Sustaining Those Working in Disasters

Continual and prolonged stress is taking a toll on the health and well-being of those who work in emergencies. Two questions that are currently top of mind for those in emergency response sectors are:

• What can we do to support the well-being of those working in emergencies?
• How can leaders and teams be equipped to navigate immense pressure without succumbing to burnout?

These questions were also on leaders’ minds in Christchurch, New Zealand, more than a decade ago. On September 4, 2010, a powerful magnitude 7.1 earthquake struck that city, triggering a sequence of earthquakes that damaged or destroyed 90% of the city’s homes, claimed 185 lives, and forced the closure of the downtown area for more than two years. The road to recovery was long and arduous.

Amid these challenges, a crucial concern emerged: how to sustain those who had a vital role in supporting the impacted population through ongoing aftershocks and earthquake impacts. Put simply, the question is how to sustain mission-driven people working under immense and prolonged pressure. This concern prompted a Winston Churchill Fellowship – a global study tour – to explore the impacts of working under prolonged pressure after disaster and the actions needed to protect the well-being of those working in emergencies. On completion of the research, a design challenge led to the creation of resources, tools, and training to sustain leaders and teams working under pressure based on lessons learned.

Research Snapshot

A study of emergency management professionals in the United States found that more than half of emergency managers suffer mild to severe secondary traumatic stress. As stated by Hollar et al. (2023):

Untreated or undertreated secondary traumatic stress can increase the likelihood of leaving the field by almost three times.… The current rate of departure portends a shortage of adequately trained emergency managers to respond to future disasters and pandemics.

The survey found that 64% considered leaving their jobs during the pandemic (up from 43% before the pandemic). Of those considering a job change, 46% considered leaving the emergency management field.

Hollar, T. L., Erickson, E., Patel, S., Guevara, K., & DeVito, R. (2023). Surveying mental health stressors of emergency management professionals: Factors in recruiting and retaining emergency managers in an era of disasters and pandemics. Journal of Emergency Management, 21(5), September/October 2023.

A Hazards Approach

Identify the Hazards

Psychosocial hazards with potential exposures are many and varied but include excessive workload, lack of rest and recovery, exposure to trauma, moral injury, unsupportive culture, lack of prioritization of effort, unnecessary politics, unhealthy team dynamics, lack of recognition, and managers who are ill-equipped to lead people under pressure. When exploring the stressors identified in the Winston Churchill Fellowship research, it became clear that the stressors people faced while working in emergencies fell into three categories:

• Unavoidable – This work is challenging and involves exposure to traumatic events, accounts, and trauma-impacted people. It is impossible to avoid these stressors, but leaders can prepare and equip people to deal with them to the best of their ability.
• Ourselves – Many people working in disasters have stories they tell themselves, with habits and behaviors that can add weight to the load. For example, there is often a need to appear capable in any situation, to self-sacrifice in the service of others, to shun help, etc.
• Addressable – Some workplace stressors are addressable and preventable. Every organization has them. They might include frustrating and ineffective systems, inadequate access to the necessary tools or resources for a role, leaders who lack the necessary skills, support, or training to effectively lead, excessive bureaucracy, internal or inter-agency politics, and an unsupportive organizational culture. The first step to keeping people safe in a hazardous environment is to identify the hazards, such as what they are for the team or organization and what they are contributing to the load people carry. The most helpful category to explore is the addressable workplace stressors.

Eliminate or Minimize Exposure to the Hazards

A common sentiment from the research was, “Yes, self-care is important, and the support we are being offered is great. But what would be much better is to address the organizational factors that are weighing us down and causing harm in the first place.”

Eliminating and minimizing exposures is the most important and influential step to prevent burnout and sustain those working in emergencies. While this work is challenging, and many stressors cannot be addressed, every organization contributes to preventable stressors. Addressing these will lighten the load for people under pressure. Getting to the source of the problem is more effective than helping people treat the symptoms.

The analogy often used in burnout prevention is the canary in the coal mine. When the canary succumbs to a hazardous environment, the answer is rarely a stronger canary. The most critical and effective step is to address the organizational factors contributing to burnout and harm.

Provide Training and PPE for Mental Well-Being

Once work has been done to eliminate or minimize exposure to the hazards, the next step is to do something to prevent harm. As with other hazards, providing education and tools so that people have what they need to keep themselves safe is critical. Educating and supporting leaders so they have the strategies and tools to support the performance and well-being of their teams under pressure is an essential step. Yes, leaders often overlook this skill development. Leading teams in high and prolonged-pressure environments is incredibly challenging and involves a particular skill set. This type of leadership does not happen by chance. Organizations must support leaders to develop these essential skills:

• Equip teams with the knowledge, skills, and practices to support each other under pressure and to pull together when it counts, especially when fatigue sets in. Again, this does not happen by accident. An intentional approach is needed.
• Equip individuals with tools and actionable insights to take a preventative approach and break through the barriers to self-care.
• Provide tools (PPE for pressure) for creating protective well-being plans and ensure accountability mechanisms are in play to prevent self-care from falling off the bottom of the list in the face of unrelenting demand.
• As with any hazard, prevention is vital. However, when harm does occur, ensure support is available for anyone harmed through their role.

Step Into a Support Role

A role that involves supporting communities impacted by disaster is incredibly rewarding and meaningful but also hazardous. Many well-being approaches are ineffective as they do not address the specific challenges and hazards that those working in emergencies face. Taking a hazards approach – a familiar approach that people are more comfortable with for other exposure hazards in the workplace – provides a framework and approach to minimize harm that gets to the heart of the challenges involved.

With alarmingly high rates of turnover among those working in emergencies, the current state and approach are unsustainable. The good news is that intentional action can and will help prevent harm. Leaders can establish the conditions to support professional and personal growth. However, hope is not a method. To turn the tide on burnout and turnover among the dedicated, mission-driven people who serve communities in the wake of disaster, leaders must act intentionally and decisively.