Historical Context

George S. Everly, Jr, PhD, ABPP

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1954 Monograph on Psychological First Aid (Published by the American
Psychiatric Association)

“In all disasters, whether they result from the forces of nature or from enemy
attack, the people involved are subjected to stresses of a severity and quality
not generally encountered …

It is vital for all disaster workers to have some familiarity with common patterns
of reaction to unusual emotional stress and … must also know the fundamental
principles of coping most effectively with disturbed people …”

—American Psychiatric Association, 1954

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1992 American Red Cross

■  Almost 40 years later, a disaster mental health initiative was fielded by the American Red
Cross

■  It consisted of a corps of licensed mental health clinicians who were provided a brief
refresher in psychological crisis intervention and informed how to work within the ARC
system

■  First national deployment: August, 1992, in response to Hurricane Andrew

■  This deployment system worked well in most disasters

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Enhancing LOCAL Surge Capacity

■  In 2005, Hurricane Katrina’s devastating impact on the Gulf Coast of the United States
demonstrated the importance of having mental health resources that extend beyond the
importation of external mental health clinicians

■  The importance of building indigenous surveillance and acute intervention resources

became obvious

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Regarding Whom to Train, IOM Wrote:

“A broad spectrum of professional responders is necessary to meet [disaster-

related] psychological needs effectively. Those outside the mental health
professions, who may regularly interface with the public, can contribute
substantially to community healing … However, these professionals will require
knowledge and training in order to provide effective support”

—IOM, 2003

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IOM also Wrote about PFA

“In the past decade, there has been a growing movement in the world to
develop a concept similar to physical first aid for coping with stressful and
traumatic events in life. This strategy has been known by a number of names
but is most commonly referred to as psychological first aid (PFA).”

—IOM, 2003

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PFA

■  Psychological first aid may be defined as a compassionate and supportive presence

designed to mitigate acute distress and assess the need for continued mental health care
(Everly and Flynn, 2005)

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Psychological First Aid

■  PFA is not a treatment for PTSD (post-traumatic stress disorder)

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The Johns Hopkins RAPID PFA Model: Five Core Elements

■  RAPID:
1.  Rapport and reflective listening
2.  Assessment
3.  Prioritization
4.  Intervention
5.  Disposition and follow-up