Practical Legal and Ethical Considerations for the Provision of Acute Disaster Mental Health Services

Call, John A.; Pfefferbaum, Betty; Jenuwine, Michael J.; Flynn, Brian

doi:10.1521/psyc.2012.75.4.305

Cited by 13 publications

(15 citation statements)

References 14 publications

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“…Comprehension of information Strength of information exchange process [ 14 , 21 , 27 , 32 , 33 , 38 , 57 , 58 ] Barriers to comprehension [ 18 , 37 , 39 , 40 , 52 , 62 ] Strategies to verify comprehension [ 14 , 32 , 37 , 62 ] iii. Voluntariness Factors influencing [ 15 , 18 , 19 , 21 , 22 , 31 , 35 , 45 ] Potential coercion due to emergency context [ 1 , 15 , 18 , 19 , 21 , 31 , 37 , 44 , 51 ] Autonomy and capacity Normative connections [ 19 , 21 , 33 , 46 , 51 , 59 ] Decision-making capacity debate [ 18 , 19 , 45 , 51 , 52 ] Limiting potential exploitation [ 1 ...…”

Section: Resultsmentioning

confidence: 99%

Ethical standards for mental health and psychosocial support research in emergencies: review of literature and current debates

et al. 2017

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BackgroundResearch in emergencies is needed to understand the prevalence of mental health and psychosocial problems and strengthen the evidence base for interventions. All research - including operational needs assessments, programme monitoring and evaluation, and formal academic research - must be conducted ethically. While there is broad consensus on fundamental principles codified in research ethics guidelines, these do not address the ethical specificities of conducting mental health and psychosocial support (MHPSS) research with adults in emergencies. To address this gap, this paper presents a review of multidisciplinary literature to identify specific ethical principles applicable to MHPSS research in emergencies.DiscussionFifty-nine sources meeting the literature review inclusion criteria were analysed following a thematic synthesis approach. There was consensus on the relevance of universal ethical research principles to MHPSS research in emergencies, including norms of participant informed consent and protection; ensuring benefit arises from research participation; researcher neutrality, accountability, and safety; and the duty to ensure research is well designed and accounts for contextual factors in emergency settings.We go onto discuss unresolved issues by highlighting six current debates relating to the application of ethics in emergency settings: (1) what constitutes fair benefits?; (2) how should informed consent be operationalised?; (3) is there a role for decision making capacity assessments?; (4) how do risk management approaches impact upon the construction of ethical research?; (5) how can ethical reflection best be achieved?, and (6) are ethical review boards sufficiently representative and equipped to judge the ethical and scientific merit of emergency MHPSS research? Underlying these debates is a systemic tension between procedural ethics and ethics in practice.Summary and recommendationsIn summary, underpinning the literature is a desire to ensure the protection of participants exposed to emergencies and in need of evidence-based MHPSS. However, there is a lack of agreement on how to contextualise guidelines and procedures to effectively maximise the perspectives of researchers, participants and ethical review boards. This is a tension that the field must address to strengthen ethical MHPSS research in emergencies.

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Section: Resultsmentioning

confidence: 99%

Ethical standards for mental health and psychosocial support research in emergencies: review of literature and current debates

et al. 2017

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“…The psychosocial support was offered to the families of the deceased, and the students and staff immediately after the tragedy, and it was extensively and proactively offered especially for those who were in greatest need as is recommended (Call et al, 2012; Hobfoll et al, 2007; Pfefferbaum et al, 2013; TENTS, 2008). The acute help for the trauma-affected students and staff included several psychoeducative group discussions and common sessions.…”

Section: Discussionmentioning

confidence: 99%

“…The accumulated knowledge about short- and long-term consequences of a mass trauma is incorporated in several evidence-based and evidence-informed guidelines and consensus statements for psychosocial care after disasters (Call, Pefferbaum, Jenuwine, & Flynn, 2012; Hobfoll et al, 2007; NICE, 2005; Pfefferbaum, Shaw, & AACAP, 2013; TENTS, 2008). The guidelines emphasize both promoting resilience and treating prolonged psychological distress after traumatic events and systematic planning and management of care.…”

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confidence: 99%

Framework of the outreach after a school shooting and the students perceptions of the provided support

Turunen

Haravuori

Pihlajamäki³

et al. 2014

European Journal of Psychotraumatology

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BackgroundA large number of bereaved family members, surviving students, and their relatives as well as school staff and the wider community were in need of psychosocial support as a result of a school shooting in Kauhajoki, Finland, 2008. A multilevel outreach project provided psychosocial care to the trauma-affected families, students, schools staff, and wider community for 2 years and 4 months.ObjectiveThis article is twofold. First, it presents the theoretical rationale behind the psychosocial support and describes the multimodal elements of the services. Second, it analyzes the trauma-exposed students’ help-seeking behavior and perceptions of the usefulness of the support they were offered in different phases of recovery.MethodInformation of students’ help-seeking and perceptions of support is based on a follow-up data from 4 months (T1, N=236), 16 months (T2, N=180), and 28 months (T3, N=137) after the shootings. Mean age of students was 24.9 (SD=10.2; 95% women). Their perceptions of the offered psychosocial support were collected with structured and open questions constructed for the study.ResultsThe results confirmed the importance of enhancing the natural networks after a major trauma and offering additional professional support for those in greatest need. The students’ perceptions of the provided care confirmed that the model of the acute and long-term outreach can be used after major tragedies in diverse situations and in other countries as well.

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“…32 Independently, disaster situations and eHealth applications raise their own questions of ethical practice, privacy, confidentiality, safety, and legality. 33 The course will cover relevant aspects referring to any differences of approach and responsibility that distinguish disaster situations from normal circumstances.…”

Section: Deh Curriculum: Objectives Design Considerations and Coursmentioning

confidence: 99%

The Role of e-Health in Disasters: A Strategy for Education, Training and Integration in Disaster Medicine

Norris

González

Parry

et al. 2018

J Int Soc Telemed eHealth

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This paper describes the origins and progress of an international project to advance disaster eHealth (DEH) – the application of eHealth technologies to enhance the delivery of healthcare in disasters. The study to date has focused on two major themes; the role of DEH in facilitating inter-agency communication in disaster situations, and the fundamental need to promote awareness of DEH in the education of disaster managers and health professionals. The paper deals mainly with on-going research on the second of these themes, surveying the current provision of disaster medicine education, the design considerations for a DEH programme for health professionals, the key curriculum topics, and the optimal delivery mode.

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Practical Legal and Ethical Considerations for the Provision of Acute Disaster Mental Health Services

Cited by 13 publications

References 14 publications

Ethical standards for mental health and psychosocial support research in emergencies: review of literature and current debates

Ethical standards for mental health and psychosocial support research in emergencies: review of literature and current debates

Framework of the outreach after a school shooting and the students perceptions of the provided support

The Role of e-Health in Disasters: A Strategy for Education, Training and Integration in Disaster Medicine

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