5. Objectives of the training
To train stakeholders for adequately
addressing the PSS needs in Corona outbreak
To train trainers who are able to further
disseminate the PSS knowledge and skills to
frontline workers
To ensure that appropriate interventions are
implemented during psychosocial support and
stigma prevention
6.
7. Objectives of the training
To train stakeholders for adequately
addressing the PSS needs in Corona outbreak
To train trainers who are able to further
disseminate the PSS knowledge and skills to
frontline workers
To ensure that appropriate interventions are
implemented during psychosocial support and
stigma prevention
8. 1 Introduction of the Participants and
Resource Persons
Representative from Education
Department
5 Minutes
2 Session objectives and ground Rules Ms Sehr Qazalbas (UNICEF) 10 Minutes
3 Present personal experience of
COVID-19
Any member asked by the Moderator 5 Minutes
4 Concept of Psycho Social Support,
Stigma and Community Based
Intervention
M. Arshad Abbasi (Social Work-PU) 30 Minutes
5 Types and Effect of Stress on
Communities
Ms Khawar Sultana (Clinical Psychologist) 20 Minutes
6 Coping Strategies for Stress
Management
Ms Farzana Razi (Clinical Pyscholgis
Psychologist)
20 Minutes
7 Development of Action Plans
- M. Arshad Abbasi
- Ms Khawar Sultana
- Ms Farzana Razi
(10+10+10)
30 Minutes
8 Identification, Development and
Agreement on Reporting
Mechanism
9 Question Answer
Psychosocial Support and Stigma Prevention Training
Session Plan
10. Reasons of Panic
• First time in our History we are facing Such Pandemics (Worst in History)
• Lack of awareness about the Pandemics
• Unreliable information
• Rumors
• Mental Health
• Information
• Ignorance
(ILLITERACY)
11.
12. Why You Are Most Important?
• Because you are working at grass roots level
• You are mobilizing the communities, thus available with vast experience and
expertise in community mobilization which is considered the back of Community
Development process
• You have thousands of teachers in the community. They can play the role of
Counselor, can provide Psycho-Social Support to the most vulnerable segments of
the society i.e. illiterate & poor at the same time.
• Ensuring Literacy is your Goal and COVID-19 requires literacy on the part of these
vulnerable population about how they can protect themselves medically and
psychologically.
• Most importantly dealing with youngsters and female in your interventions
17. What is a crisis event?
A crisis event is a major event outside the range of
ordinary everyday experience that is extremely
threatening to those involved, accompanied by feelings
of powerlessness, horror or terror, e.g. deaths,
accidents, disasters, serious illness (Health epidemics
bring with them social and psychological
consequences that often undermine people’s ability
to carry on with their lives).
18. Characteristics and Implications of Crisis
• A rapid and serious deterioration in a situation
• Numerous victims or numerous people whose lives are in danger
• The unique nature and the extent of the crisis plunges the
population into a situation of great distress
• Substantial material destruction
• Institutional management undergoing great difficulty or incapable
of managing the situation.
19. What makes events critical?
When you will be delivering these training in physical
presence of the participants then conduct a Group
Work in pairs.
Discuss the following questions:
• Think how the Corona crisis can affect your community
• What are the characteristics of this event?
• What factors will make it a crisis situation?
• What factors increases the psychosocial impact of the event?
20. 1. Characteristics of the event
2. Crisis/post-crisis environment
3. Individual characteristics
4. Family and community resources
Factors influencing the psychosocial
impact of crisis events
21.
22. Factors influencing the psychosocial
impact of crisis events
1. Characteristics of the
event
– Natural versus man-
made
– Intentionality
– Degree of preventability
– Scope of impact
– Suffering
– Degree of expectedness
– Duration of the event
2. Crisis/post-crisis
environment
– Weather
– Accessibility to area
– Amount of physical
destruction
– Number of deaths
– Number of child
deaths
23. Factors influencing the psychosocial
impact of crisis events
3. Individual
characteristics
– Age - stage of life
– Mental health
– Social support systems
– Disabilities
– Social economic status
– Religion
– Disaster history
– Previous traumatic
experiences
– Education, IT
4. Family and
community
resources
– Weather
– Accessibility to area
– Amount of physical
destruction
– Number of deaths
– Number of child deaths
– Available support
systems
24. What is mental health and psychosocial
support (MHPSS)?
MHPSS is an approach to
enhance psychosocial well-being
of the community by preventing &
treating mental health conditions.
This includes preventive,
promotive, & curative MHPSS
services in the form of
specialized and non-specialized
services to the community.
.
It also extends to care and
support offered by external and
specialized psychological and
social services with the aim to
protect and promote emotional,
individual, and social
wellbeing.
MHPSS can be delivered in
specific programmes or be
integrated within other
activities
The common approach to PSS
is:
• A community based approach
to facilitate the resilience of the
affected population
• A way to mobilize the power of
humanity
• A means of maintaining health
and well-being of stakeholders
The preventive MHPSS
services include
psychological and social
interventions.
Promotive MHPSS
services include
psychological, and
social interventions
Curative MHPSS services
include psychological and
pharmacological services.
WHO and IASC guidelines suggest that
MHPSS services may be provided via
non-specialized mental health workers
who may include; teachers, health
workers, community members trained on
modules of MHPSS identification and
interventions.
25. The global humanitarian system uses the term MHPSS to
unite a broad range of actors responding to emergencies
such as the COVID-19 outbreak, including those working
with biological approaches and sociocultural
approaches in health, social, education and
community settings, as well as to ‘underline the
need for diverse, complementary approaches in
providing appropriate support’.
What is Mental Health & Psycho Social
Support MHPSS)?
26.
27. In recent decades, several trends have affected pandemic probability,
preparedness, and mitigation capacity. Various factors—population growth,
increasing urbanization, greater demand for animal protein, greater travel and
connectivity between population centers, habitat loss, climate change, and
increased interactions at the human-animal interface—affect the likelihood of
pandemic events by increasing either the probability of a spark event or the
potential spread of a pathogen (Tilman and Clark 2014; Tyler 2016; Zell 2004).
With global population estimated to reach 9.7 billion by 2050 and with travel
and trade steadily intensifying, public health systems will have less time to
detect and contain a pandemic before it spreads (Tyler 2016).
The increasing threat posed by antibiotic resistance also could amplify mortality
during pandemics of bacterial diseases such as tuberculosis and cholera and
even viral diseases (especially for influenza, in which a significant proportion of
deaths is often the result of bacterial pneumonia co infections) (Brundage and
Shanks 2008; Van Boeckel and others 2014).
Conspiracy Theory and COVID-19
ہے۔۔ ضروری جاننا یہ لیئے اس ہیں سے لٹریسی اور ایجوکیشن آپ کیونکہ
28. IMPACTS ON HUMAN LIFE
Pandemics can cause significant, widespread increases in morbidity and
mortality.
Pandemics can cause economic damage through multiple channels, including
short-term fiscal shocks and longer-term negative shocks to economic
growth.
Individual behavioral changes, such as fear-induced aversion to workplaces
and other public gathering places, are a primary cause of negative shocks
to economic growth during pandemics.
Some pandemic mitigation measures can cause significant social and
economic disruption.
In countries with weak institutions and legacies of
political instability, pandemics can increase political
stresses and tensions. In these contexts, outbreak
response measures such as quarantines have sparked
violence and tension between states and citizens.
29. During the early phase of the manifestation of
SARS, several psychiatric comorbidities such as
depression, panic attack, anxiety, psychomotor
excitement, suicidality, delirium, and psychotic
symptoms were reported۔
Past Evidences
30. Substantial evidence from the past studies of the
impact of SevereAcuteRS, MidEastRespSyndrome, influenza, and
EBOLA epidemics on the at-risk population, the
suffering individuals and healthcare providers
showed neuropsychiatric linkage.
Past Evidences
31.
32. • In any epidemic, it is common for individuals to feel stressed and
worried.
• Fear of falling ill and dying.
• Avoiding approaching health facilities due to fear of becoming
infected while in care.
• Fear of losing livelihoods, not being able to work during
isolation, and of being dismissed from work.
• Fear of being socially excluded/placed in quarantine because of
being associated with the disease (e.g. racism against persons who
are from, or perceived to be from, affected areas).
COMMON RESPONSES OF PEOPLE AFFECTED-1
33. • Feeling powerless in protecting loved ones and fear of losing loved ones
because of the virus.
• Refusal to care for unaccompanied or separated minors, people with
disabilities or the elderly due to fear of infection, because parents or
caregivers have been taken into quarantine.
• Health care workers may avoid reporting for duty out of fear of becoming
infected with COVID19, and health facilities may close.
• Feelings of helplessness, boredom, loneliness and depression due to being
isolated.
COMMON RESPONSES OF PEOPLE AFFECTED-2
34. COMMON RESPONSES OF PEOPLE AFFECTED-3
• Exposure to any severe stressor is a risk factor for a range of long-
term mental and psychosocial problems (including anxiety and
mood disorders as well as acute stress and grief reactions).
• Physical isolation of individuals, families or communities exposed to
the Corona virus (COVID-19) is a further risk for psychosocial
problems.
• Social problems may emerge after a population is exposed to the
virus and the COVID-19 response: for example, breakdown of
community support systems, and social stigma and discrimination
associated with COVID-19.
• There is likely to be a drastic decline of income generation within
communities due to travel and work restrictions, loss of family and
community members and the collapse of businesses.
35. • Furthermore, frontline workers (including nurses,
doctors, ambulance drivers, case identifiers, medical
social officer, pharmacists and others) may experience
additional stressors during the COVID-19 outbreak:
• Stigmatization towards those working with COVID-19 patients and their remains
• Strict biosecurity measures: - Physical strain of protective equipment - Physical
isolation making it difficult to provide comfort to someone who is sick or in distress -
Constant awareness and vigilance - Strict procedures to follow preventing
spontaneity and autonomy
• Higher demands in the work setting, including long work hours, increased
patient numbers and keeping up-to-date with best practices as information about
COVID-19 develops.
• Reduced capacity to use social support due to intense work schedules and stigma
within the community towards frontline workers
• Insufficient personal or capacity to implement basic self-care, especially among
people living with a disability
• Insufficient information about the long-term exposure to individuals infected by
COVID-19
• Fear that frontline workers will pass COVID-19 onto their friends and family as a
result of their work
36.
37. Constant fear, worry, uncertainties and stressors in the
population during the COVID-19 outbreak
• The constant fear, worry, uncertainties and stressors in the population during the
COVID-19 outbreak can lead to long-term consequences within communities,
families and vulnerable individuals:
• Deterioration of social networks, local dynamics and economies
• Stigma towards surviving patients resulting in rejection by communities
• Possible higher emotional state, anger and aggression against government
and frontline workers
• Possible anger and aggression against children, spouses, partners and family
members (increase of family and intimate partner violence)
• Possible mistrust of information provided by government and other
authorities
• People with developing or existing mental health and substance use disorders
experiencing relapses and other negative outcomes because they are avoiding
health facilities or unable to access their care providers.
38. Issues of Epidemics like COVID-19
• All too often, there is neglect of, or even resistance to, the
involvement of mental health professionals in a public health
response during an acute crisis.
• Likewise, health care workers may avoid reporting for duty
out of fear of becoming infected with COVID19, and health
facilities may close.
39. Why do people in crisis situations need MHPSS?
• People in crisis situations often have to cope with experiences
that may have a deep and lasting emotional, mental and social
impact.
• Prolonged uncertainty, insecurity, fear, despair and powerlessness;
• Disruption of everyday social contacts and routines;
• Exposure to acute, life-threatening and frightening situations;
• Severe injuries, illnesses or physical disabilities;
• social stigma; mutual distrust and hostility because of ethnic origin or
mental state, or suspicion of carrying disease;
• Humiliation, captivity or slavery;
• Isolation, discrimination, exclusion or displacement;
• Separation from caregivers or loved ones;
• Gender-based violence;
40. Why provide psychosocial support?
• Mental health and psychosocial support staff (LIKE MSOs,
Psychiatric Social Workers, Psychologists) have key
skills that may be critical during an outbreak, such as
experience of working with angry, violent or resistant
individuals and communities and helping health staff to
cope.
• They may provide useful support to other health staff in
dealing with such problems.
• An essential part of preparing for a public health
response is affirming beforehand the essential role of
mental health and psychosocial support expertise
throughout the emergency.
41.
42. Why psychosocial support is important?
• When faced with an emergency, community members may
show great altruism/humanity and cooperation, and people
may experience great satisfaction from helping others.
• Support offered to such groups are targeted and integrated
into community-wide interventions to avoid reinforcing
stigma.
• Mobilizing early and adequate psychosocial support can
prevent distress and sufferings from developing into
something more severe.
• Psychosocial support helps people develop resources for
managing their distress thus protect them from mental
health issues and strengthens their resilience.
44. Something about Corona…
Group yourselves into 4 groups; give a
short presentation about the
following questions:
• What is Cornoa? How is it transmitted?
• What are some of the rumours related
to Corona?
• What are some of the people’s
reactions and behaviour related to
Corona outbreak?
• What can we do to protect ourselves
from getting Corona?
45. Example of Stigma
A study detailing the psychological trauma
of bereaved families and victims of MERS
states that a family affected by the
infection claimed that the general public
avoided them, and were socially isolated
even after being treated and declared free
of the disease.
46.
47. Stigma related to Corona
• Stigma occurs when people negatively
associate an infectious disease, such as
COVID-19, with a specific population.
• In the case of COVID-19, there are an
increasing number of reports of public
stigmatization against people from
areas affected by the epidemic.
• Unfortunately, this means that people
are being labelled, stereotyped,
separated, and/or experience loss of
status and discrimination because of a
potential negative affiliation with the
disease.
48. CAUSES OF STIGMA
• Ignorance/misconceptions – misperceptions about the cause or
onset of the disease as a curse from the gods, punishment for one’s
sins, witchcraft, black magic, demonic, spirit possession, etc.
• Cultural factors/belief system – this about the myth and are
misunderstanding.
• Media – Stigma in the media is especially harmful because the
media plays an important role in shaping and reinforcing community
attitudes, i.e., spreading wrong information.
• For example, cinematic depictions of schizophrenia are often
stereotypic and characterized by misinformation about symptoms,
causes and treatment. Schizophrenic characters portray violence
behaviour, carry dangerous act, and commit suicidal and homicidal
behaviours.
• Lack of information systems–lack of education to both
professionals and to the general public.
49. Effects of Stigma related to Corona
Stigma can:
• Drive people to hide the illness
to avoid discrimination
• Prevent people from seeking
health care immediately
• Discourage them from adopting
healthy behaviors
• Induce psychological distress
and cause behavioral
dysfunction
50. Tips on possible actions to counter stigmatizing
attitudes:
Spreading the facts: Stigma can be heightened by insufficient
knowledge about how the new coronavirus disease (COVID-19)
is transmitted and treated, and how to prevent infection.
Engaging social influencers such as religious leaders on
prompting reflection about people who are stigmatized and how
to support them, or respected celebrities to amplify messages
that reduce stigma.
Amplify the voices, stories and images of local people who
have experienced COVID-19 and have recovered or who have
supported a loved one through recovery to emphasize that most
people do recover from COVID-19.
51.
52. DOS and DON'TS
DO Don’t
talk about the new coronavirus disease
(COVID-19)
attach locations or ethnicity to the
disease, this is not a “Wuhan Virus”,
“Chinese Virus” or “Asian Virus”. The
official name for the disease was
deliberately chosen to avoid
stigmatisation - the “co” stands for
Corona, “vi” for virus and “d” for
disease, 19 is because the disease
emerged in 2019.
53. DOS and DON'TS
DO Don’t
talk about “people who have COVID-19”,
“people who are being treated for COVID-
19” “people who are recovering from
COVID-19” or “people who died after
contracting COVID19”
• refer to people with the disease as
“COVID-19 cases” or “victims”
“people who may have COVID-19 or
“people who are presumptive for COVID-
19”
• talk about “COVID-19 suspects” or
“suspected cases”.
talk about people “acquiring” or
“contracting” COVID-19
• talk about people “transmitting COVID-
19” “infecting others” or “spreading the
virus”
speak accurately about the risk from
COVID-19, based on scientific data and
latest official health advice.
• repeat or share unconfirmed rumours,
and avoid using hyperbolic language
designed to generate fear like “plague”,
“apocalypse” etc.
talk positively and emphasise the
effectiveness of prevention and treatment
measures.
• emphasise or dwell on the negative, or
messages of threat. We need to work
together to help keep those who are
most vulnerable safe.
54. DOS and DON'TS
DO
Emphasize the effectiveness of adopting
protective measures to prevent acquiring the
new coronavirus, as well as early screening,
testing and treatment.
55. Stigma related to Corona
Make sure you portray different ethnic
groups. Materials should show diverse
communities that are being affected, and show
communities working together to prevent the
spread of COVID-19.
Balanced reporting. Media reporting should be
balanced and contextualized, disseminating
evidence-based information and helping combat
rumor and misinformation that could lead to
stigmatization.
Link up. There are a number of initiatives to address stigma
and stereotyping. It is key to link up to these activities to create
a movement and a positive environment that shows care and
empathy for all.
56.
57. O, Professionals: You have an Important Role to Play.
Do Your Part
in preventing and stopping stigma surrounding people have acquired COVID-19
1. Spreading the facts. Use Social Media
2. Engaging social influencers
3. Amplify the voices
4. implementing a “hero” campaign
5. Make sure you portray different ethnic groups.
6. Ethical journalism (For example, in Panic on the Streets (1950, directed by Elia Kazan), to avoid
mass panic across the city of New Orleans, the US Public Health Service and the police agree to not
notify the press of a death resulting from pneumonic plague.)
7. Link up
8. Communicate about COVID-19 with your staff.
9. Communicate about COVID-19 with your patients.
10. Screen patients and visitors for symptoms of acute respiratory illness (e.g.,
fever, cough, difficulty breathing) before entering your healthcare facility.
11. Ensure proper use of personal protection equipment (PPE)
12. Encourage sick employees to stay home.
13. Separate patients with respiratory symptoms so they are not waiting
among other patients seeking care.
58. • Take breaks from watching, reading, or listening to news stories, including
social media. Hearing about the pandemic repeatedly can be upsetting.
• Take care of your body. Take deep breaths, stretch, or meditate. Try to eat
healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid
alcohol and drug.
• Make time to unwind, go slow and relax.
• Try to do some other activities you enjoy.
• Connect with others. Talk with people you trust about your concerns and how
you are feeling.
Personal Care: Things you can do to support yourself
59. For responders
• Responding to COVID-19 can take an emotional toll on you. There are things you
can do to reduce secondary traumatic stress (STS) reactions:
• Acknowledge that STS can impact anyone helping families after a traumatic
event.
• Learn the symptoms including physical (fatigue, illness) and mental (fear,
withdrawal, guilt).
• Allow time for you and your family to recover from responding to the pandemic.
• Create a menu of personal self-care activities that you enjoy, such as spending
time with friends and family, exercising, or reading a book.
• Take a break from media coverage of COVID-19.
• Ask for help if you feel overwhelmed or concerned that COVID-19 is affecting
your ability to care for your family and patients as you did before the outbreak.
60. For people who have been released from quarantine
Being separated from others if a healthcare provider thinks you may have been
exposed to COVID-19 can be stressful, even if you do not get sick. Everyone feels
differently after coming out of quarantine. Some feelings include :
• Mixed emotions, including relief after quarantine
• Fear and worry about your own health and the health of your loved ones
• Stress from the experience of monitoring yourself or being monitored by others
for signs and symptoms of COVID-19
• Sadness, anger, or frustration because friends or loved ones have unfounded
fears of contracting the disease from contact with you, even though you have
been determined not to be contagious
• Guilt about not being able to perform normal work or parenting duties during
quarantine
• Other emotional or mental health changes
• Children may also feel upset or have other strong emotions if they, or someone
they know, has been released from quarantine. You can help your child cope.
61.
62. Factors that Influence the Emotional Impact on
Children in Emergencies
The emotional impact of an emergency on a child depends on a child’s
characteristics and experiences, the social and economic circumstances of the
family and community, and the availability of local resources. Not all children
respond in the same ways. Some might have more severe, longer-lasting
reactions. The following specific factors may affect a child’s emotional response:
• Direct involvement with the emergency
• Previous traumatic or stressful event
• Belief that the child or a loved one may die
• Loss of a family member, close friend, or pet
• Separation from caregivers
• Physical injury
• How parents and caregivers respond
• Family resources
• Relationships and communication among family members
• Repeated exposure to mass media coverage of the emergency and aftermath
• Ongoing stress due to the change in familiar routines and living conditions
• Cultural differences
• Community resilience
63. There are many things you can do to support your child
• Take time to talk with your child or teen about the COVID-19 outbreak. Answer
questions and share facts about COVID-19 in a way that your child or teen can
understand.
• Reassure your child or teen that they are safe. Let them know it is ok if they feel
upset. Share with them how you deal with your own stress so that they can learn
how to cope from you.
• Limit your family’s exposure to news coverage of the event, including social media.
Children may misinterpret what they hear and can be frightened about something
they do not understand.
• Try to keep up with regular routines. If schools are closed, create a schedule for
learning activities and relaxing or fun activities.
• Be a role model. Take breaks, get plenty of sleep, exercise, and eat well. Connect
with your friends and family members.
