What are the biggest challenges of providing psychological first aid in a disaster setting?

The greatest ethical issue is that of creating new realities for a person through the analysis, interpretation and judgment of the practitioner. CRISIS facilitators are taught during training how harmful this can be for someone who is faced with a disordered world following a critical or meta-critical incident.

'Teacher' - to thine own-self be true! - Psychological Stress. Many of us who have provided or provide mental health assistance during a major/critical incident are very empathetic, if not full-blown empaths. We can take-on the feelings of the victims. It is imperative that we get proper rest, nourishment, time away, etc. for our own well-being. Compassion fatigue is real. Acute stress from such an event can evolve into PTSD, if we are not cautious. We cannot be everything to everyone! Other considerations - On a side note, do not assume religion and/or religious help is for everyone!

Often overlooked is “access to those who need assistance”. While time is of the essence in debriefing first responders, their work will usually get in the way of that. It’s difficult if not near impossible, especially in smaller communities for emergency services to stop long enough to access psychological support until the event is long over. By then the “piling on” of trauma and the cumulative effects that presents will complicate things for them in both short and long term. A seemingly simple option would be to rotate first responders frequently between the frontline and their support channel. However, in the face of personnel and financial constraints, this is not the reality. Bridging that gap continues to be a great challenge.

I think one of the biggest practical restraints is competing priorities. As important as psychological first aid is, both for responders and for survivors, the physical (physiological and safety) needs take precedent. Even if you have the necessary resources and staff available, which is unlikely, in order to address it psychological needs, you may have to put a pause on whatever the person is doing, which might be surviving a disaster (for survivors) or saving lives (for responders), or it might simply be perceived that way and people may push back.

Training on the essential need for PFA prior to a disaster is a determining factor if it will be accepted and prioritized during a disaster.

I want to address the availability of appropriate trained mental health personnel to support the community in case of a PSY need. First of all, usually those professionals come from a volunteer (ad-hoc) mobilisation, that has to do with the overall availability of that kind of professionals inside the community. Which is usually limited, as the mental health professionals, are affected by the disaster as any other group. Even if professionals are available, they probably sometimes lack experience in PFA, that differ from counseling or psychotherapy, usually the field of the majority of the experts. A solution could be the establishment of PSA response teams, with professionals trained and ready to be deployed, in any disaster incident.

A significant challenge in providing psychological first aid in disaster settings is the limited availability of resources, particularly personnel. The scarcity of trained mental health professionals hinders immediate support. Hospitals, often dealing with an influx of emergency cases, may prioritize physical care, straining staff, and delaying psychological aid. This time constraint leaves survivors coping with the emotional aftermath without prompt assistance. Overcoming this challenge requires strategic planning and resource allocation to seamlessly integrate psychological first aid into the broader emergency response framework.