Understanding Mental Health

Trauma

What is a traumatic event?

A traumatic event can be any stressful incident or series of incidents that precipitate significant anxiety/arousal reactions within the school community.  It is recognized that in a school’s daily life there are a multitude of events that are anxiety producing and stressful and that require a managed, effective response.  However, there exist a range of events that require a more directed approach in order to ensure the safety of the school community and to reduce the intensity of emotional reactions to these events.  Some of these traumatic events include:

  1. violence and threats of violence

  2. tragic accidents resulting in severe injury or death

  3. suicide

In these circumstances, an effective response from the school is required to diffuse potentially volatile situations, to give direction to staff and to limit further negative consequences.  Evidence-based practices indicate that specific interventions are needed within the school community to avoid panic, to attenuate negative reactions and to return the school to normal operation as smoothly as possible.  Postvention following a traumatic event involves two important and closely intertwined activities undertaken to maintain or restore order and to provide emotional and psychological support.  Administrative measures such as informing staff members of the tragic event and developing with them a plan of action clearly demonstrates that the situation is under control and that the school community is safe and secure.  Emotional and psychological support is provided to help members of the school community cope the troubling thoughts and feeling that result from exposure to a tragic situation. 

What schools can do

Traditionally, during a crisis or following a traumatic event, schools have called upon the services of outside trained mental health professionals to provide psychological support.  Recent research in this area suggests that professionals (psychologist, guidance counselor, special needs consultant, spiritual animator, school social worker, etc.) who are familiar with the school environment and are known to the school community would be best suited to provide support most consistent with a school’s climate and culture.

First response

Following a traumatic event, it is important that both administrative and psychological interventions are based on an analysis of the situation, evaluation of the various needs with a particular focus on individuals who are most vulnerable and the implementation of a variety of interventions that correspond appropriately to the identified needs.  An evidence-based framework for providing appropriate support following traumatic events is Psychological First Aid.  This model is centered on providing comfort, care and aiding natural recovery.  The 8 components of Psychological First Aid are:

  1. contact and engagement

  2. safety and comfort

  3. stabilization

  4. information gathering: current needs and concerns

  5. practical assistance

  6. connection with social supports

  7. information on coping support

  8. linkage with collaborative services.

The care and concern expressed to the students by teachers and a principal who know them best and are close to them on a daily basis provides this type of emotional and psychological support. Sharing a few moments to cry together and to be held and hugged by your teacher an extremely powerful intervention.  

The National Child Traumatic Stress Network and the National Center for PTSD has made available the Second Edition of Psychological First Aid Field Operations Guide. Refer to: http://www.nctsn.org/content/psychological-first-aid

In providing support to schools following a traumatic event, it is important to recognize that not everyone in a school community experiences a tragic event in the same manner.  When a school community is exposed to a traumatic event it is completely normal for individuals to experience a wide range of reactions, including physiological, behavioural, cognitive and emotional.  Generally, three types of responses are most likely to occur.  Individuals who are closely involved in a tragic event may commonly react with shock, disbelief and fear, which give way to feelings of anxiety, anger and sadness.  These responses are normal and temporary stress reactions.  While temporary stress reactions can be expected, some individuals may develop more acute stress reactions or subsequently Post Traumatic Stress Disorder.  When the traumatic event involves a death, it is expected that some individuals in the school community will experience feelings of intense sadness, loss and emptiness or grief reactions.  Grief reactions may be experienced by those individuals who have a very close and special attachment to the deceased person.  Initial grief reactions may be replaced by more complicated and long term grieving.  When a death occurs by suicide, vulnerable individuals within the school community may develop a heightened sense of helplessness and despair and may experience suicidal reactions.

Many factors influence the nature and severity of these reactions in individuals including proximity to the event or the victims, pre-existing vulnerabilities (psycho-social or mental health problems), personal experiences (a recent illness or death of a loved one) and for students, their cognitive and emotional development.  Recognition of the various types and intensities of reactions holds important implications for planning realistic and effective interventions following a traumatic event.  Clearly, any interventions that are put into place should be based on an analysis of the differing individual needs.  Massive school wide interventions that do not take into consideration varying individual needs can result in increased levels of discomfort and distress in a school.  Particular attention needs to be paid to suicide postvention as research studies have suggested that interventions that inadvertently glorify, dramatize or validate suicide as a credible solution to one’s problems increase the probability of contagion and increase the risk of suicidal crises. 

For a comprehensive program for school based postvention following a suicide, refer to:  

http://www.aqps.info/media/documents/postvention.pdf  

http://www.maine.gov/suicide/docs/Guideline.pdf

Most students and staff recover from traumatic events with little formal intervention by using their traditional support system such as parents, family, friends, religious affiliations, etc. One of the prime objectives of school based interventions is to facilitate and encourage these naturally occurring support systems.  The reality of today’s society is that a child’s teacher plays a significant role in providing emotional and social guidance and support to the students when they are faced with challenging situations. Feedback from teachers has indicated that they believe they are in the best position to offer students the support they need following a crisis, but they sometimes feel unsure about what to say or how to intervene.  As well, while schools are encouraging students to speak to their parents about their feelings and reactions, some parents may feel poorly equipped to respond appropriately.  In order to help support teachers and parents, fact sheets can be prepared by professionals on topics that include the warning signs of distress, what to look for in children’s reactions or how to respond to their questions and how to provide reassurance.  

For comprehensive tip sheets for teachers and parents, refer to:

We tend not to talk about illness, accidents or death.  Understandably, these are not pleasant topics.  However, when tragedy strikes we are shocked and may feel unprepared to deal with the situation.  Almost everyone affected, whether administrator, teacher, psychologist, parent or student, has a similar initial reaction and questions how they are going to be able to manage the situation. The truth is, everyone does manage and does cope.  Some handle it a little bit better, some not quite as well, but everyone does manage.  We may feel that the next time we are confronted by a similar situation we will be better prepared.  However, we always hope that there is no next time.

 

 

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