Core tips Those who crawled out of the rubble, holding back the pain, calling out the names of their loved ones but could not hear the response; those who were spared and rushed to school to see the pale bodies of their children; those who knew that their loved ones were buried deep in the rubble, but could do nothing …… Wenchuan earthquake, tightly connected to the heart of every Chinese! At this point, mental health experts urgently call for not only public health intervention for those affected by the disaster, especially those who have lost loved ones, but also psychological crisis intervention, which plays a vital role in post-disaster reconstruction. According to experts, psychological intervention in major disasters is divided into six steps: assessing and clarifying the focus of the problem; ensuring patient safety; providing support, especially emotional support; developing coping resources; finding solutions and developing a plan; and gaining patient commitment and cooperation. A combination of measures such as removal from the traumatic environment, psychotherapy, and medication can also be applied. Provide emotional support to the affected person [Psychological Phenomena] Earthquakes can cause acute stress reactions in people, producing great emotional turmoil, including physical injury and exposure to extreme danger; witnessing the death of loved ones or mass death and injury; traumatic experiences of helplessness and hopelessness; isolation and having to choose between helping others or fighting for one’s life. We may not be able to experience it, but we can imagine that people in disaster areas need not only material assistance, but also psychological assistance. Expert Tips】Acute stress is a psychological reaction that occurs immediately after a disaster and usually lasts for a few hours or more, so psychological intervention is necessary and crucial. The earlier and faster the intervention is carried out, the more beneficial and effective it is for the victims; conversely, the absence of timely psychosocial intervention will leave the victims with serious long-term psychosocial functional after-effects. Mental health personnel can integrate psychiatric interventions. Psychiatric interventions are an integral and organic part of the overall disaster relief and mitigation efforts, which are carried out in an organized manner under unified leadership and in cooperation with all aspects of personnel. Mental health personnel should be involved in the actual work, more and closer to the victims, to understand their psychosocial difficulties and obstacles, which is conducive to psychological intervention. Specific intervention methods include: home visits, psychological clinics, on-site, individual conversations, group interviews, etc. Acute stress causes mental shock, and disaster victims often cannot help but cry and confide, which is a natural psychological protective reaction. Therefore, we should not discourage or even encourage them to “spill the beans”. Our first task is to be an “understanding confidant”, that is, to give moral support. Psychological phenomena] Among the affected people, in the minutes, hours and days after the disaster, there may be obvious psychological abnormalities, such as confusion, repetitive movements, stereotyped speech, emotional numbness, emotional loss of control, sitting still, shouting, depression, pessimism, helplessness, despair, agitation, fear, fidgeting, and possibly hallucinations. They may “see” their deceased relatives and “hear” calls from loved ones who are not with them. Some of them may also drink to drown their sorrows, smoke more, or even take drugs to relieve their pain. [Expert Tips] The physical struggle and mental shock can put the affected person in a rapidly depleted state, with the patient appearing exhausted and extremely tired, not paying attention to anything, not interested, and seemingly numb. They may be hungry, cold and face dehydration leading to electrolyte disturbances. Therefore, immediate food, water and electrolyte replacement is necessary; at the same time, it is important to try to create conditions that allow them to get rest and sleep. Recurring depression and mourning of the affected people, they need company and someone to take care of them to prevent their excessive and unexpected behavior; listen and try to communicate, so that they can talk freely and pour out their grief. At this time, the affected people are in a state of emotional hunger and thirst: they need someone to listen to them, but also need others to give comfort and warmth. If possible, temporary self-help groups can be organized to reunite the affected people with their relatives and friends, and if there are strong affected people, they can be used as a role model to give great warmth and encouragement to those who cannot hold themselves together. Encourage the affected people to devote themselves to a new life [Psychological phenomenon] The symptoms of the affected people will usually be gradually reduced after 48 to 72 hours after the disaster, and most of them will be relieved within 30 days, but some people’s psychological reaction to the disaster will continue for months or years, and they will show post-traumatic stress disorder. At this time, although the time has changed, they still see things, touching the scene, the disaster fragment in the mind, dreams repeatedly flash. [Expert Tips] At this time, we should help the affected person recognize, face and accept the fact of loss, and tell them that crying is a natural expression of emotion, not weakness, when they are in pain. It is important to allow and encourage the affected person to cry and talk repeatedly, and to tell them that other ways such as journaling are also conducive to emotional expression. Mental health professionals and all people can comfort the affected person and motivate them not to give up their original goals in life, even though they may be altered by the bereavement experience, and the confirmation or reconstruction of goals is an important step toward recovery. In this process, the memory and mourning of the deceased can also be integrated into future life goals. Early intervention should help them adjust to and cope with the traumatic event and not spend too much time on emotional venting. Provide a relaxing, healing environment for the trauma victim, improve quality of life, and intervene early if psychiatric symptoms are present, or not if they are not. Respect them if they don’t want to talk about it, and retreat in relationships.