MENTAL HEALTH MOMENT
MENTAL HEALTH MOMENT
December 1, 2000
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"We always admire the other fellow more after we have
tried to do his job." - William Feather
The Science and Ecology of Early Development 2000 Initiative
http://grants.nih.gov/grants/guide/pa-files/PAS-00-108.html
Visit this page to read how health behavior researchers can
team up with their colleagues in anthropology, economics,
epidemiology, history, political science and sociology to
apply for research grants to study the environmental, social,
economic or developmental factors that affect children
living in poverty. Grants may cover up to five years of the
research. The Science and Ecology of Early Development 2000
Initiative is co-sponsored by the National Institute of Child
Health and Human Development and the National Institute of
Mental Health.
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China Cultural Tour Information
https://www.angelfire.com/biz3/odocspan/china1.html
http://www.gct.com - Grand Circle Travel
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The Office of Minority Health Resource Center invites applications
for its Resource Persons Network, a group of minority health
experts who volunteer to provide technical assistance to community
based organizations across the country. Activities include
reviewing grant proposals; speaking at conferences and workshops;
serving as advisors to committees and work groups; serving as
subject experts for the media; and providing advice on developing
and evaluating health programs. Contact: Information Specialist,
(800)444-6472.
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HOW TO IDENTIFY CHILDREN AT RISK FOR LONG-TERM
PROBLEMS RESULTING FROM DISASTERS
It is important for educators, parents and others to be
able to identify possible problems early on when children
may have ongoing emotional difficulties following a
disaster. Children's emotional well-being is not always
apparent from their behavior. Therefore, it is important
to spend time with them discussing their experiences and
feelings. During these interactions it may be possible
to obtain information regarding the areas discussed below
and therefore identify children who may require closer
monitoring. These areas and information deal with the
elementary school child.
When determining if a child is having a serious problem,
it is important to consider how the child acted prior to
the disaster. For example, if the child was usually shy
or withdrawn, then this type of behavior following the
disaster would not be as unusual. Children who react in
ways that are very different from their usual manner, or
who are much more extreme and persistent in their usual
behavior should be monitored closely. It is also important
to be familiar with children's typical reactions following
a disaster in order to judge whether or not a reaction is
problematic.
Predicting Children At Risk
There are predictors that can be used to guide professionals
in identifying which children may be most at risk for
difficulties many months and even a year following the
disaster. These predictors of long term difficulties include
the following categories: Disaster Related Experiences,
Psychological Issues, and Behavioral Issues. Because
each child's situation is unique, it is not possible to
specify exact rules dictating how many symptoms predict
long-term difficulties. However, based on the guidelines
provided, if you are concerned about a child, the best
response is to notify the school counselor or psychologist.
With their assistance, a plan can be developed to address
the situation in school, to notify a parent, and/or to
refer to an outside professional.
1. Disaster Related Experiences:
Children who have experienced any of the following are more
likely to have long term difficulties:
* Threats to their physical safety during the disaster
* Lost their belongings or house during the disaster
* Family had to relocate as a result of the disaster
* Children who report that they were very upset during
and after the disaster
* Children who thought they might die during the disaster
* Children who attended schools following the disaster
that had multiple schedule changes, double sessions,
or a lot of disruption.
2. Psychological Issues:
A. Post Traumatic Stress Disorder (PTSD)
One of the best ways to assess psychological distress following a
disaster is to measure a child's level of Post Traumatic Stress
Disorder with a questionnaire like the Reaction Index. Children
who evidence symptoms of PTSD soon after the disaster are more
likely to experience PTSD many months after the disaster. Children
who are in the Severe or Very Severe levels of PTSD on the
Reaction Index should be carefully monitored.
The main symptoms of PTSD are as follows:
* Re-experiencing of the disaster during play, dreams, or
flashbacks. For example, a child may:
~ Repeatedly act out what happened in the disaster when playing
with toys
~ Have many distressing dreams about the disaster
~ Be distressed when exposed to events that resemble the
disaster or at the anniversary of the disaster
~ Act or feel as if the disaster is happening again
* Avoidance of reminders of the disaster or general numbness to
all emotional topics. For example, a child may:
~ Avoid all activities that remind him/her of the disaster
~ Be unable to remember parts of the disaster
~ Withdraw from other people
~ Have difficulty feeling positive feelings
* Increased "arousal" symptoms. For example, a child may:
~ Have difficulty falling or staying asleep
~ Be irritable
~ Have difficulty concentrating
~ Startle more easily
B. Additional Psychological Predictions To Identify Children At Risk
* Children who use ineffective ways of coping with stress such as
denial, passivity, or avoidance. For example, children who make
statements like:
~ "I wished the bad things had never happened." (Denial)
~ "I didn't do anything because the bad things can't be fixed."
(Passivity)
~ "I tried to forget it all the time." (Avoidance)
* Other major stressful events happened to them after the disaster
such as their parents divorced, a parent lost his/her job, or a
new sibling was born.
* Insufficient or diminished social support from the child's
family, friends and/or teachers. For example, a child who:
~ Feels alone
~ Doesn't have anyone to share his/her feelings with
~ Doesn't have anyone to spend time with
~ Has to relocate following a disaster
~ Has friends who move away because of the disaster
* Girls are more likely than boys to report long-term symptoms of
Post Traumatic Stress such as being nervous, having more
stomachaches, fearing another disaster, or feeling more alone.
3. Behavioral Issues
If children are having any of the following problems soon after
the disaster, they may be at a higher risk for long-term difficulties:
* Frequent aggressive outbursts
* Large decline in academic performance
* Withdrawal from activities and play with other children
* Frequent complaints of nausea, headaches, stomachaches
* Persistence avoidance of being alone
* Dangerous risk-taking behavior
* Continued preoccupation with the disaster as a primary focus
in life
* Persistent refusal to attend school
Behavioral And Emotional Reactions Of Elementary School Children
In addition to the above, elementary school children may experience
a wide variety of other behavioral and emotional symptoms following
a disaster. The following are some of these symptoms with specific
examples:
Fears
* Fear that they will be left alone or separated from their family
* Fear that something will happen to one of their family members
* Fear of the dark
* Fear of being alone
* Fear that they caused some part of the disaster
Regressive Behavior
* Acting like a younger child
* Irritability
* Whining
* Clinging behavior
Behavioral Difficulties
* Aggressive behavior at home or school
* Angry outbursts
* Hyperactive or silly behavior
* Difficulty sharing with others
Depressive Symptoms
* Crying
* Withdrawal from others
* Changes in appetite
* Insomnia or not wanting to sleep alone
* Nightmares
* Sadness
* Loss of interest in previously preferred activities
School Difficulties
* Poor concentration in school
* Decline in academic performance
* Refusal to attend school
All of the above are common reactions children report following
a major disaster. Many children exhibit some subset of these
reactions for a short period of time. In most cases, these
symptoms will improve over time. However, in some cases, the
symptoms may not resolve, and there may be reason to be more
concerned.
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For further information on this topic, go to the following URL
and use the search engine to find and purchase books. Begin by
trying the following descriptors: children and disasters, PTSD
and children, PTSD and disasters, disasters and child behavior,
schools and disaster, etc.
https://www.angelfire.com/biz/odochartaigh/searchbooks.html
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Contact your local Mental Health Center or
check the yellow pages for counselors, psychologists,
therapists, and other Mental health Professionals in
your area for further information.
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