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Millions of volunteers respond after disasters, with 24-46% of them being at risk of developing post-traumatic stress disorder (PTSD). Studies examining PTSD in community samples generally have estimated that around 90% of adults have experienced one or more traumatic events in their lifetime. However, in spite of this high exposure only about 10 -12 % of them develop PTSD. Therefore, it is likely that factors beyond the event itself contribute to the development of PTSD and that the complex exposure on multiple levels that accompanies a disaster makes volunteers more vulnerable to development of PTSD. Some of these volunteers have been part of an aid agency for a long time (core), while others only join in response to the current disaster (non-core). The difference in level of training, familiarity with the aid agency and thus the internal support network, is often great in these two groups. Furthermore, many of the new volunteers have lost family members and friends and considerable resources themselves. It is unclear who develops PTSD symptoms, how they differ between core and non-core volunteers and which factors predict their longitudinal course. No study has to date been published on differences between core and non-core volunteers.

In this study, symptoms of PTSD were assessed at 6, 12 and 18 months post-earthquake in 449 community volunteers in Indonesia. Demographics, previous mental health service use, self-efficacy, social acknowledgment and type of tasks were assessed at 6 months. In both core and non-core volunteers, two PTSD symptom trajectories emerged: resilient (90.9%), and chronic (9.1%). In both trajectories, core-volunteers had fewer PTSD symptoms than non-core volunteers. Core volunteers in the chronic trajectory were characterized by having sought prior mental help, reported lower levels of self-efficacy and social acknowledgment, and were more likely to have provided psychosocial support to beneficiaries. The results emphasize the importance of providing adequate support especially to the large number of non-core volunteers involved in disaster recovery operations. It is often difficult to follow up on the non-core volunteer group, as they may move around and may only volunteer for a day or days, while others may volunteer for weeks or months. The importance of immediately establishing a registry of volunteers is critical in order to allow for follow up of mental health complaints in the aftermath of the disaster.

The study also suggests that those who provide psychosocial support may be at increased risk of developing PTSD symptoms. This may be due to secondary traumatization from listening to narratives of beneficiaries especially in the case of volunteers who, as a part of the affected community, may be just as affected themselves. As the humanitarian aid community scales up to train volunteers to provide psychosocial support to beneficiaries, these findings become even more significant. Specific interventions may need to be developed to support these volunteers in the aftermath. Lastly, social acknowledgement was quite significant in relation to complaints. As studies on returning veterans have shown, acceptance from the community is an important predictor of complains. Organizational leadership should keep this in mind and highlight the volunteer work when discussing the work they carry out during and post-disaster, as well as recognize the work formally e.g. handing out icons of appreciation to the volunteers when the disaster has passed. Such simple forms of acknowledgement may buffer against PTSD complaints, which may be a relevant topic for future research.

Discussion Questions

  • What efforts could be taken (or interventions) to minimize the psychological impact on disaster volunteers?
  • How should humanitarian organizations follow up on non-core volunteers that might never return back to the organization?
  • What are good ways to increase feelings of social acknowledgement for disaster volunteers?

Reference Article

Thormar, S. B., Sijbrandij, M., Gersons, B. P., de Schoot, R., Juen, B., Karlsson, T., & Olff, M. (2016). PTSD Symptom Trajectories in Disaster Volunteers: The Role of Self‐Efficacy, Social Acknowledgement, and Tasks Carried OutJournal of Traumatic Stress.