Mental Health,

Psychosocial Support
Services and
Psychological First Aid
President Quirino Treasured Child
School Inc.
August 17, 2020
 k a
t a
s id?
m u t
Ka kap a
na

PSYCHE

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MENTAL HEALTH
Mental Health refers to a state of
well being in which the individual:
• realizes one’s own abilities and
potentials
• copes adequately with the normal
stresses of life

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MENTAL HEALTH
Mental Health refers to a state of well
being in which the individual:
• displays resilience in the face of
extreme life events,
• works productively and fruitfully, and
• is able to make a positive contribution
to the community.

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IMPACT OF COVID-19 IN
OUR MENTAL HEALTH?

•STRESS
•ANXIET
YWHO (World Health Organization) 2020

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EMOTIONAL
CHALLENGES
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STRESS

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Stress- is a biological and psychological response
experienced on encountering a threat that we feel we
do not have the resources to deal with.

A stressor is the stimulus (or threat) that causes stress,

e.g. exam, divorce, contraction of Covid-19, death of
loved one, loss of job.

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Sudden and severe stress generally produces:
 Increase in heart rate
 Increase in breathing (bronchodilate)
 Decrease in digestive activity (do not feel hungry)
 Liver released glucose for energy (glycogenolyss)

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 Research suggests that the part of the brain called the
limbic system is hyperactive during times of negative
emotions and stress, explained Lily Brown, PhD, an
assistant professor of Psychology in Psychiatry at the
Perelman School of Medicine and director at the Center
for the Treatment and Study of Anxiety.
The limbic system acts as a control center for feelings and
reactions. For example, the well-known fight or flight
response begins in the limbic system, triggering feelings
of anxiety and fear.

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18
 “
STRESS CAN BE EXPLAINED
SCIENTIFICALLY.
BLAME YOUR
HYPOTHALAMUS!

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ANXIETY

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 Uncertainty and Anticipation Model of
Anxiety (Grupe & Nitschke , 2013)
• Exaggerated estimate of threat:
Resulting in overly pessimistic expectations.

• Hypervigilance of threat:
Not only are almost any stimulus seen as a danger
but attention for threatening stimuli increases.

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 Uncertainty and Anticipation Model of
Anxiety (Grupe & Nitschke , 2013)
• Deficient appreciation of safety:
You have difficulty recognizing safe
environmental cues.

• Behavioral and cognitive avoidance:

To reduce the fear, a defense mechanism is
developed. 22
 Uncertainty and Anticipation Model of
Anxiety (Grupe & Nitschke , 2013)

• Heightened reactivity to threat: The

greater the uncertainty, the greater the
physiological response is to the threat.

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Uncertainty and Anticipation Model of
Anxiety (Grupe & Nitschke , 2013)

Dynamic interactions among these five

key psychological processes allow for
anticipatory responses to uncertainty
about future threat.

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DEPRESSION

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DEPRES
SION

1.HOPELESSNESS

2.HELPLESSNESS
 “
When you’re suffering from depression, life can seem
overwhelmingly bleak and hopeless. It can interfere
with your ability to think straight, drain your energy,
and make it difficult to get through the day. Even as
some countries and regions begin to ease stay-at-
home restrictions, it seems unlikely that life will fully
return to normal any time soon.

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How COVID-19 affects Depression
1. Isolation and loneliness fuels
depression. Human beings are social creatures.
Being cut off from the love, support, and close
contact of family and friends can trigger
depression or make existing symptoms worse.
Months of social distancing and sheltering at
home can leave you feeling isolated and lonely,
having to face your problems alone.
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How COVID-19 affects Depression

2. A troubled relationship may be even worse

than loneliness. While strong and supportive
relationships are crucial for your mental
wellbeing, being forced to spend months
quarantined in a troubled, unhappy, or abusive
relationship can be even more damaging to your
mood than being alone.
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How COVID-19 affects Depression

3. Anxiety can lead to depression. All the fear

and uncertainty surrounding COVID-19 means
it’s natural to worry. When your worries spiral
out of control, though, they can cause panic and
anxiety. Since anxiety and depression are
believed to stem from the same biological
vulnerability, one can often lead to the other.
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How COVID-19 affects Depression

4. Stress levels are soaring. Experiencing a

major change in your life, such the death of a
loved one, the loss of a job, being diagnose of a
serious illness, or financial or relationship
difficulties, can bring overwhelming levels of
stress.

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How COVID-19 affects Depression
5. We’re turning to unhealthy ways of coping. The
boredom, loneliness and stress of being in
lockdown, struggling financially, or having to juggle a
job and home school your kids, can prompt unhealthy
ways of coping. Maybe you’re drinking too much,
abusing drugs, or overeating junk food in an attempt to
self-medicate your mood and deal with stress. While
these methods may provide a brief respite, in the long-run
they’ll make your depression symptoms much worse.
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SUICIDE

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 The media has
reported on several
heart-wrenching
suicides believed to
be linked to the toll
COVID-19 is taking
on individuals.
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BOREDOM

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Our reactions have revealed we don’t really
understand boredom. Top 10 (and in one instance top
150!) "things to do when bored" lists are popping up
on the internet. But, as the restless child pleading for a
fix to their boredom knows, telling a bored person to
take up a hobby is like telling a drowning person to
swim to shore. If they could, they would. Boredom
signals a deeper problem, and requires a more
thoughtful response.
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ROLE OF
EDUCATIONAL
INSTITUTIONS

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Mental Health and Psychosocial
Support is used to describe a range
of activities that aims to
protect/promote psychosocial well-
being of individuals and
communities in their affected
environment and/or prevent or treat
mental disorder.

-DepEd Order No. 14 s. 2020

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1. Promote mental health

2. Provide basic support services for individuals at risk

or already have a mental health condition

3. Establish efficient linkages with other agencies and

organizations that provide or make arrangements to
provide support, treatment and continuing care.
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Employers shall develop appropriate
policies and programs on mental health
in the workplace designed to:

• raise awareness on mental health issues,

• correct the stigma and discrimination associated with
mental health conditions,
• identify and provide support for individuals at risk, and
• facilitate access of individuals with mental health
conditions to treatment and psychosocial support.
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PSYCHOSOCIAL
SUPPORTS
NORMAL ADAPTATIONS
AND COPING RESPONSES
1. seeking help from others or offering help to others

2. talking about their experiences and trying to make

sense of what happened
3. trying to stay safe until the danger has passed, and

4. seeking information about the welfare of their loved ones.

They may “fight” to survive, “take flight”, or “freeze”, but go on
to adapt.

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Psychosocial support is essential for maintaining good
physical and mental health and provides an important
coping mechanism for people during difficult times.

Psychosocial interventions constitute the backbone of any

MHPSS response and include a range of social activities
designed to foster psychological improvement, such as
sharing experiences, fostering social support, awareness-
raising and psychoeducation.
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OTHER COMMON GENERAL
REACTIONS

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EMOTIONAL

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COGNITIVE

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 DIFFICULTY
CONCENTRATING

WORRY

PREOCCUPIED

DECISION
MAKING
DIFFICULTY
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SOCIAL

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 CONFLICT

SOCIAL
WITHDRAWAL

RELATIONSHIP
PROBLEMS

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Common Reactions in
the Young Age Group

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PSYCHOLOGICA
L
FIRST-AID (PFA)

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Psychological First Aid
(PFA) describes a
humane, supportive
response to a fellow
human being who is
suffering and who may
need support (Sphere,
2011 and IASC, 2007).
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PFA involves the following themes:

• providing practical care and support, which does not

intrude;
• assessing needs and concerns;
• helping people to address basic needs (for example, food
and water, information);
• listening to people, but not pressuring them to talk;
• helping them to feel calm;
• helping people connect to information, services and social
supports;
• protecting people from further harm. 55
PFA aims to provide psychosocial support reflecting
aims similar to those of Physical First Aid – to assist
people in the emergency / disaster situation to
survive, to minimize psychological injury and to
facilitate recovery.

It is a method of helping people in distress so they

feel calm and supported to cope better with their
challenges. It is a way of assisting someone to
manage their situation and make informed decisions.
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 The basis of psychological first aid is caring about
the person in distress and showing empathy. It
involves paying attention to reactions, active
listening and, if needed, practical assistance, such as
problem solving, help to access basic needs or
referring to further options for assistance. PFA helps
normalize worry and other emotions and also
promotes healthy coping and provides feelings of
safety, calming, and hope.

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 WHAT
PFA IS
NOT?
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• It is not something that only professionals can do.

• It is not professional counseling.

• It is not “psychological debriefing” in that PFA does

not necessarily involve a detailed discussion of the event
that caused the distress. 59
• It is not asking someone to analyze what happened to
them or to put time and events in order.

• Although PFA involves being available to listen to

people’s stories, it is not about pressuring people to tell
you their feelings and reactions to an event. 60
CORE ACTION LOOK
PRINCIPLES
(3L) LISTE
N
LINK
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 O K
L O
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refers to how to assess:

• safety,
•find those with priority needs, or
serious distress
•the current situation
• who seeks support
• what the risks are
•the needs of the affected
• expected emotional reactions
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 DISTRESS REACTIONS TO CRISIS
• Physical symptoms: shaking, headaches, fatigue, loss of
appetite, aches and pains
• Anxiety, fear
• Weeping, grief and sadness
• Guilt, shame (for having survived, or for not saving others)
• Elation for having survived
• Being on guard, jumpy
• Anger, irritability

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 DISTRESS REACTIONS TO CRISIS
• Being immobile, withdrawn
• Disorientation: not knowing one’s name, where one is from
or what happened
• Inability to speak, or to respond to others
• Confusion, emotionally numbness, being in a daze or state
of disbelief
• Inability to care for oneself or one’s children (not eating or
drinking, or able to make simple decisions)
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 LOOKING REMOTELY
Some Considerations:
• Social Media posts
• Social exclusion or no longer responds to
correspondences (emails, calls, messages, etc.)
• Low work productivity (poor work output, does not
submit on time, does not attend meetings, etc.)

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 T E N
L I S
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refers to how to:

to those who need support, to their

concerns, help them to feel calm.

• Listen with Eyes (full attention),

• Ears (truly hearing the worries of those
affected), and
• Heart (with genuineness and respect)
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refers to how to:

• begin the conversation

• introduce the helper
• pay attention and listen actively
• accept feelings
• calming someone in distress
• ask about needs and concerns
• help find solutions to needs and
problems
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 ACTIVE LISTENING

A way of listening and responding to another person that

improves mutual understanding. A structured form of
listening and responding that focuses the attention on
the speaker

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 IN K
L
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refers to how to assist with:

people to basic needs and services, to information,

to their loved ones, to further support

• accessing information
• connecting with loved ones and social support
• tackling practical problems
• accessing services and other help.
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 CONSIDERATIONS
Refer to specialized help if a caller:

• has not been able to sleep for the last week and is confused and
disorientated
• is so distressed that they are unable to function normally and care
for themselves or their children by, for example, not eating or
keeping clean
• loses control over their behavior and behaves in an unpredictable
or destructive manner
• threatens harm to themselves or others

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 CONSIDERATIONS
Refer to specialized help if a caller:

• starts excessive and out-of-the-ordinary use of drugs or alcohol

• are living with a psychological disorder and/or were taking
medication prior to the situation of distress may also need
continued mental health support.
• presents chronic health conditions and need more supports.
• presents symptoms of severe mental health conditions
• is experiencing violence or is being sexually abused in any way.

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LINK

Give information.
Ask what they know and
believe about the problem and
where and how they get
updated information.

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LINK
Connect to Social
Support.
Ask how they stay in touch
with their loved ones, friends;
access their religious practices,
family rituals, etc.
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 LINK

Refer.
Ask if there any practical problem
or challenges. Refer to other
services, if needed.

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 LINK
End the conversation.

Summarize the conversation by

highlighting key issues discussed and
the action points identified. Agree on
a follow up if possible and end the
call by thanking for the
conversation.
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79
THINGS TO SAY AND DO
Try to find a quiet Let them know you Provide factual information
hear them, for example, IF you have it. Be honest
place to talk and about what you know and
minimize outside nod your head and
what you don’t know. “I
say… “hmmmm.”
distractions. don’t know but I will try to
find out about that for you.”

Stay near the person Give information in

but keep an
Be patient and
a way the person can
appropriate distance calm. understand – keep it
depending on their age,
simple.
gender and culture.

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THINGS TO SAY AND DO
Acknowledge how Respect privacy. Acknowledge
they are feeling, Keep the
and any losses or person’s story
the person’s
important events confidential, strengths and
they share with
you, such as loss of
especially when how they have
home or death of a
the disclose very helped
loved one. “I’m so private events.
themselves.
sorry…”

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THINGS NOT TO SAY AND DO
Don’t pressure Don’t interrupt or Don’t give your
someone to tell rush someone’s opinions of the
story. person’s situation,
their story. just listen.

Don’t touch the Don’t judge what Don’t say… ”You

person if you’re not they have or shouldn't feel that
sure it is appropriate haven’t done, or way.” or “You
to do so. should feel lucky you
how they are
survived.”
feeling.
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THINGS NOT TO SAY AND DO
Don’t make up Don’t use too Don’t tell
things you technical them someone
don’t know.
terms. else’s story.
Don’t talk Don’t give false Don’t feel you have
to try to solve all
about your promises or
the person’s
false
own troubles. problems for them.
reassurances.
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 CONSIDERATIONS FOR REMOTE PFA
1. Empathy and warmth.
2. Attention and affirmation:
3. Acceptance
4. Safety
5. Asking the right questions.
6. Be aware that its normal to react with anger,
frustration or confusion when experiencing adversity.

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 LOOK
CORE ACTION
PRINCIPLES LISTE
N
LINK
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Who are the
Vulnerable
and
Needs Special
Help?
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 1. Children, including adolescents.
2. People with health conditions or
disabilities.
3. People at risk of discrimination or
violence.

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PROFESSIONAL
BEHAVIOR IN
DELIVERING PFA
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 Operate Model Be
only within
healthy visible
the
responses Maintain
framework and confidentiality
of an : calm,
authorized courteous availabl
disaster , e
response
organized
system
, helpful

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 Remain Be Pay
within the knowledg attention
scope of Make eable and to your
your appropriate own
expertise
sensitive
referrals emotional
and (culture
designated and and
role diversity) physical
reactions

Practice self-care
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SELF-
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WAYS TO TAKE CARE YOUR MENTAL
HEALTH AS A HELPER:
Think about what has helped you cope in the past and what you can do to stay
strong.
Try to take time to eat, rest and relax, even for short periods.
Try to keep reasonable working hours so you do not become too exhausted.
Remember, you are not a SUPERMAN nor a WONDERWOMAN.
Minimize your intake of alcohol, caffeine or nicotine and avoid nonprescription
drugs.
Check in with fellow helpers to see how they are doing, and have them check in
with you.

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93
MEKENI-LIKHA THERAPY
Mekeni is a kapampangan term that means
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“come” and likha as to create
 LAMBING

HAPLOS
LamBiLos Therapy

BIRO 95
8H THERAPY

HUGS HALIK IN THE

AIR
HELLO HALAKHAK

HAPPY HAPLOS HOPE HUMOR

EXPRESSION
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SALDET-
SAET One of the strengths
THERAPY of the Filipino
character is hard
Means: “diligent move”
work and industrious.

-(Movement for Moral

Recovery Program,
1988

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 4F THERAPY

FOOD SHARING FAMILY SUPPORT

FINANCIAL SUPPORT

FAITH
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 MUSIC
AND
DANCE
THERAPY
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EXERCISE

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REFERENCES:
• Prof. Dr. Adelaida C. Gines, RGC, RPsy (2020) - Best Fit Pratices in the
COVID-19 contagion: A Transition To a New Normal

• Francis Ray Subong, MEd, RGC, LPT (2020) - Discovering Guidance and
Counseling Services in the New Normal

• Julian Montano, PhD (2020) - Living Through a Time of Crisis

• Teodulo Pamintuan-Gonzales, SJ PhD (2020) - Resiliency in the New

Normal

• Leticia Peñano-Ho, PhD (2020) - Helping the Helpers: Caring for Yourself
While Helping Others

• Teodulo P. Gonzales, S.J (2020) - Masters' Lessons in the Field of

Counseling/Therapy

• Francis Ray D. Subong, RGC, LPT (2020) - Helping Others through

Psychological First Aid

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 KEEP YOUR
MENTAL STATE
HEALTHY AT
ALL TIMES!
BE PROUD OF
YOUR
BEAUTIFUL
SCARS!
#WeCanHealAsOne
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