What would happen if a major windstorm, wildfire, or other disaster damaged your home and community and left you and fellow residents without food, water, or shelter for a long time? Are you and others likely to be significantly distressed? If so, this would be natural.
Despite the clear need, most emergency management programs don’t focus on preparing people for the social, psychological, emotional, and behavioral stresses and traumas caused by disasters. To the extent that they address these issues at all, it is by providing disaster mental health services to stabilize people after they are impacted by an adversity.
Some efforts are being made to expand the traditional approach to emergency management to proactively build “community resilience.” But this definition of resilience has primarily meant redesigning and hardening external physical infrastructure in communities such as buildings, transportation, water, and power systems. Little attention has been given to enhancing the human social, psychological, emotional, and behavioral dimensions of community resilience.
These limitations became evident to me after hearing a presentation by the director of the Federal Emergency Management Agency (FEMA) about their new community resilience program, and then reviewing their National Resilience Guidance document. Much of what is discussed will be helpful. For example, FEMA is expanding its work to engage multiple partners in addressing external physical risks associated with natural and human-caused disasters before they occur, not just reacting to them afterward.
However, there is little concrete about what I believe must now be one of the top focuses of emergency management services. That is to proactively prepare people for the social, psychological, and emotional distresses and traumas speeding their way due to snowballing disasters and emergencies.
Helping communities get ready for accelerating acute and chronic traumatic stresses is critical because the global climate-ecosystem-biodiversity (C-E-B) catastrophe is speeding up.
Last year was the hottest in recorded history, with global temperatures rising by 2.7 degrees Fahrenheit (1.5 degrees Celsius) above pre-industrial levels for an entire year. Records were also broken for ocean heat, sea level rise, melting of glaciers, and Antarctic sea ice loss. The World Economic Forum has said biodiversity loss and ecosystem collapse are now among the top five risks facing the world. The links between damage to the atmospheric climate, terrestrial and marine ecosystems, and biodiversity is why I call it the C-E-B catastrophe.
One of the consequences of these disruptions will be more frequent, extreme, prolonged, and increasingly complicated disasters that can traumatize 10 to 60 percent of the people who are directly impacted, including 10 to 30 percent of emergency responders.
When natural disasters activate, or are combined with, human-caused disasters such as interpersonal aggression or violence, 25 to 75 percent of those directly affected can be traumatized. Secondary trauma can also occur in 10 to 20 percent of the people who know someone who is impacted or watch disasters unfold from afar. And, often, many types of toxic stresses are mixed with acute disasters or persist long after the disaster has ended.
The number of people who experience a mental health problem as a result of a disaster consequently often outweighs those with physical injuries by 40 to 1.
The toxic stresses and acute traumas resulting from these events are contributing to epidemics of mental health and psychosocial problems occurring in the United States and other nations. They include, but are not limited to, severe anxiety, depression, posttraumatic stress disorder, complicated grief, and increased suicidality.
The traumatic stressors are also activating rising drug and alcohol abuse, spousal and child neglect and abuse, aggression, and violence.
These mental health and psychosocial problems are undermining the health, safety, and security of individuals, families, and entire communities in numerous locations.
They are also making the provision of disaster management services more difficult to implement, more stressful for emergency responders, and more costly.
In their new National Resilience Guidance document, FEMA has begun to consider the "social" dimensions of resilience. This is a positive step forward. However, the document provides only a limited conceptual description of the issues. It does not clarify what building individual and collective human resilience actually involves or how they can integrate it into their focus on external physical resilience.
One of the likely reasons for FEMA's late start on this critical issue is the belief among many in the emergency management field that social, psychological, and emotional harm can be minimized if external physical infrastructure is fortified. However, the earth’s climate and ecological systems are rapidly changing, often in never-before-seen ways. This will make it increasingly difficult, and sometimes impossible, to project the precise type, intensity, scope, and locations of impacts and, thus, the type of infrastructure modifications that can prevent serious harm to people. As the C-E-B catastrophe worsens, we should therefore plan for the likelihood that many external physical resilience projects will have limited effect or fail.
Given these limitations, what FEMA and other emergency management organizations can do is to make it a top priority for all staff and partners to learn what building human individual and collective resilience for relentless disasters and toxic stresses actually requires. It is not about "grit" or "bouncing back." That's because, as the C-E-B catastrophe worsens, it will frequently be impossible to return to previous conditions, and doing so would often be unwise because many of those conditions are drivers of the C-E-B catastrophe.
Equally important, many people do not want to return to the conditions they formerly experienced if those circumstances included significant dysfunction. They want to improve their sense of well-being significantly above previous levels. This starts by helping people learn how to calm and stabilize their body, mind, and emotions when they are distressed. It also involves discovering how to see adversities as opportunities to learn from the experience, grow, and find new constructive sources of meaning, purpose, and hope in their lives.
With this understanding, it will become evident that building human resilience in communities for relentless C-E-B catastrophe-generated disasters and toxic stresses is very different from providing mental health services.
Enhancing human resilience involves the use of a forward-looking, strength-based approach that boosts local skills, resources, assets, and other "protective factors" that help people remain healthy by buffering them from and allowing them to push back against toxic stresses and traumas. Many protective factors can also help people recover when they are psychologically traumatized by adversities. Mental health services, in contrast, treat individuals who experience symptoms of pathology after they appear.
As I have described in previous posts, communities typically enhance local protective factors by organizing wide and diverse "Resilience Coordinating Networks." These are multi-sectoral coalitions that use a public health approach to implement strategies that enhance the capacity of all adults and young people to remain socially, psychologically, emotionally, and behaviorally healthy and resilient before, during, and following all types of adversities.
A number of communities in the United States and internationally are successfully using this approach.
Building robust social connections throughout the community is often one of the top protective factors emphasized by these initiatives. This is vital because family, friends, and neighbors are typically far more important than emergency responders during the first three to five days of most disasters, and often for weeks or months afterward, as well. Enhanced social connections are also vital to overcoming the toxic social isolation and loneliness that is pervasive today and producing mounting mental health issues that are often aggravated by disasters.
Another protective factor that is commonly focused on by community resilience initiatives is helping all adults and youth become "trauma and resilience-informed." This starts by helping them understand that there is nothing wrong with them when they experience physical, psychological, or emotional distresses during adversities. Their reactions are natural human biological responses to threats. It also involves teaching everyone simple age- and culturally appropriate methods they can use to calm and stabilize their nervous system when they are distressed, and then use adversities as catalysts to find new sources of meaning, purpose, and hope in their lives.
Most community resilience initiatives focus on other protective factors as well to strengthen and sustain individual and collective resilience.
FEMA and other emergency management organizations should learn from these initiatives and focus on building true community resilience by fully integrating efforts to strengthen the human dimensions of resilience with their work to enhance external physical resilience.
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