SERVICES This chapter addresses the basis for the provision of psychological services to individuals and communities affected by disaster. It first defines the term “psychological services” as used in this publication and then deals with the aims and rationale of specialist psychological services, the logistics of service delivery in the disaster context, its integration with emergency management and self-monitoring by psychological service providers. 2.1 Psychological Services For the purposes of this publication the term “psychological services” refers to those specialist psychological services which apply skills ranging from psychological first aid to long term clinical treatment provided by personnel trained to the level appropriate to the task. 2.2 Aims and Rationale Psychological services in disasters aim to encourage “wellness” by addressing psychological vulnerability in order to limit the development of psychopathology. Alternately, they help affected populations to shift the balance from maladaptive or traumatic responses to adaptive ones. In each case the aim is to preempt later pathology and to alleviate it should it occur. Psychological services need to be specialised, because disasters generate varying degrees of chaos and render many of the everyday systems and coping mechanisms dysfunctional or impotent. Responses to disasters need to be conceptualised differently to orthodox responses.
Orthodox psychological services usually deal with established problems and are customarily delivered within established diagnoses, frameworks and social structures. Disaster responses are acute, varied, fluid and require specialised conceptualisations to assist assessment, diagnosis and help and in particular, prevention of established responses. While orthodox treatments see “clients” and “patients” as needing cures from pathology, psychological services in early disaster phases emphasise normative responses and aid in pre-empting illnesses. Established professional and institutional attitudes can even be quite unhelpful. People struggling with the effects of threats to their lives may resent being seen as “crazy”, ill, or “pathological”. They experience such judgements as additional stressors.