Community Support Interventions

Guidelines for Community Support Interventions in Remote Areas

Target group:

Community members impacted by the trauma and who wish to participate in a supportive group intervention.

Aim:

To mitigate the impact of the event; to promote community cohesion; to maximise potential for recovery; to promote positive coping strategies; to educate as to the likely effects of the trauma; and when and where to seek specialised assistance.

Facilitators:

Mental health practitioner (Indigenous practitioner if Indigenous community - alone or in collaboration with non-Indigenous mental health practitioner).

If a community level response is required such a need should be established with community representatives (not just state health employees). The offer of community interventions must be accepted and the response team invited into the community. It is strongly recommended that mental health practitioners implementing community support interventions should be known to, and have knowledge of the community concerned, and be able to provide sensitive immediate as well as ongoing support.

The format of community support interventions is the same as that of supportive group interventions outlined above. In addition:

Community resources appropriate to the particular community, such as community leaders, elected representatives, community elders, traditional healers and on-site religious representatives, should be involved or consulted or invited to participate.

In some situations, elements of mediation or conflict resolution may be usefully incorporated into community interventions. The importance of an existing relationship with the community is emphasised if such elements are to be incorporated, as they should only be incorporated from a position of sensitivity and knowledge.

In remote Indigenous communities, interventions should be provided by Indigenous mental health professionals alone or in collaboration with non-Indigenous mental health professionals. Cultural world-views and culturally meaningful responses to make meaning of or come to terms with the event should not be discouraged. Assertive or aggressive interventions should be avoided. Flexibility and sensitivity should be key components of the response. Rigid or prescriptive formats for interventions are not recommended.

Mental health professionals implementing community interventions should not seek to replace or usurp existing community strengths or resources or strategies. In some instances, an on-site assessment of the situation may indicate 'masterful inactivity' on the part of the response team. This assessment by debriefers should be respected by their employers and not be seen as a response failure.

A philosophy of community empowerment may be seen as doing 'as much as necessary, but as little as possible'. In some instances the most appropriate role may be to provide support and education to local people serving as key supports for others in the community.

Community support interventions should be followed by the offer of individual support/debriefing interventions for those directly exposed to the event.