Reducing Distress in Disaster Affected Healthcare and Social Service Providers: A Natural Experiment Study

Background and Purpose. Over the past 30 years climate related disasters have more than quadrupled. Health care and social service providers who work in these disaster affected areas are among the most vulnerable to physical and mental health disorders due to contending with first response and rescue operations, and providing emergency medical care, counseling and navigation of services to disaster affected individuals and communities. They often do so while simultaneously coping with personal losses, injuries and other stressors brought about by the disaster. Considering the high vulnerability of these providers during and after environmental hazards, it is critical that evidence-based interventions made available to support their short and long-term emotional health. To address the needs of healthcare and social service providers, this study examined the efficacy of a psychosocial intervention, Resilience and Coping in the Healthcare Community (RCHC), provided in the aftermath Hurricane Harvey, which struck the gulf coast in 2017.

Methods. This natural experiment study compared the experiences of participants (N=312) in three study conditions over an 18-week study period: Condition 1: RCHC only; Condition 2: RCHC plus additional MHPSS services (RCHC+); Condition 3: Waitlist Comparison. Study participants were surveyed at four time points to determine the impact of the intervention on key outcomes including post-traumatic stress, coping, and professional quality of life. Linear mixed models (LMM) were used to analyze program effects across time points. All analyses were completed in SPSS 22.0.

Results. Participants in both the RCHC and RCHC+ conditions experienced significantly greater increases in healthy coping strategies including use of emotional support [t(193)=-3.92, p<0.001] and positive reframing [t(193)=-4.29, p<0.001] compared to participants in the comparison condition. There was a significant reduction in post-traumatic stress symptoms across time for all conditions. Controlling for gender and home damage, there was a significantly greater decrease in PTSD in the RCHC+ condition compared to the comparison [t(236)=2.07, p=.039]. The RCHC condition also saw greater reductions in PTSD scores between baseline and 18-weeks than the comparison condition, however, it was not significant. No significant differences were found between groups on professional quality of life.

Conclusions and Implications. We found that both the RCHC and RCHC+ interventions were valuable tools in helping healthcare and social service workers cope with the dual stress of being a disaster survivor and responder. Given the high vulnerability of these providers during disaster response and recovery, studies should continue to examine the efficacy of interventions designed to reduce the emotional impact of responding to and surviving these events.