Addressing Disaster Mental Health Needs of Children: Practical Guidance for Pediatric Emergency Health Care Providers
Section snippets
Practical Assistance
In the aftermath of a disaster, pediatric emergency health care providers will need to be able to provide psychological first aid to children and their families, conduct a brief assessment for the presence of adjustment problems and risk factors for difficulties with adjustment, and provide rapid and effective triage for mental health concerns. Preparedness efforts should also focus on identifying systems of care that are suited to hospital settings for the screening and management of emotional
Psychological First Aid
The American Red Cross defines psychological first aid (PFA) as “the practice of recognizing and responding to people who need help because they are feeling stress, resulting from the disaster situations within which they find themselves”.34 Psychological first aid is practical assistance that includes offering emotional support, providing information and education, encouraging the practice of positive coping, and recognizing when more help is needed and helping individuals to get this extra
Children's Immediate and Short-Term Reactions to Disaster
How children react in the setting of a disaster depends on a number of factors, including the nature and extent of their direct involvement, their preexisting vulnerabilities and coping skills, and their age and developmental/cognitive level.3, 4, 33 Some common reactions that hospital staff may observe in children in the immediate and short-term aftermath of a disaster8, 12, 22 include the following:
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Fears. After a disaster, children may develop fears related to the particular event (eg, after
Mental Health Triage
As soon as possible after initial medical stabilization and evaluation, assessment for adjustment reactions should be initiated. Without active screening, many children with mental health problems are not likely to be identified.39 This secondary triage will help clarify whether the symptoms observed are likely to represent an underlying physical condition, permit initial brief intervention and support for distress already evident, and identify children most likely to benefit from referral for
Mental Health Interventions
There are evidence-based interventions for children with PTSD and trauma-related disorders after any type of trauma, including disasters. Trauma-focused Cognitive Behavioral Therapy has been strongly recommended as the treatment for children experiencing PTSD and adaptations to this treatment have recently been made to incorporate traumatic grief.41 Children who experience the death of a family member or friend may benefit from bereavement counseling or support. Health care professionals will
Impact of Disaster on Professional Staff
When a disaster strikes a community, it is important to remember that providers along with their patients often have significant losses.3 Health care providers may need to respond to a dramatic surge in the number and level of acuity of patients at the same time they may be worried about the well-being of their family or friends and feel torn by these competing obligations. It is therefore helpful for professionals to have in place family disaster preparedness plans, so that alternative
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Just-in-Time Training for Disaster Response in the Austere Environment
2019, Clinical Pediatric Emergency MedicineCitation Excerpt :Consideration must be given to long-term care for patients with life-changing injuries, such as those who require amputation. Psychosocial impact and manifestations in children should be recognized, mitigated and managed as part of immediate care, with plans and capacity developed for long-term support.44 Parents often seek care for their children prior to themselves so it is important to recognize when adults with children also require care.
Responding to the psychosocial needs of children and families in disasters
2010, Critical Care Nursing Clinics of North AmericaCitation Excerpt :Children have more overall surface area relative to body mass, and therefore, are more likely than adults to absorb poisonous toxins.2,3,5,8 Pediatric disaster experts consider the psychological and psychosocial challenges for children during disaster to be more complex than the physiologic challenge.3,8 Children often have difficulty verbalizing their feelings in relation to disaster events.
Mental health consequences of trauma: The unseen scars
2010, Clinical Pediatric Emergency MedicineCitation Excerpt :These recommendations could easily be adapted and applied to individual events. Schonfeld and Gurwitch56 propose that emergency providers are uniquely skilled in supporting families and patients in these disasters who have emotional and psychological problems related to their crisis. This psychological first aid includes providing appropriate information without overburdening the already stressed family, creating a calming supportive environment whenever possible, minimizing patient separation from family members, minimizing pain, and emphasizing positive coping strategies and communication.
Mental Health Concerns
2009, Clinical Pediatric Emergency MedicineSocial vulnerability, gender and disasters. The case of Haiti in 2010
2020, Sustainability (Switzerland)