# Psychological First Aid & emergencies

Nepal's counselors work in a country of earthquakes, floods, landslides, fires and bus accidents. PFA is what everyone can do in the first hours and days: humane, practical support that follows three verbs and one rule: do no harm.

**Someone who is not responding, badly injured, or unable to care for themselves or their children** needs medical help first: ambulance [102](tel:102) or [112](tel:112) / [100](tel:100), then the nearest health facility. Everything on this page comes after that.

## Look · Listen · Link, and what PFA is not

### LOOK

- Check safety of the scene
- Who has urgent basic needs?
- Who shows serious distress reactions?

### LISTEN

- Approach calmly; introduce yourself
- Ask about needs and concerns
- Listen; help people feel calm: do NOT force them to talk about what happened

### LINK

- To food, shelter, water, medical care
- To family and loved ones (reunification)
- To accurate information and services
**PFA is not:**

- Professional counselling
- "Debriefing", making survivors retell the trauma; evidence shows this can harm
- Diagnosing
- Something only professionals do
Most acute reactions, crying, numbness, trembling, insomnia, are *normal reactions to abnormal events* and settle with safety, information, and connection. **The ones to escalate:**

- Not responding at all (treat this first as a possible medical emergency: check breathing, get medical help)
- Risk to self or others
- Unable to care for self or children
Remember the IASC pyramid from [Wellbeing & intervention](https://manoatlas.com/wellbeing.md): in an emergency your biggest mental-health act may be organising the water queue so it is safe for women at night.

Look · Listen · Link. Three verbs anyone can carry into a flood camp or a bus-crash site. The rule under them is the whole ethic of PFA: support without pushing, and never make someone retell what they are not ready to tell.

Key points

1. PFA is humane practical support in the first hours and days: Look (safety, needs), Listen (without pressing), Link (to services and people).
2. It is not debriefing, not counselling, not diagnosis; most acute reactions are normal responses to abnormal events.
3. Medical danger comes first; escalate anyone unresponsive, at risk to self or others, or unable to care for themselves or children.
Learn more

Pick one, not all.

Free guide[WHO: Psychological First Aid; Guide for Field Workers](https://www.who.int/publications/i/item/9789241548205); THE manual; ~60 pages, free, exists in Nepali translation.

Guideline**IASC Guidelines on MHPSS in Emergency Settings (2007)**: the pyramid and the do-no-harm checklists.

Video · 5 min[The psychology of PTSD (TED-Ed)](https://www.youtube.com/watch?v=b_n9qegR7C4): what you are trying to prevent from taking root.


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*Source: https://manoatlas.com/pfa · Licence: CC BY-NC-SA 4.0. Mano Atlas is an educational resource, not a diagnostic tool.*