Psychosocial Support in Disaster Management in India

INTRODUCTION

Disaster is a severe disruption; ecological and psychosocial, which greatly exceeds the coping capacity of the affected community (World Health Organization, 1992). India is a country of diversity, diverse geographical nature makes it vulnerable to different natural calamities such as cyclone, drought, earthquake, flood, avalanche, landslide, cloudburst, etc. Man-made disasters such as riots, terrorist attacks, and stampedes are also very frequent in India. But most common disasters in India are floods, drought, earthquakes, cyclones, and riots. The impact of disaster depends on the nature and magnitude of the disaster. No one is untouched by the disaster, consequences of disaster may vary from individuals to individuals. The psychological consequences may vary from well-being, functioning, stress, fear, uncertainty, physical symptoms, and post-traumatic disorders (Galea, et al. 2005).  

The impact of disasters can be divided into broadly four types. These are-  

Physical: The physical impact of disaster depends upon the type of disaster. Death, fracture, injury, cuts, etc. are common in earthquakes, tsunamis, flash floods and landslides. Floods and droughts have different kinds of physical impact. Riots and terrorist attacks are having physical impacts like bullet injury, stab wounds, burning, etc. (NIMHANS, 2005). 

Economic: All kinds of disasters take economic trolls from human beings. The death of earning members of the family can have an enormous economic impact. Disasters may damage houses and shelters of people. Death of livestock and damage of agricultural crops can cause a huge economic burden for farmers.  Disaster may damage business, workshops, transports, etc. and affect those people whose livelihood depends on these (NIMHANS, 2005).  

Social: Disaster may affect the family structure, sudden death of a family member can cause a single-parent family, widow or widower, orphan and so on. Neighborhood and community also get damaged and their normal functioning gets interrupted. At the post-disaster situation, most of the institutions become non-functional law and order of disaster-affected places get affected. In this situation, some people get involved with various criminal activities such as theft, robbery, snatching, sexual assault etc. Domestic violence, drug and alcohol abuse, neglecting day-to-day responsibilities are also very common in the post-disaster phase (NIMHANS, 2005). 

Emotional: All kinds of disasters severely affect the emotional wellbeing of the survivors. In the aftermath of any disaster, the most common emotional feelings are helplessness, hopelessness, and frustrations. Repeated thoughts of the event make people restless and not able to cope with the experience they have gone through. Fear of recurrence of the event causes anxiety, sleeplessness, restlessness, and low confidence to resume normal life (NIMHANS, 2005). 

The survivors go through four main phases of reactions after the disaster. These are –

Rescue phase: The rescue phase is the first phase of disaster response phase. This phase lasts up to 72 hours from the event. It is usually referred to as the “Heroic Phase’ in terms of emotional reaction. In this phase great integrity is noticed, altruism is high. People work together to prevent the hazard of the disaster (Rao, 2006). 

The relief phase: the second phase is known as the relief phase lasting from two to six months after the event. This phase is also known as the ‘Honeymoon Phase’. In this phase, survivors go through high levels of optimism. In this period many governments, voluntary, and community organizations overpour relief materials and extend support. The government makes high promises to the survivors, these make them compassionate and caring (Rao, 2006).  

The rehabilitation phase: The next phase is the rehabilitation phase and it lasts from one year to two years from the event. The rehabilitation phase is also recognized as the ‘Disillusionment Phase’. In this phase supply of relief and support from outsiders reduce. Promises made by the government get delayed, most of their expectations remain unfulfilled. Then survivors realize that they have to give up the hope of help and they have to make their own (Rao, 2006).  

Reconstruction phase: Reconstruction or rebuilding phase is the last phase survivors go through. This phase lasts for years or may extend to lifetime. Survivors and community work along to make normal functioning. This phase includes the disaster preparedness training programme in high-risk areas (Rao, 2006). 

The emotional impact of disaster depends on three main factors. These are 1.  Nature, magnitude, suddenness and frequency of the disaster, 2. Survivor’s age, education or exposure, gender, family conditions, physical health, personality, coping ability, social support, nature and magnitude of the loss, 3. Preparedness level, social support system, leadership quality and past experience of the community. (NIMHANS, 2005).

Primary support systems like family, neighbourhood and community get affected by disasters. The primary support system is the most important in human life, to come first to provide help to cope with any crisis.  After disaster family, neighbour and community become nonfunctional. In this situation providing psychosocial care is essential and others simultaneously. Psychosocial first aid at the beginning decreases the risk of psychological morbidity and helps the survivors to cope with the situation in an adaptive way (Nimhans, 2005). It has been revealed that late intervention can make the situation worse and the survivors can become reserve and uncooperative. They often come up with various physical symptoms which are manifestations of psychological issues of their traumatic experience. No one is untouched by the impact of the disaster, emotional impacts are often neglected because it is not visible like physical injury and loss of property. It is important to extend the role of tertiary support systems such as governmental and non-governmental agency, voluntary organization and other institutions. Important entities at Natioal level for disaster managment.

DISASTER MENTAL HEALTH IN INDIA

India has witnessed so many natural and man-made disasters and developed strategies to manage disaster tactfully to reduce its impact. Mental health professionals in India realized the importance of psychological intervention in disaster management long back. In 2004 Tsunami massively destroyed the southern part of coastal India. This was the worst natural disaster that happened in the recent history of the country. Almost 2,27,898 people lost their lives, many people lost their means of livelihood, valuables and many more, the loss was huge. Various agencies of the government and voluntary organizations responded quickly to the victims. Rehabilitation of the survivors was started as soon as possible (National Disaster Management Guidelines, 2009). Mental health services were also provided to the survivors and during this time mental health professionals brought out various evidence-based data. They realized the need of adopting a holistic approach in disaster management. It was clear by this time that only medical rehabilitation, financial rehabilitation or shelter will not be effective (Chandra, et al, 2006).

National Disaster Management Act 2005

The Government of India has passed the National Disaster Management Act (NDMA) in 2005. Aim of this act is “the effective management of disasters and for matters connected therewith or incidental thereto.” (National Disaster Management Act, 2005). The act ensures to work effectively various government agencies for disaster preparedness and response promptly in any disaster situation. Four important entities at the national level have been placed in a structured way in this law. These entities are- 

National Disaster Management Authority (NDMA)

The National Disaster Management Act, 2005 has formed the National Disaster Management Authority (NDMA). Prime Minister is the Chairperson of the NDMA and it has developed a proper structure of disaster management. NDMA works at the national level, at the state level there is State Disaster Management Authority (SDMA) and at the district level, there is District Disaster Management Authority (DDMA). NDMA has many roles and responsibilities to prevention, risk reductions, mitigate disaster situations. It develops, approves and implement policies on disaster management, coordinates with various ministries and governmental departments at the time of requirements, makes provisions for funds. NDMA makes guidelines for various agencies, take measures for prevention, preparedness and risk reduction. It also provides support to other countries at the time of major crisis management (Government of India, 2011).

National Institute of Disaster Management (NIDM)

On 16th October 2003 the National Centre for Disaster Management upgraded and designated as the National Institute of Disaster Management (NIDM) by the Government of India. Again in 2005 National Disaster Management Act this institute got the recognition as a statutory organization. The aim of this institute is to develop training modules, providing training, organizing special lectures, seminars, conferences, conducting research on disaster preparedness, mitigation and response, documentation, publication of books, journals and other resources (Government of India, 2011).

National Disaster Response Force (NDRF)

The National Disaster Response Force (NDRF) has been established under the National Disaster Management Act, 2005. This is a specialist force to response disaster situations.  NDRF is formed by eight Central Para Military Forces. Personnel of this force are specially trained and equipped to an effective response to any kind of disasters or crisis situation. There are special teams in the NDRF to manage the Chemical, Biological, Radiological and Nuclear (CBRN) disasters also. Currently NDRF battalions have been posted at various places of the country as per the vulnerability profile (Government of India, 2011).

Nodal Center for Psychosocial Support in Disaster:

NIMHANS being a pioneer mental health institute in India has contributed a lot to the psychosocial support in disaster management in this country. NIMHANS being the nodal center for psychosocial support in disaster management has taken various initiatives to create resources in this field (NIMHANS). This is the only institute in India to offer a fellowship programme in psychosocial support in disaster management, the aim of this programme is to create trained human resources. Except this NIMHANS organizes various workshops on psychological first aid, preparedness programme, training and awareness programme on psychosocial support in disaster management. NIMHANS works with various state government agencies as well as non-governmental organizations and advocates for psychosocial support in disaster management. This institute also has published many print and electronic resources such as training modules, workbook, leaflet, brochure, poster etc. (NIMHANS, 2020). 

CONCLUSION

India has experienced many crisis situations in past and from that experience, it has developed various policies and systematic structures to early response and reconstruction effectively. Now India has changed its focus from crisis management to preparedness and reduce the risk. Earlier only focuses were given to providing physical health services to the survivors but with time mental health services were also getting attention.  Psychosocial support in disaster has become significant part of disaster interventions. Policies are taken at the national and regional levels to provide psychosocial support. 

REFERENCES

Chandra, V., Pandav, R., & Bhugra, D. (2006). Mental health and psychosocial support after the tsunami: observations across affected nations. International Review of Psychiatry, 18(3), 205-211. 

Galea, S., A. Nandi, and D. Vlahov. (2005). The Epidemiology of Post-Traumatic Stress Disorder After Disasters. Epidemiologic Reviews, 27 (1), 78–91.

Government of India. (2011). Disaster management in India. Ministry of Home Affairs, Government of India, New India. 

Ministry of Law and Justice, 2005, Disaster Management Act, 2005, Legislative Department, Government of India.

National Disaster Management Guidelines: Psycho-Social Support and Mental Health Services in Disasters, 2009. A publication of the National Disaster Management Authority, Government of India. ISBN 978-93-80440-00-2, December 2009, New Delhi.

NIMHANS. (2020). Centre for PSS in Disaster Management. Retrieved from National Institute of Mental Health and Nurosciences: https://nimhans.ac.in/centre-for-pss-in-disaster-management

Rao, K. (2006). Psychosocial support in disaster-affected communities. International Review of Psychiatry, 18(6), 501-505.

Sekar, K. (2005). Psychosocial Care in Disaster Management: Facilitation Manual for Trainers of Trainees in Natural Disoasters. NIMHANS, Bangalore.

World Health Organization (1992). Psychosocial Consequences of Disasters: Prevention and Management, World Health Organization, Division of Mental Health, Geneva, Switzerland.

Conflict of interest: None
Role of funding source: None