title: Psychological First Aid: Rapid proliferation and the search for evidence.
abstract: Psychological first aid (PFA) has become the flagship early intervention for disaster survivors, with recent adaptations for disaster responders, in the post-9/11 era. PFA is broadly endorsed by expert consensus and integrated into guidelines for mental health and psychosocial support in disasters and extreme events. PFA frameworks are proliferating, with increasing numbers of models developed for delivery by a range of providers for use with an expanding array of target populations. Despite popularity and promotion there remains a dearth of evidence for effectiveness and recent independent reviews of PFA have highlighted this important gap. This commentary juxtaposes the current propagation of PFA against the compelling need to produce evidence for effectiveness and suggests a series of actions to prioritize and expedite real-time, real-event field evaluation of PFA.
authors.affiliation: Center for Disaster & Extreme Event Preparedness (DEEP Center); University of Miami Miller School of Medicine; Miami, FL USA.
authors.forename: James M
authors.initials: JM
authors.lastname: Shultz
authors.affiliation: Australian Centre for Posttraumatic Mental Health (ACPMH); Department of Psychiatry; The University of Melbourne; East Melbourne, Victoria Australia.
authors.forename: David
authors.initials: D
authors.lastname: Forbes
keywords: early intervention; evaluation; evidence; five essential elements; psychological first aid; stress first aid