With the hindsight of Paddington and other major incidents, this articlehighlights key psychosocial issues arsing for those responding to disasters, byDr Anne Eyre and Mary Jacob Oh no, not again! Was the reaction of many involved in the Southall railcrash who, within the first weeks of the inquiry, heard the first news reportsof the fatal rail crash at Ladbroke Grove, outside Paddington. “Oh no, notagain!” we all uttered after the Hatfield crash, coming as it did in thewake of the first anniversary of Paddington. These events and reactions to them remind us of the importance of thinkingabout disasters in terms of a whole cycle of events from planning (pre-event)through to learning and applying lessons (post-event), rather than justfocusing on the impact stage and the immediate aftermath. Good disastermanagement involves responding to all phases of this disaster cycle: in termsof planning, responding, reviewing, evaluating and improving preparedness. Thisfundamental principle became abundantly clear to those who managed theoccupational health response to the Paddington disaster within the MetropolitanPolice with hindsight afforded by recent rail disasters. Human aspects lag behind Many organisations prepare for disasters in predominantly technical andoperational terms, focusing, for example, on business recovery in relation toIT systems and the operational management of a disaster. Planning andresponding to the human aspects in the event of a major incident or disasteroften lag behind this emphasis on the physical and technical dimensions of theworkplace, even when organisations recognise in principle that their humanresources are their most important asset. Part of the reason for this is ourassumption that “it won’t happen here” which explains why one of themost common reactions of those first hearing of an incident involving theirstaff is shock and disbelief. At such times of initial chaos and confusion theneed for clear, appropriate and workable disaster plans and staff support ismost fundamental, particularly as the OH department of an organisation will beexpected to play an important role in staff support. The first response of OH managers hearing news of the Paddington disasterwas to consider the best way of providing additional proactive support to linemanagers in charge of the practical response and, through them, to thoseofficers working directly at the disaster site. Applying the lessons learnt fromthe Southall disaster, where frontline support had been less obvious, theimportance of facilitating and being seen to provide up-front support from thestart was recognised. The Metropolitan Police Directorate of Occupational Health received dozensof requests for advice and support in the first few hours and days from avariety of sources and levels within the organisation. They ranged fromindividual officers and stations with direct involvement in the major incidentresponse, to co-ordinators of specialist teams, personnel managers and senioroperational and strategic commanders. The fact that all levels of staff wereasking for help highlighted the increasing awareness of the psychosocialeffects of responding to disasters within the police service and theacknowledgement of the role of occupational health in meeting the needs ofdisaster teams. Physical presence important A further lesson learnt and applied since the Southall disaster is the needfor OH personnel to be physically present providing support and consultationalongside operational managers in the immediate aftermath. Although thisincluded providing psychological debriefing services, their role was muchbroader than that: any managers working under the intense and extraordinarypressure of responding to a major incident need extra support in makingdecisions that will impact on both their own and others’ health, safety andwell-being. At Paddington this included decisions about staff deployment,length of hours worked and operational debriefing. Because the review ofSouthall had highlighted the importance of high-profile, proactive and visiblepresence of staff support services, occupational health staff were deployed topolice stations at Paddington and Notting Hill to support and adviseoperational managers. Other occupational health departments should learn from this and build intotheir own disaster contingency plans provisions for proactive psychosocialsupport of all staff coping in the aftermath of a crisis. Addressing the needs of staff and the public For the Metropolitan Police, responding to disaster entails addressing theneeds of their own staff as well as the public. Responding to major incidentsis both rare and different to ordinary police work and hence both the support providedand level of need are much greater than usual. According to an editorial inPolice Review (19.November 1999), “Dealing with Paddington was aboutordinary men and women being called upon to perform extraordinary tasks”.As the calls for extra assistance came in during the first few days, withindications that up to 1,000 staff might need debriefing, it became clear thatexisting resources would be stretched. As well as meeting the needs of disasterworkers, the Directorate was still expected to provide its usual trauma supportand emergency counselling service. In meeting the needs arising from the disaster it was decided that allnon-urgent work be suspended. This is a difficult decision for any organisationto make in the aftermath of a crisis since it is one that is likely to have animpact on all staff, not just those directly involved in an incident and itsresponse. One of the lessons to take away from this is the need fororganisations to consider at the planning stage how they will meet not only theextra needs arising from the disaster itself, but also their ongoing routinework, particularly if the demands on support staff will continue for someconsiderable time. A varied and flexible approach to help It soon became apparent that the nature of the help required by staffresponding to Paddington would need to be varied and flexible, particularlysince the personnel involved in the response were carrying out verywide-ranging tasks within varying departments and at different levels. In keepingwith contemporary thinking, psychological debriefing was made available butadapted to the particular demands thrown up by this incident and accompanied byother forms of support too. Information about the psychological and physical impacts of trauma wasdistributed to officers at the end of their shifts with group debriefingsoffered after their involvement in the disaster had ended rather than simply 72hours after the incident. Flexibility here also meant responding to the factthat the teams that worked together at the disaster site were invariablydifferent to usual team structures. Most teams felt strongly that they wantedand needed to be debriefed as a team rather than separately through their owndepartments. This also meant that debriefings took place in larger groups thannormal. Oursourcing as a solution Many organisations plan to outsource psychological debriefings in the eventof major incidents. The involvement of outsiders may have both advantages anddisadvantages. The Metropolitan Police’s Directorate of Occupational Health felt itimportant not only to provide support itself (with some crucial support fromcolleagues in county forces) but also to increase its own understanding of keyrelevant operational issues likely to arise. Drawing on its previous experiences of debriefing members of the specialistBody Recovery and Identification Teams, it therefore attended operationaldebriefs prior to conducting psychological ones. A key issue to consider hereis the value attached to debriefers’ knowledge and understanding of both theoperational and cultural issues involved within the organisational context of adisaster, its management and its impact. Evidence-based practice Debates about the nature, timing and effectiveness of psychologicaldebriefing after disasters remain contentious, and there is a common call forevidence-based practice in this field. The Metropolitan Police is activelyreviewing and evaluating its own occupational health services provided afterthis disaster through commissioned research. This is being conducted currentlyby the University of Northumbria. It is also conducting its own internalreview. This has so far flagged up the importance of considering disasterplanning beyond the single organisation’s response and capabilities. Disasters are increasingly likely to have an impact beyond singleorganisations and communities as both recent rail accidents, flooding and othercrises have shown. In societies such as the United States the idea ofdeveloping disaster-resistant communities has extended disaster planning beyondsingle organisations to much broader inter-organisational and cross-borderlevels. This may well be the logical conclusion for disaster planning inBritain in future, but organisations need firstly to ensure their own internalplans are up-to-date and effective. For any organisation, good disaster planning should embrace bothtechnical/physical and psychosocial aspects. Plans for staff support should besimple, adaptable and easily accessible so that they are understood andappreciated by all members of the organisation. More fundamentally, trainingand awareness of the impact of sudden death, particularly on a mass scale, andof the nature and role of occupational health services in supporting staff inthe event of disasters needs to be provided more extensively than it is atpresent. With the benefit of hindsight, those organisations that have experienceddisasters and their aftermath are among the most active supporters of this. Inan age when we are witnessing more graphically than ever the devastatingeffects of disaster alongside growing appreciation of the rights andresponsibilities of those caught up in them, organisations can no longer affordonly to be wise after the event. It is not only trains that can go off the rails: planning for and respondingto the health and safety of personnel both before and after disasters must bean important priority. Dr Anne Eyre is a specialist in disaster management and Mary Jacob is amanager directly involved in the Metropolitan Police’s Occupational HealthService. They share a special interest in learning and applying the lessons tobe learnt from analysing the psychosocial issues arising for staff andorganisations responding to disasters. Related posts:No related photos. Comments are closed. Previous Article Next Article Going off the railsOn 1 Mar 2001 in Personnel Today
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