Emergencies and disasters can harm the health of people and communities in many ways. Often, the direct physical effects are readily seen, while the impacts on people's mental health and wellbeing may be less obvious and are sometimes hidden. Minimising the suffering of individual people, families and communities, and averting the risk of emotional and psychological injury are important parts of the response to any emergency.
This guidance makes recommendations that are relevant to all Category 1 responders and other organisations. It will be of particular interest to those involved in the wider Care for People response, including:
• Local authorities
• Health Boards, and
• Third sector organisations
A stepped care model is recommended, based on the principles of psychosocial care as exemplified by Psychological First Aid. This model recognises that people who are involved in serious incidents generally respond with great resilience. Although some degree of distress is common, it is usually temporary, and the majority of people do not require the support of mental health services.
The guidance recommends that all responders should be able to deliver Psychological First Aid and should be aware of the different ways in which people react psychosocially to emergencies. It also recommends that they should understand how to make referrals for the small minority of people who may need specialised mental health interventions.
Help with practical difficulties following emergencies and the opportunity to participate in the recovery phase can be of great importance to maintaining wellbeing. Therefore, psychosocial care is closely connected with other aspects of the response, particularly Care for People, Recovery and Public Communications strategies. This means that an integrated approach to planning and responding is essential.
The guidance makes recommendations for each stage of an emergency, and provides a framework for planning, training and service preparation. Its timeline is based on the principle that assistance may be required over an extended period.
The recommendations draw on Scottish, UK and international sources of expertise including work on behalf of the UK Government for the North Atlantic Treaty Organisation ( NATO) Joint Medical Committee and by the European Network for Traumatic Stress ( TENTS) programme. In particular, they are based on Guidance for Responding to the Psychosocial and Mental Health Needs of People Affected by Disasters or Major Incidents  .