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“Psychological first aid to avoid complication”

Emergency Rehabilitation

Mehdi Firouzi supervises the psychosocial teams in Syria. He explains the benefits of psychological first aid after a tragedy like the February 6th earthquake.

Man walking in front of destroyed building's rubble and an excavator

Destruction in Jenderes, Northwest Syria | HI

More than 50 mental health and psychosocial specialists, from HI and its partners, support survivors.

“People are now in a “survival mode”

"In psychological terms, people are now in a 'survival mode.' We provide them with psychological first aid (PFA). This includes one-to-one consultations, conversations that the psychosocial workers have with patients, caregivers, relatives of a wounded person – whoever needs it. Such a supportive conversation can take around 30 minutes. The idea is to stabilize the person, to try to calm him or her down.

This is mostly done by very active listening, by giving them the room, the safety and the time to talk about what they want to talk about, and to give them back the feeling of being in control. During these conversations, we acknowledge their concerns, we validate their feelings, which are feelings of distress, of anxiety or maybe anger. After natural disasters it is not unheard of that some people may express feelings of anger, for example, if the aid response was delayed.

Many people in Northwest Syria have expressed feeling abandoned. So, there may be a lot of anger. We also keep an eye on any severe symptoms of distress that some may show. Again, the crisis is still very recent, so a lot of people are still in in hyper-alertness mode. They're still very anxious. Some of them, for example, will not be sleeping these days.

To ensure their basics needs are met

Many will be concerned about the safety of their children, about their future if they have lost their homes. There are still aftershocks in the area. This is also can be triggering for people who have lived through the earthquake and makes it more difficult for people to feel safe.

We also try to make sure that their basic needs are met like shelter, food, clothing... If people have basic needs that aren't met, we try to identify them and to link with existing organizations.

We conduct these PFA consultations at a multitude of hospitals (emergency wards, inpatient or outpatient departments), health centers and community centers. We have to deal with the large influx of wounded people, some of whom will be mentally or physically scarred for life.  

To reduce the risk of psychological complication

When we talk about people who have just been through the earthquake, it's still very hard to tell how many of them will continue to have anxiety symptoms because it's quite a complex situation. It's reasonable to give some time before saying, OK, this person is showing very severe symptoms and may be at risk of, for example, developing post-traumatic stress disorder (PTSD) in the long term. However, we know that if survivors of a traumatic incident, such as the earthquake and its aftermath, are given enough time, safety, basic needs (food, shelter, warm clothing, etc.) and social support (through family, community, peers, etc.) they are able to mentally recover without the need for specialised mental health support. It is therefore important that we facilitate access to these basic needs as best as we can.

The benefits of PFA

PFA reduces the risk of psychological complications. People who receive PFA are less likely to remain in a protracted state of anxiety. This can help them better recover from the initial shock.

So PFA is a way to mitigate the risks to a certain extent. It's not a a magical tool. It doesn't cure anyone. It doesn't save anyone, but because we focus so much on stabilizing someone and encouraging them to think of solutions for themselves to give them back some control over the situation, that in a way reduces the risk of further complications later on. See it as the psychological equivalent of putting a blanket on someone and giving them a hot cup of tea after a severe incident has occurred."


Date published: 02/21/23


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