 Populations with Special Needs 16 Older People’s Typical Reactions Feeling of multiple losses Disoriented as routine is interrupted Use of denial as a normal defensive reaction Immediate fear response, followed by anger and frustration Concentration and communication difficulties Physiological responses

17. Module 5 Populations with Special Needs 17 Helping Older People Ensure safety Give factual information Reassure by providing information about normal reactions Be supportive and build confidence Identify secure attachments and relationships Talk about the event Be aware of cultural backgrounds

18. Module 5 Populations with Special Needs 18 Helping Older People (cont.) Facilitate access to aid and support services Ensure that they are not isolated Establish Routine Provide opportunities for continuity, culture and history Help them to maintain their sense of community and preserve cohesion

19. Module 5 Populations with Special Needs 19 Persons with Disabilities (Physical/Mental Illness/Substance Abuse/Developmental) May need assistance in negotiating the “second disaster”, applying for assistance from aid agencies May need some accommodations within shelters May need assistance in replacing lost prescriptions

20. Module 5 Populations with Special Needs 20 Persons with Disabilities Always link with existing services for their disabilities Seek advice if these are evident or suspected: Suicidal ideation Homicidal ideation Depression lasts longer than two weeks Active hallucinations or delusions Rage Aggression Inability to care for self or carry out activities of daily living

21. Module 5 Populations with Special Needs 21 Previous Experience with War/Trauma/Disaster Previous, and especially repeated, exposure to death and injury may increase a person’s risk of developing psychological problems after a disaster.