Psychological first aid after a disaster: what the WHO guide asks you to do and not do

After a disaster, you don't need to be a professional to help someone through the first days. The World Health Organization's Psychological First Aid (PFA) field guide, published in 2011, sets out what ordinary helpers can do and what they should avoid. Japan's National Center of Neurology and Psychiatry, which publishes the Japanese edition, calls the WHO version the most widely accepted PFA internationally.

Look, listen, link

PFA rests on three action principles: look (check for safety and notice people in need), listen (approach, ask about needs, help people feel calm), and link (connect people with information, services and loved ones).

What not to do

The guide's "don'ts" include:

• Don't pressure people to tell you their story.
• Don't make false promises or give false information.
• Don't think and act as if you must solve all of someone's problems for them; don't take away their sense of being able to care for themselves (our paraphrase).
• Don't talk about your own troubles.

The Japanese edition adds examples of phrases to avoid, such as telling someone they shouldn't feel that way, or that they should just be glad to have survived (our translation).

Children

The guide notes that young children may return to earlier behaviours such as bedwetting or thumb-sucking and cling to caregivers; school-age children may believe they caused bad things to happen; adolescents may feel "nothing" or feel different from or isolated from their friends. "In general, children cope better when they have a stable, calm adult around them."

In Japan

• Japan's health ministry advises rest and sleep first, and notes that most worries ease over time.
• Helplines are mainly in Japanese: the national mental health line (0570-064-556, call charges apply) and Yorisoi Hotline (0120-279-338, 24 hours).
• After large disasters, DPAT (disaster psychiatric assistance teams) support mental health care in affected areas.

If distress doesn't ease, or sleep doesn't come back, see a doctor. This article is not a substitute for medical care.

A Japanese version is available: "被災した人の心のケア" (in Japanese).