Health practitioners should select materials according to the needs of the disaster-impacted individual, in consideration of the services and resources available in the local community, and with awareness of their own skill level.

Although an ongoing process, initial assessment helps establish goals and priorities for the intervention, and plans for addressing them. Assessment also alerts the health practitioner to the degree or level of intervention that may be useful.

For example, a brief intervention that involves administration of a screening tool, a discussion regarding the issue and provision of an informational handout may be all that is required, or a more advanced intervention provided by a specialist mental health clinician may be warranted. Assessment also provides clues about the most effective timing of intervention. In the post-disaster period, for example, when individuals are overwhelmed, a low intensity psychological intervention may best suit the disaster-impacted individual’s capacity to engage at that time. An improvement in the presenting problem or a settling of the individual’s circumstances may enhance motivation to engage in other, more intensive, interventions at a later date.

Service provision may be disrupted in the aftermath of disaster, and available services may be overwhelmed by demand. Health practitioners, even where they identify limitations to their competence, may be the only available option for assistance. In this case, materials within the toolkit include a range of strategies of varying complexity available for the practitioner to choose from. Some health practitioners may feel more confident offering behavioural strategies rather than, for example, trauma-focussed cognitive strategies that are best implemented by mental health practitioners who are competent in the use of cognitive therapy. Finally, ongoing assessment of the individual’s progress with the problem in question is vital, and health practitioners should be alert to the need to refer on should the limits of the support they provide be reached.

Although the majority of disaster-impacted individuals will not experience a mood disorder, or episodes of suicidality, it is possible that some people will experience a deterioration in their mental state over time. Health practitioners are encouraged to be aware of available mental health services and referral options in their local area. General Practitioners are often an excellent source of support, both in terms of facilitating activation of mental health care plans and referral to specialist mental health providers, as well as being aware of available mental health services in the post-disaster period. Family members, friends, and telephone and web-mediated crisis support services may also offer assistance.

Finally, the use of the materials within the toolkits implies not only a start, but also a conclusion to the relationship between health practitioner and disaster-impacted individual. This may occur as a natural consequence of the resolution to the individual’s difficulties, or as a result of an identified need to refer to other health practitioners. Attention should be paid to the use of relapse management strategies and the importance of effective and appropriate termination strategies.

Sleep Toolkit

HIGHLIGHTED TOOLKIT

Sleep

Sleep disturbances are common in the days and weeks after disaster, and may involve difficulties falling asleep and staying asleep, as well as the experience of nightmares.

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