Longer-term Support for Survivor and Bereaved after Disaster
Disaster Action is a charity whose members are survivors and bereaved from UK and overseas disasters. One of our aims is to raise awareness of the needs of those directly affected by disaster amongst emergency planners and responders. The following leaflet has been written for responders and is based on our collective experience of 28 disasters.
People’s response to a disaster depends on the individual. There are some whose need for support (from others affected and/or from support services) is primarily or even exclusively in the immediate aftermath. For others, this need may arise some time after the event (six months, a year or even considerably longer) when the impact on their lives is such that they may turn to external support, or to others directly affected.
It should be borne in mind that those affected by less high profile and/or smaller incidents have felt that their needs are less well recognised and catered for than those affected by larger scale disasters.
In terms of organised services, any transition from full-time provision to part time and then the closure of a service should be managed with considerable care. Good and sensitive communication is vital and consulting users on what they would wish for, and when, may also be valuable. Any such consultation process must have real substance, however.
In previous disasters, maintaining contact with a key worker through a telephone support service, after the closure of a drop-in centre (such as provided by Camden following the 1987 King’s Cross underground fire) has been of considerable value. This service remained in place for three years after King’s Cross so that those affected could continue to discuss issues of importance to them and receive information and signposting to other services (see below).
Our comments should be read in terms of a general need for services, within which there may be a centre such as the 7 July Assistance Centre, which developed following the closure of the Family Assistance Centre in London in August 2005, but not exclusively so.
Disaster Action promotes a needs-driven, user-led approach to organised service provision. This is not a substitute for self-support but an addition to it. The ideal is to enable people to help themselves, while facilitating access to ongoing practical/medical/financial/legal help for survivors and bereaved, including those whose disaster-related needs may not become apparent until some time after the disaster. This could include, for example, longer-term health consequences or support needs that may arise out of life-changing physical injury. The need for practical/medical/financial/legal help to be available may continue for a considerable period of time.
The most effective support is a practical, signposting (or gateway) service that enables people to access the services they may require including psychological intervention if needed. In the past, such services have been provided through drop-in centres, outreach services, telephone helplines and virtual (Internet-based) support networks.
Clear information on the roles and responsibilities of the different agencies involved should be made available, as well as clear signposting on accessing available support services. Support should be offered on a non-judgemental basis and that those providing services should be appropriately trained, experienced and supported. It is useful if those involved in running such support services are in contact with other agencies and bodies that are involved in aspects of the aftermath such as the police.
Many people find the mutual support of others affected by their own, and sometimes other, disaster(s) to be helpful and in some cases even the most valuable form of support. An important implication of this is that those providing services should make available, at the earliest opportunity, the means for those directly affected to be in contact with and meet each other if they wish to. This may include the provision of meeting spaces and other practical assistance such as help with travel arrangements and providing refreshments. Anything more organised may be controlling, and unhelpfully stifle the emergence of the independent qualities that make such self-help and self-determining support groups so beneficial for those who choose to join them.
It should be for the individuals affected to decide for themselves whether, when and why they wish to form a group, as well as how any such group might be run (see Disaster Action leaflets Setting up Family and Survivor Support Groups and Setting up and Running an E-forum Discussion Group).
The desire to meet and join with others affected by a disaster may emerge very soon after the incident, or not for some months or even years afterwards.
Following disasters some people have found it helpful to participate in smaller groups with a focus on emotional support and an opportunity to talk about their personal experiences. The ways in which these groups have been organised and their relationship to the type of independent action/support groups mentioned above can vary.
For example, following the 11th September attacks in 2001, such smaller groups were organised some months after the formation of the main group and initiated by members of that group themselves. By contrast, after the 2004 South East Asia Tsunami, those formally providing the Tsunami Support Network before the independent group was formed facilitated the smaller groups.
The need for, nature and way in which such facilitated support groups may work will vary considerably. Sensitive and appropriate management is required for them to be effective. In our experience they work best when organised and facilitated by those with appropriate expertise, experience and knowledge of trauma and disasters (as opposed to general bereavement and counselling). A solid professional grounding in ethical issues is also needed. Facilitators should understand the dynamics of such groups (such as the fact that in some cases survivor only and/or bereaved only membership works best), and be fully aware of the role and relationship between these groups and other recovery-related strategies and services.
At the same time, responders should understand that many people will not find this approach appropriate for their needs as individuals.
As well as memorial services soon after a disaster, it is to be expected that a disaster should be marked on future anniversaries. This is the case for disasters of whatever origin. In the shorter term, those affected will wish to know that their suffering and that of their loved ones continues to be recognised and acknowledged by the wider community, and by government. Involving the bereaved in arrangements for the events is important. In the longer term, families and survivors may wish to make arrangements themselves for such events.
A key service is financial support to attend memorial services for those who need to travel. Those affected are likely to expect central and local government support for the creation of a permanent memorial to those who died.
Many of those affected will wish to have continuing information through informed sources (the police, the coroner, etc.) concerning the judicial processes. In addition, families and friends may benefit from support during and at any relevant hearings, which may not take place for a considerable time after the disaster. Many will wish to have detailed answers to their questions about why and how a disaster occurred and what happened in the aftermath. Others may choose not to ask for/have such information.
There are a number of examples of support services that have been of benefit to families through the inquest and any criminal trial. In the case of the Lockerbie disaster, funding and support services were made available through the United States Office for Victims of Crime for live video links to the trial of the accused (12 years after the bombing). The services included financial support to travel to the video links and travel and accommodation costs for those who wished to attend the trial for a period. A secure website was made available to families, with detailed information about the conduct of the trial. This support had a highly practical focus, but psychological support was also made available.
The greatest source of support for those affected by a disaster is likely to be from those who have been affected by the same incident, both in terms of individual relationships and as distinct groups. In addition, for some the opportunity to meet with those who have experienced other disasters can be helpful. Disaster Action was formed in response to this need. In 1991, its founder members came together in recognition of the value of collective experience in offering mutual support as well as the opportunity to educate and advocate a more effective culture of disaster prevention and management.
Disaster Action is not a frontline responder to disaster. As an independent advocacy and advisory service representing the interests of those directly affected, we can offer guidance and the benefit of our extensive experience to those providing individual and collective support services. This can be done through telephone and email (and meetings if appropriate). We recommend that survivors and bereaved people should be made aware of Disaster Action and given access to our leaflet series, When Disaster Strikes, which can be downloaded from our website. We can also help facilitate the coming together of independent survivor/family groups.
Disaster Action would like to thank all those who assisted in the writing of this leaflet.