Let’s get into the Action: World Mental Health Day 2016: Psychological First Aid

7^th October, 2016: While I was coming out of the W.T. Young Library, University of Kentucky after short session of study, I was stopped by a girl. She politely asked me to fill up the form if I have time. I couldn’t decline it.

The form was standardized assessment tool for mental health status and when I completed filling up the form, the other girl immediately scored my test and referred me to a trainee consultant, who counseled me for short time. May be I didn’t require longer counseling based on my score and she informed me to come to the center if I need any help. They were providing psychological first aid. They were essentially working in response to World Mental health day 2016 with theme of Psychological first aid. That simple information actually helped me to find ways if I need any help in the future.

We are human and I feel human emotions are the most unpredictable things in the world and the distance between our normal mental status and abnormality is very thin. Anyone can switch over to other side at any moment. An instant of stress, anxiety, physical diseases, imbalance in the neurotransmitters could switch us to dark side of our mental health status. Especially when the world is turning competitive, eccentric, individualistic, we may suffer the things which we don’t want to. Even the healthiest looking human could be living with unseen turmoil and emotional disturbances around us.

A case of Nepal: Nepal was about to recoil from the wreckage of ten years long civil war (1996-2006) and was about to produce its precious new constitution. In April 2015, massive earthquake hit the Nepal and left many people bereaved due to loss of family, home, tangible and intangible valuables. Still many of us see its aftermath in shattered, cracked walls of home, teary eyes of the people who lost dear ones, mother, father, sisters, brothers, sons, daughter and other relatives, frustration because of amputated legs, nails and wires lingering in the bones, scarred skin and faces, frightful expression of kids and adults when something shakes the bed.

This is just an example of a disaster in Nepal. There are other several emergencies like war and violence in Syria and other countries, everyday hurdles, deadlines, and racing and fleeting lifestyle in which we have to fit ourselves for every new advances, we are in constant need of psychological assurance and social settings that pacify our emotional disturbances and racing hearts.

In such scenario, expert consultation from psychologists and psychiatrists is not available and accessible all the time due to their inadequate number and limited presence only at the tertiary level care centers and urban areas. We need someone by our side who can provide psychological first aid just the way a simple trained person can deliver cardio pulmonary resuscitation to a dying person with cardiac arrest. A person who can make someone accept the reality and help to find the ability to fight with the reality. A person who can arouse the passion for something in life, a person who find time to listen and create social environment that bind people together.

World Health Organization (WHO) is celebrating this mental world health day on October 10 with the slogan of Psychological First Aid. This harbinger is innovative and pragmatic way to achieve the holistic health as our current health system is mainly focused on physical symptoms and illness. This will surely sensitize our current health care service.

What can we do?

Most of the time, I see the trend of celebration of such important days with conferences and workshop where all the professionals and specialists gather up and share knowledge and stimulate each other. But we fall short in taking action, providing and continuing the services to the people in need. I hope psychologists, psychiatrists, mental health nurse experts, public health professionals, social workers would be leading this motto to action. Training and Preparing a bunch of people for first aid is only one aspect dealing with it. Other measures like formation of some form of society and communities such as literary clubs, professional’s clubs, youth clubs, mother’s group, Recreation group in the college, schools, villages with principles of inclusion, group work and cooperation would be equally helpful.

Who are Public Health Professionals: Any Boundary??

Public health is not a very new subject. The history of Cholera epidemic and study led by John Snow and subsequent action of sanitary reforms dated in nineteenth century provide insight into evolution of modern Public health. Nevertheless, definition, area of Public Health remained vague for a long time.

We used to have discussions on definitions, scope and boundaries of Public health in Classes. I remember we agreed that Public Health is broad. Some even said, “the scope of Public Health ranges from beneath the land to the sky. There is no limit in the zone of Public health.” We concluded that everyone who are working to improve the health of people are Public health professionals. We weren’t completely wrong though. Indeed, if you are working for the welfare of people, that's absolutely public health action. But in my today’s understanding, it contravenes against the essence of Public Health.

Why do we need demarcation?

Before I clarify why it contravenes the principle of public health, I would like to focus why it is necessary to demarcate the scope and to define Public Health professionals.

Professional growth of Public health: Once you are certain that which land is yours, then you will be better able to design the city there. People will design the buildings, roads, other infrastructures, and invest money to expand the area. In similar fashion, Once the scope and area of Public Health is demarcated, it will be a lot easier to decide on what to invest, where to invest. At least the government will not be baffled whether to build a Hospital or Public health outlet providing education to a target group when government allocates funds on the title of Public Health.

Solidarity: only the wolfs form the pack, fishes make the school and animals make horde and similar people make the community. They can set a goal, solidify and work to reach that goal provided that they have resources. Such Unions will help to strengthen the communal feelings and they work for their advancements. This will help in leaving impact to the society.

Working Environment: This demarcation will help in ensuring the capacity and limitation of the public health professionals.

Who are Public Health Professionals?

Institute of Medicine defines Public Health Professionals, “a person educated in public health or a related discipline who is employed to improve health through a population focus”. Scutchfield and Keck in Principles of Public Health Practice restate that “The test for whether something should be considered part of public health is the presence of a focus on a population group or community and on a preventive strategy or a preventable outcome.” There are two key things that public health focuses an action of prevention and approach as population group or the community. The action of prevention ranges from primordial prevention to tertiary level of Prevention and this should be targeted to the Population health. To define a public health professionals and public health practice, these two factors should always be taken into consideration.

Because of vague definition of Public health professionals, it has become really difficult to enumerate Public health workers and It is a global issue. Physician, Nurses, veterinarian, engineers, administrators, anyone can be public health workers. However, the two key elements should be taken into consideration. It is essential to devise workforce taxonomy in Public health because of its current undefined nature. Public health occupations can broadly be divided into four main categories: 1. management and leadership, 2. professionals and scientific, 3. technical and 4. outreach and support services. Theses public health professionals should have professional competencies to carry out certain essential public health services such as monitoring health status, diagnosing and investigating health problems and health hazards in the community, informing, educating and empowering people about health issues, mobilizing community partnerships to identify and solve health problems, developing policies and plans that support individual and community health efforts, enforcing laws and regulations, Research.

It is necessary to reevaluate definition of Public health workforce for professional growth, unity and benchmark. 

References:

F. Douglas Scutchfield and C. William Keck. Principles of Public Health Practice. 2009.