In the face of natural disasters, let’s not forget the mental health needs of the kids

In 2017, the United States sustained direct hits from some of the strongest hurricanes on record, affecting millions of children and families in Texas, Puerto Rico, Florida and the U.S. Virgin Islands. Reconstruction of the ravaged areas will continue for years.

Hidden among the debris are two critical facts. The psychological trauma and grief caused by these disasters will almost certainly persist beyond federal support for survivors, which tends to dry up shortly after the waters recede.

{mosads}Moreover, those most deeply impacted are those who were most vulnerable well before the storm struck due to poverty, community violence, substandard housing conditions, and displacement from previous natural disasters.

Lingering aftereffects from disasters have quiet constituencies and are easy to ignore. For these children and their families and communities, sustained support is needed to ensure that professional help is available to assess and treat the most frequent and long-term disaster-related mental health problems of posttraumatic stress, depression and maladaptive grief reactions.

Children and teens are especially susceptible to mental health challenges stemming from traumatic events, and damage from natural disasters can be long lasting in the absence of intervention. Findings from prevention science tell us that the negative impact of natural disasters on children and adolescents can be avoided, minimized or even reversed.

Prevention science acknowledges that the first line of defense is to reduce the risk of exposure to trauma in the first place — in this case, preventing the devastating effects of hurricanes on our infrastructure with environmental protections and smart investment of tax dollars.

Additionally, ensuring that psychosocial supports are in place in high-risk regions will help prevent the development of adverse emotional and behavioral effects of natural disasters and provide for a rapid response by community professionals.

Light-touch responses abound. For example, teachers and clinicians can be trained in early preventive interventions, such as Psychological First Aid. Families can be educated how best to handle normal reactions to disasters and obtain much-needed resources. Schools, religious institutions and community centers have the potential to serve as the primary setting for child and family-based services when disasters occur.

The second line of defense in the prevention science toolbox includes specific research-backed programs and interventions that address the effects of traumatic stress on multiple aspects of child development, from brain and cognitive development, to social skills, coping and mental health. A number of evidence-based trauma-informed interventions for children and their families have been established for delivery in schools.

Importantly, they include training for teachers, school counselors and social workers to recognize the signs of traumatic stress, thus providing child-serving professionals with the tools to respond effectively. Interventions designed to target families and whole communities are also available and shown to markedly reduce adverse psychological outcomes in disaster-exposed youth.

By investing time and money for staff training, communities can be prepared both for the immediate aftermath of storms and also for longer-term problems such as disengagement or dropout from school and persistent mental health issues. The benefits of this approach compared with the modest cost should compel policymakers to act.

We call upon federal officials to work with state and local agencies toward preparedness and sustained disaster relief for both physical and mental suffering through the following actions:

• Work with disaster-prone communities to ensure they have the mental health service infrastructure in place before disaster hits
• Fund rapid response training to address psychosocial needs of children and families with evidence-based preventative programming.
• Support public health agencies in tracking survivors and monitoring their mental and behavioral health needs for at least five years.
• Provide training for teachers, social workers and clinicians in developmentally and culturally appropriate screening, assessment and trauma-informed intervention.
• Require evaluation of the outcomes of prevention and treatment efforts as stewards of public dollars to ensure the money is spent with accountability.

Congress, state, and local legislators have the power to prevent long-term challenges associated with natural disasters. We know a great deal about where disasters are most likely to hit, who is most impacted, how to prevent the worst effects and how to manage issues that do arise.

Exercising power judiciously means thinking long-term about disasters and investing in evidence-based preventive solutions wherever possible.

Aaron Sawyer, Ph.D., is a federal healthcare consultant, and a member of the National Prevention Science Coalition to Improve Lives. Julie Kaplow, Ph.D. is the director of both the Trauma and Grief Center and the Harvey Resiliency and Recovery Program at Texas Children’s Hospital. She is also an Associate Professor in the Department of Pediatrics, Section of Psychology at Baylor College of Medicine. And she is a member of the National Prevention Science Coalition to Improve Lives. Kristin Moore, Ph.D. is a senior scholar in youth development, child trends, and a member of the National Prevention Science Coalition to Improve Lives. Diana Fishbein, Ph.D. is professor of human development and family studies at The Pennsylvania State University, director of the Program for Translational Research on Adversity and Neurodevelopment, and co-director of the National Prevention Science Coalition to Improve Lives.