As the earthquake response in southeastern Türkiye shifts toward rebuilding and rehabilitation, one of the key priorities is the mental health of the millions impacted by last month's disaster.
Scores of teams are working in hundreds of tent and container cities established across the affected region, trying to help survivors deal with pain and loss of unimaginable proportions.
The focus has been on "psychological first aid,” according to Hatice Cagil, a young counseling psychologist. "Watch, listen and connect. That is how we summarize psychological first aid,” she told Anadolu Agency (AA) at a tent city currently home to hundreds of survivors in the province of Adıyaman.
"Our aim is to understand what people need. We have to really hear what they are saying, and even what they are unable to express at the moment. There also needs to be a bond of trust, to let them know that we are here for them.” Respect for space and privacy is crucial, and survivors should not feel pressured to share in any way, she explained.
"What happened here was tough for everyone. People are now getting to a point where they are able to tell us what they’ve been through,” said Cagil, who is part of a 16-member team working with people living in more than 300 tents.
Over in Islahiye, a district of Gaziantep province that was one of the 11 provinces ravaged by the twin tremors, clinical psychologist Can Ahmet Boz is deployed at a container city currently home to hundreds. He used an analogy to explain his team’s work: "It’s like bleeding, actually, when you cut your hand. It’s now just over a month and this is the acute period for traumatic events. We first have to stop the bleeding and dress the wound before the actual healing begins.”
Identifying the "strengths and resources” of every individual is a primary objective, but how that is done differs vastly for adults and children, said Boz, who is part of a team from the Hasan Kalyoncu University in Gaziantep.
"For adults, we have them over for tea or coffee and let them do the talking, if they want. Sometimes they say nothing, sometimes they break down and express what they’re feeling,” he explained while also echoing Cagil’s words about not pressuring people to share.
There is a step-wise process for children that caters more to nonverbal communication, including drawing or painting, solving puzzles, and creativity with Lego and playing dough, he added.
Both Cagil and Boz said the mental health impact of the disaster varies across age groups, though there are similar manifestations of trauma such as disturbed sleep patterns, anxiety, and other signs of post-traumatic stress disorder.
Cagil said her team has been surprised to see some children "recovering much faster” than expected.
"Among adolescents, there is a lot of anxiety about the future,” she said, citing examples of teenagers who "are unable to even leave their tents” and others who have developed problems such as bed-wetting.
"Adults and parents have to think about both themselves and children, so that’s an extra burden for them,” she added.
Despite the evident age differences, Boz said every person has certain in-built mechanisms to cope with trauma, and helping them access those remains the main task of any mental health support team.
"We are trying to find their coping strategies ... They have the resources that can help them in difficult times,” he said.
"Later – maybe two or three weeks or a month – we will move on to the next part, which is psychotherapy. For now, we are trying to somehow prepare them for therapy,” he explained.
At the same time, play activities and psychosocial activities and workshops are organized throughout the day for children in tents and container houses in Adıyaman, also ravaged by a pair of quakes.
Under the management of volunteer expert teams, the alleviation of negative feelings is encouraged through activities that start with morning sports. The teams affiliated with the Elaziğ Youth and Sports Provincial Directorate working in the container city established in Altınşehir visit the container houses in the morning and invite the children to activity areas.
Social worker Besire Akar, who spends hours engaged with children, told Anadolu Agency (AA) that volunteer teams from various Turkish cities are deployed in Adıyaman.
Stating that they try to overcome the effects of the earthquake on children via games and sports, Akar said: "We start the day with morning sports. We collect the children by making trains and walking around the streets and bringing them to our activity area. We continue the day with educational, instructive and entertaining games."
Pointing to the fact that it is fun to participate in games, Akar said the psychology of the children is improving day by day.
However, the effects of the earthquakes on the general population across the country linger, with an increase in people experiencing sleep disorders, according to several experts and associations, including Turkish Sleep Medicine Association (TUTD). Board member of the association, Prof. Dr. Hikmet Fırat, said, "Sleep disorders may in cases cause metabolic diseases, psychological diseases and cardiovascular diseases in the future.''
He also said that after the Kahramanmaraş-centered earthquakes, post-traumatic stress disorder (PTSD) has emerged in many people, an inevitable condition for those living in the earthquake-hit zone. "This is actually a natural response of human beings; it is a response of the body and results from hormonal changes triggered by a terrifying event,'' he concluded.
The death toll from the Kahramanmaraş-centered twin earthquakes in Türkiye's southeast was revised Monday and has reached 48,448, Interior Minister Süleyman Soylu said during news conference in Malatya.
