Psycho Social First Aid

(PFA) for GBV

Survivors
জিবিভি সারভাইভারদের জন্য মনো- সামাজিক প্রাথমিক সেবা
What is Mental Health and Psychosocial
support (MHPSS)
• Any type of local or outside support that aims to protect or
promote psychosocial well-being and/or prevent or treat mental
disorder (IASC, 2010) – this is not being a therapist!
• It protects the dignity of survivors and enhances the health and
well-being response
• Layered support at many different levels with complementary
support to survivors, which helps cover a range of situations
Why is Mental Health and Psychosocial Support
important for me as a police officer
Police may be the first person to speak with someone following an experience of
an extremely stressful event.
• We know from a lot of research that survivors of very stressful events have
better long-term outcomes when the first people they talk to respond in a
compassionate way that does no harm. But doing this is harder than we think!
Sometimes we can accidentally do harm when we’re trying to help. Providing
compassionate responses is a skill that you will learn in this programme.
• You will not be expected to provide mental health care or be a therapist! Just
give a caring response and help the survivor get find the support they want and
need
IASC Guidelines for Mental Health & Psychosocial Support （ IASC,
2007 ）
 Gold standard for humanitarian settings
 Principle: “Do No Harm” and non-judgmental

Stop too much focus on PTSD/trauma Stopping harmful

“Psychological Debriefing”
-a challenge for police!
Starting with care for ourselves
As a police officer, providing health and mental health support to survivors of GBV and women
and families in general can be difficult and stressful. It can affect your own mental health.
• It is important to remember to take care of your own mental health as well.
It is difficult to provide good care for others if we ourselves are struggling
Starting with care for ourselves
Take a moment to reflect and write down:

• What do I like to do to take care of

myself?
• What does my team do to take care of each
other?
• What support do I have in place?

Be responsible to yourself and others by paying

attention to self-care on a daily basis.
Seek help when you…
• Have upsetting thoughts or memories
• Feel very nervous or extremely sad
• Have trouble sleeping

Consult a professional if these difficulties

persist more than two weeks
Psychological First Aid for Police
• What is PFA?

• PFA action principles

• Special considerations for GBV

Question?
If they receive community support after an extremely stressful event, what fraction of people will
develop more severe mental health issues – depression, post-traumatic stress disorder, traumatic
stress responses?

25% - will be fine

50% need community support 25%
will need specialized care
– typically have experienced repeated stressful events

A majority of people (75%) recover with time if basic support

and needs are met.
Factors that influence how well someone recovers
from an extremely stressful event, such as GBV
Personal Factors: Stressful Event:
Age, Education Perceived magnitude
Health (physical (large or small)
& mental) Onset
Single or multiple
Personal
Person’s events
history Respons
Personality e to
Event

Community:
Cohesive community
Past stressful event experiences
Vulnerable or marginalized
groups
Adequate infrastructure and
 Why PFA?
Key resilience factors
• People do better over the long-term if they…
• Feel safe (key for GBV), connected to others, calm & hopeful
• Have access to social, physical & emotional support
• Regain a sense of control by being able to help themselves
• Regaining control is particularly essential for survivors of GBV. Support people in
the way in which they want to go forward.
How do our experiences shape our
brains?

• One trial learning – we learn something threatening, dangerous or with strong

negative emotions very fast!
• We don’t want to reinforce a loss of control!
What PFA is
• Humane, supportive and practical assistance to fellow human beings who
have recently suffered exposure to serious stressors, such as GBV and
involves:
• Non-intrusive, practical care and support
• Assessing needs and concerns
• Helping people to address basic needs
• Listening, but not pressuring people to talk
• Comforting people and helping them to feel calm
• Helping people connect to information, services and social supports
• Protecting people from further harm
What PFA is not
• It is NOT something only professionals can do
• It is NOT professional counselling
• It is NOT “psychological debriefing”
• It is NOT asking people to analyze what happened or put time and events in order
• Although PFA involves being available to listen to people’s stories, it is NOT pressuring people
to tell you their feelings or reactions to an event
• Discuss.
 PFA is…
Evidence informed & consensus
based
• Perceived poor social support in early aftermath of stressful events, such as
GBV, is associated with increased PTSD.

• Professional consensus:
• Humanitarian guidelines support PFA (IASC, Sphere, TENTS)
• Consensus principles for providing effective social care are consistent
with the principles for promoting resilience, which are a key component
of PFA
Psychological First Aid (PFA)
Prepare:
Learn about the crisis event
Learn about available services/supports
Learn about safety and security
concerns
Look: Listen: Link:
• Check for safety •Approach • Help address basic
•Check for people people who needs/access
3Ls w/ obvious may need services
urgent basic support • Help people
needs • Ask about cope
• Check for people people’s w/problems
w/ serious needs/concerns • Give information
distress • Listen to people, • Connect people
reactions and w/
help them feel loved
calm ones/social
support
 GBV survivors: Prepare, Look, Listen,
Link
• Confirm their safety
• Ask the survivor if they feel safe talking to you in this current location. Make sure they feel comfortable in the space.
• Ensure their safety by treating the information with confidentiality and referring them for immediate protection if necessary.
• Have an explanation if you are interrupted. For example, discussing a local event or issue.
• Ask about their most important needs and concerns, including basic needs
• Do not assume you know what someone needs. Some actions may put someone at further risk of stigma, retaliation
or harm.
• Listen to people and help them to feel calm
• Listen to their story. Do not overreact, stay calm, be kind and do not blame.
• Comfort the survivor, do not doubt the survivor and never investigate the situation.
• Listen more than you speak. It is okay to be quiet.
• Do not give advice or promise anything you cannot provide.
• Ask open ended and non-judgmental questions.
• Ask for the survivor’s permission before making any referrals.
• Do not mediate between the survivor and the perpetrator or a third person (e.g. family), or suggest to call or bring these people in.
 Reactions to stress are diverse
Can include these indicators occurring within a month of the extremely stressful event:

• Avoidance behaviors

• Heightened sense of threat

• Insomnia

• Heart palpitations
• Mood and behavioral changes

• Physical pain

• Re-experiencing symptoms

These are normal coping reactions to extremely stressful events and many people will recover in time without professional help.
When is it more than stress?
• If indicators or responses are strong, last for longer than a month, or impair day-to-
day function, they may reflect more severe issues and professional assessment and
intervention can be useful.

• Exposure to stressors can also result in co-occurrence with other mental health conditions,
which could benefit from professional interventions.

• Can result in post-traumatic stress disorder or depression, but typically this occurs when there
are other risk factors – lack of community support, past stressful events, poverty, health
Key take away points
• Most people recover with time. Only a small fraction develop severe mental health issues.

• Identify and support what the survivor needs using Prepare, Look, Listen, Link.

• Focusing on the survivor enables a do no harm approach to interactions.

• Refer if the person cannot function with daily activities for more than 2-4 weeks.
Multi-Sectoral Referral
Mechanism for GBV
Cases

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GBV referrals means?
A processes by which survivor
gets in touch with professionals and/or institutions
Who communicate and work together, Through
in a safe, ethical and confidential manner ,
for comprehensive support

GBV referrals include

medical care,
mental health and psychosocial support,
police legal and justice assistance,
Social Services.
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Health care is the priority in almost all GBV referrals.

GBV referral mechanism follow
survivor-centered Approach;
Survivor centered approach includes;
survivors' rights and needs are first and foremost
safety of GBV survivor,
ensuring confidentiality,
respecting the GBV survivor,
and practicing non-discrimination

Ensures that survivors are active participants in defining their needs 23

and deciding what response and support options best meet those needs.
 Why we called multi-sectoral Referral?
• Survivors typically have multiple and complex needs that require a comprehensive set of
services

• One single organization cannot effectively provide all of these services

✔ Coordinated, multi-sectoral response is necessary

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Consequences of ineffective GBV referral
• More distress to the survivor
• Re-experiencing trauma and flashbacks;
• Longer term impact on well being and behavior;
• Possibility of stigma, isolation by family / community,
• leading to more violence towards survivors;
• Increases risks of retaliation by the perpetrator;
• Insensitive response by service providers;
• Negative health impacts such as STDs/STIs and unwanted pregnancy;
• Delay in justice, loss of evidence – justice delayed is justice denied;

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Steps of establishing effective Referral
System for Service Desk
Discussion with the relevant service providers
Develop a referral pathway (Service Directory)
Develop referral cards and forms
Identification of referral focal persons and build their capacity
Coordination, follow up and update referral pathways

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Service Directory includes information
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Referral Slip in Service Desk SOP
Service registers and Desk Reporting
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সার্ভি স ডেস্ক মনিটরিং
থানা পর্যায়

সার্কে ল ও জেলা পর্যায়

রেঞ্জ ও মেট্রোপলিটন পর্যায়

পুলিশ হেডকোয়ার্টার্স পর্যায়

Thank YOU

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