Most people working under dramatic circumstances cope with the stress through self-care and social support. The natural healing process can be supported through social or peer networks and/or with professional help. If the natural stress responses persist or escalate, they can develop further into stress-related disorders.

The risk of this increases when personnel experience:

1. Threat to life or health
A critical incident could be a life threatening situation, violence, an accident, kidnapping, imprisonment or forced separation from colleagues. Other traumatic events that can provoke fear or helplessness are, for example, witnessing someone die or get injured, or having to handle corpses.

2. Dramatic loss
Dramatic loss can involve losing a body part or bodily functions, losing important material resources, failing to save someone in need or the loss/injury of a colleague.

3. Wear and tear
Humanitarian personnel are often in a state of hypervigilance for long periods. Accumulated stress over time without sufficient rest and recovery is harmful. Stress factors in the organisation itself can also contribute, such as unclear structure and leadership or a poor psychosocial work environment.

4. Inner conflict / moral injury
Inner conflict arises when there is a discrepancy between personal values and the realities of a disaster zone. Moral injury occurs when the inner conflict intensifies. This can occur when personnel feel forced to engage in behaviours that violate personal convictions or are unable to prevent abuse, for instance. Facing ethical dilemmas over time is straining. This can lead to personnel questioning their role in the deployment.

Acute, chronic and ethical stress can be prevented before, during and after deployment.

Tips for prevention

Physical exercise: Physical fitness increases physical, mental and emotional resilience. Get into shape before departure and maintain fitness during deployment. Strength and speed improves your chances of both helping others and getting to safety.

Stress management: Make rehearsal and exercises part of your daily routine. Experiment with different stress management techniques. By identifying techniques that work for you and automating these, you will find it easier to use them when it’s really needed for yourself or others.

Rest and recovery: Eat, drink and rest regularly to avoid exhaustion. When critical incidents happen you need energy for managing them. Self-care is not selfish, but necessary to perform well on the job. By taking care of yourself you can take care of others.

Social connections: Maintain friendships and take initiatives to connect. Create a plan for how to keep in touch while you are deployed. Talk to your loved ones about how important social support is when a crisis arises. Before leaving, find a loved one that can take your call when things get serious. This will lower the threshold to seeking support.

Work environment: Create a healthy work environment characterized by openness and peer support. Solve conflicts as soon as they arise. Discuss possible dilemmas and ethical challenges. Participate in group sessions and contribute to psychosocial initiatives, even when times are not tough. Building trust takes time. When crisis suddenly strikes you need to have trust in each other.

Meaning: Be aware of your own motivations and expectations before you depart for the mission. Why are you here? What is the goal? When it comes down to it, what is really important in your life? Write this down to remind you when needed. Bring photos of your loved ones or things that symbolise something important to you. Plan something specific that you can look forward to when you get home.

Read more under “Preparation for deployment” and “Advice on returning home”