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Posted on Sep 12,2017

Disasters can have long-lasting mental health impact on all of those involved, including children and families, first-responders, and health professionals.  Disasters may cause stress on belief systems, as well as behavioral, emotional, and cognitive processes.   Psychological first aid is a key component of addressing the mental health of those impacted by disasters and providing appropriate treatment in a timely manner, and can be provided by all health care providers.

For children: Behavior changes may include increased anxiety, fear, irritability, reduced concentration, sleep problems, regression in toileting, regression in development, withdrawal from activities, and tearfulness, among others.  Somatic symptoms, including headaches and stomachaches, may also be signs of stress.  For those working with these children, create an open and understanding environment. Allow children to ask questions and answer the questions at a developmentally appropriate level.  Give children honest answers, but do not force them to ask questions if they do not wish.  You can allow children to use drawings, toys, writing, or other strategies to express themselves. Acknowledge the child’s thoughts, feelings, and reactions.  Be prepared to repeat your responses as the child continues to process.  Continuing family routines and structure will be important, as is returning to school, which promotes a sense of normalcy.  Be reassuring, but don’t provide unrealistic promises, including that there won’t be another hurricane or natural disaster. Remember, children watch their parents and other adults; they will be looking to you to model your reaction and response.

Children who have experienced trauma in the past may be particularly vulnerable to trauma, with the potential for a prolonged and/or intense reaction.  Additionally, preexisting mental health problems may be significantly exacerbated by the stress of the disaster and recovery. 

For some, using relaxation techniques, including apps such as HeadSpace, Mindfulness for Children, Positive Penguins, and Mindful Minutes are likely to be helpful. Children who continue to ask questions and have emotional reactions to the hurricane, as well as those with ongoing sleep problems, increased separation anxiety, refusal to go to school, and other behaviors that impact daily living, should see a mental health professional or contact their current mental health provider. 

For parents: Parents responses can be based on a number of factors, including other life stressors and previous traumas, as well as proximity, duration, destruction, and displacement as a result of the event.  If parents are evidencing depression, social withdrawal, increased irritability, anxiety, frustration, anger, changes in appetite, tearfulness, changes in work performance, and overprotective behaviors, additional support may be necessary.  Making sure parents are getting adequate sleep and eating regularly meals, as well as staying connected with others and maintaining normal routines will be key.  Should emotional reactions begin to interfere with daily activities, consultation with a mental health professional is recommended.
 
For patients and families with mental health needs, please consult JHACH Psychology and Psychiatry, or the patient may consult their insurance provider for a list of in-network mental health professions near their home.

Additional Resources:
American Academy of Child and Adolescent Psychiatry – Disaster Resource Center (http://www.aacap.org/aacap/Families_and_Youth/Resource_Centers/Disaster_Resource_Center/Home.aspx)

American Counseling Association – Trauma and Disaster (http://www.counseling.org/knowledge-center/trauma-disaster)

American Psychological Association (http://www.apa.org/topics/trauma/)

CDC (https://emergency.cdc.gov/coping/index.asp)

SAMHSA Disaster Distress Helpline (www.samhsa.gov/find-help/disaster-distress-helpline)


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