My plan over the past week was to craft a post about psychiatrists becoming agents of social control in China. Then federal agents killed another person in Minneapolis.
During the Covid-19 pandemic, I posted few entries here. This was a natural consequence of me not writing in general. Fatigue and anxiety were constant companions. Why was a psychiatrist working as the medical director for one of the largest homelessness services agencies in the county during a public health crisis? The pressure felt relentless.
By December 2020, I also felt anger because I was disappointed:
As the federal government has not provided any coherent response to the actual disease pandemic, I do not expect that it will provide any response to the psychological suffering that has already occurred and will continue to occur due to Covid-19.
Nearly a year had passed since the first US death from Covid. There was no indication that this federal government had any interest in applying lessons learned from epidemics elsewhere. The Pan-American Health Organization published a free document—free!—entitled, Protecting Mental Health During Epidemics.
At that time, though, I still held hope in my heart. Government often does not move fast. This is desirable: If government moves too fast, smaller jurisdictions don’t have the chance to give feedback or adapt.
By 2025, we would all learn that this government would use speed against its people.
By January 2022, my anxiety, anger, and disappointment had disappeared. The chronic anxiety and fatigue had squashed everything else.
I recognized at the time that this was a problem.
Worry had become an ingrained habit, so it was easy to express this concern:
I worry about the psychological consequences of this pandemic in the years to come. We continue to focus on the viral pandemic; the psychological pandemic has already arrived. We have yet to see an organized response to that.
Months ago I had already reluctantly recognized that we could not rely on this government to help us. We crafted our own best practices; we cobbled together our own policies and procedures. Within the community we shared information and ideas. We pooled together what power we had to push local government authorities to meet our needs.
You, dear reader, are gracious to give me the gift of your attention. I know some of you work as psychiatrists, psychologists, and other health professionals. Because this federal government is moving fast and has shown that it is unreliable, let me share with you the manual for Psychological First Aid:
Gives guidance on responding to disaster or terrorism events using the Psychological First Aid intervention. This evidence-informed approach helps to assist children, adolescents, adults, and families in the aftermath of disaster and terrorism.
Here’s the two-page overview.
I wish it had a stronger evidence base, and I don’t like that the last update was in 2006. (WHO has a similar psychological first aid manual, though its last update was in 2011.)
People other than mental health professionals can administer psychological first aid. Much of it seems like common sense, but if you have made it this far in this post, you’re probably feeling generally calm. Common sense often disappears during times of stress. The time to learn how to manage yourself, to practice having equanimity in the face of calamity, is when you are calm.
May what is happening in Minneapolis not happen in your city. May you already be a member of PRKA (People Reluctant to Kill for an Abstraction):
resisting the urge to generalize, insisting upon valuing: the individual over the group; the actual over the conceptual; the small, decent act over the sudden violent lunge; the complicated reality of the present moment over the theoretically euphoric future supposedly to be obtained via murder or massacre.
Maria Yang, MD 