MENTAL HEALTH MOMENT
MENTAL HEALTH MOMENT
July 28, 2000
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There are thousands to tell you it cannot be done,
There are thousands to prophesy failure;
There are thousands to point out to you one by one,
The dangers that wait to assail you.
But just buckle in with a bit of a grin,
Just take off your coat and go to it;
Just start in to sing as you tackle the thing
That "cannot be done", and you'll do it.
- Edgar A. Guest
(Poet)
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The American Cancer Society offers three new
research scholar awards: Research Scholar Grants for
Beginning Investigators(up to $250,000 per year for
four years), Research Scholar Grants for Health Services
or Health Policy and Health Outcomes Research (up to
$250,000 per year for four years) and Research Scholar
Grants for Psychosocial and Behavioral Research (up to
$500,000 per year for five years; preference given to
pairs of senior and junior researchers). Application
deadline: Oct. 15. Contact: American Cancer Society,
(404) 329-7558; email: grants@cancer.org
Web site: http://www.cancer.org
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Mark October 5 on your calendar for the 2000 National
Depression Screening Day. Register by August 1 to host
a screening site.
Last year, more than 100,000 people attended the annual
event, held at more than 4,000 screening sites across
the country.
The National Depression Screening Day organizers provide
participating sites with implementation instructions,
publicity ideas, and the necessary educational and
screening materials. The participating sites handle
local publicity and provide the professionals to conduct
the educational and screening components.
For more information and registration materials, write
the National Depression Screening Day, One Washington St.,
Suite 304, Wellesley Hills, MA 02181-1706 or Phone:
(781)239-0071.
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China Cultural Tour Information
https://www.angelfire.com/biz3/odocspan/trip.html
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PROVIDING HELP FOR CHILDREN AND FAMILIES
FOLLOWING DISASTERS - Part II
1. Loss, Death and Mourning
It is not unusual for a disaster, particularly a major
disaster in which there has been loss of life, to
trigger children's questions about death and dying. The
fear of the loss of mother or father underlies many of
the questions and symptoms a child may develop, such as
sleeplessness, night terrors, clinging behavior and
others. Often, when loss has occurred, the children's
problems are overlooked. No one assists them in
handling their reactions to the loss. When a mother or
father dies, most children are fearful of what will
happen to them if the remaining parent dies as well.
Being told that adults will look after them is very
reassuring. The children should be encouraged to voice
their questions. The adults should be as honest as they
can be with their answers. For example, questions about
what happens to a person after death can be answered
with the statement that the wisest men and women through
the ages have tried to answer this question. However,
there is no sure answer. Explanations dealing with
heaven and hell, or afterlife, or the flat statement
that after death there is nothing are confusing to a
child.
It is not uncommon for children to make believe that the
deceased parent is still alive. They may call the
remaining parent or family a liar and deny their parent's
death. Some children may go back and forth between
believing and not believing that the parent has died
and may ask such questions as "When is Daddy coming
home from being dead?" or "I know Mommy's dead, but
when is she going to make my supper?" Young children
may not realize that there is no return from death -
not even for a moment.
Although many of the same issues that adults struggle
with in coming to terms with death are also found in
children's struggles. Magical thinking is more prevalent
in childhood. Most children, when they are very young,
believe that wishing for, or thinking about, something
can make it happen. Children who have had angry thoughts
or death wishes toward the parent (as most children have
at one time or another) need to be reassured that these
thoughts did not cause something to happen. Children may
believe that fighting with a sibling can cause a parent's
death and that ceasing to fight will prevent the other
parent from dying. They need reassurance that the
parent's or family member's death was not their fault,
that it was caused by an accident or illness. It is
comforting to be told that there are some things they
cannot control, such as parents getting sick or having
an accident or dying. These can be contrasted with
things they can control, such as the games they play,
whether or not they play fairly, whether or not they do
their chores and homework.
Bothe child and family may suffer loss of pets, property,
valuables, and treasured sentimental objects. Such losses
may have as much impact on them as the loss of a loved
one. A mourning process can be anticipated. When family
treasures or sentimental objects are still available,
they can be helpful to the mourners. They often provide
something tangible as a security object. Families in
disaster frequently turn to the ruins to retrieve what
seem like valueless objects. This is understandable
because mourning pertains to the loss of home and
objects as well as to loss of loved ones.
Workers need to know that mourning has a purpose and
that crying by both a child and an adult is helpful.
A child needs to be aware that thoughts about the dead
person are likely to come to mind over and over.
Forgetting takes time and overt mourning helps the
integrate the loss more quickly. The family that expresses
concern and annoyance at a child who asks the same
questions about death over and over again needs to
understand that this is the child's way of adapting to the loss.
2. Suicidal Ideation
Threats or attempts to injure or kill oneself in latency-
age children and younger are rare. However, they are not
uncommon among adolescents. Any indication of suicidal
feelings must be taken seriously. The most frequent
motivation is loss of close family, a sweetheart, and of
significant objects such as pets, instruments, or a car.
Even loss of the opportunity to participate in team
sports for the year may bring on serious depression.
Feelings of helplessness, hopelessness, and worthlessness
are strong indicators of suicide potential, expressed
verbally or nonverbally through behavioral signs -
withdrawal, asocial behavior, loss of interest, apathy,
and agitation; physical symptoms - sleep and appetite
disturbance; and cognitive process changes - loss of
alternatives, poor judgment, and reasoning ability.
Evidence of caring and concern are the most immediate,
effective elements of help which can be provided by all
workers. Generally, however, any person with suicidal
ideation should be referred to professional help.
3. Confusion
A trouble sign that requires immediate attention, confusion
implies a deep-seated disturbance which also probably
requires referral to a mental health professional.
Confusion generally refers to a disorientation in
which the young person has lost the ability to sort out
incoming stimuli, whether sensory or cognitive. As a
result he/she is overwhelmed by a profusion of feelings
and thoughts. Associations with familiar objects may
be distorted or disappear, regressive behavior may
reappear, and feelings displayed may be inappropriate
for the occasion. In extreme cases, immobilization or
uncontrolled movement may occur. The mental health
professional can begin the process of helping to reorient
the children by talking to them calmly, by providing them
with specific information, and by being caring and
understanding.
4. Antisocial Behavior
Behavior problems - group delinquency, vandalism, stealing,
and aggressiveness - have been reported in some communities
following a disaster. These behaviors may be a reaction
of an adolescent with low self-esteem to community
disruption. A major problem for the adolescents is the
boredom and isolation from peers which comes from
disruption of their usual activities in school and on
the playground. One way to counteract this is to involve
adolescents and their peers, under adult direction, in
clean-up activities which may be therapeutic to the
teenagers and beneficial to the community. The adolescents
also serve as an excellent resource for helping elderly
people and babysitting for families.
It should be remembered, however, that young people of
this age have difficulty expressing their fears and
anxieties, lest they seem less competent to their peers
and themselves. The use of peer rap groups, in which
teens can talk about their disaster experiences and
ventilate feelings, is helpful in relieving buried
anxieties. A "natural" setting for these rap groups,
such as school, work or task sites, or wherever teenagers
congregate, is desirable. Training teenagers to lead
their own rap groups should be considered. Boy Scout
and Girl Scout leaders and teachers are natural leaders/
trainers.
CHILDREN WITH SPECIAL NEEDS
Two groups of children with special needs are briefly
discussed below: those with prior developmental or
physical problems; and those who have been injured or
become ill as a result of the disaster. Both require
more intensive attention in a disaster than normal or
less seriously affected children.
1. The Exceptional Children
Exceptional children are defined as those who have
developmental disabilities or physical limitations,
such as blindness, hearing impairment, orthopedic
handicaps, mental retardation, cerebral palsy, etc.
Exceptional children have special needs that require
consideration when a disaster occurs. Disasters and
their periods of disruption bring additional burdens
upon the parents of exceptional children. These parents
have problems just in coping with their children's
needs on a day-to-day basis. The emotional needs of
exceptional children are very likely to be exacerbated
by a disaster of any magnitude.
Most exceptional children live in their own homes and
receive assistance from community agencies. The agencies,
part of the network of human services in the community,
may need to be alerted to the special needs of the
children in home settings. Exceptional children find it
more difficult to function when their usual home
environment is damaged or if they are moved to strange
surroundings. Helping such children to understand what
has occurred requires heightened sensitivity. Generally,
it would be desirable to have professionals who normally
are in contact with the children assist in providing
help. The professionals are able to locate and identify
the children in the community and determine what special
services they need, such as schooling or medical care.
Exceptional children depend to a greater extent than
other children on the consistency and predictabiltiy of
their environment and the people around them. Familiarity
with their surroundings is particularly important to
mentally retarded children, who tend to become confused
and agitated by traumatic events. One reaction is
increased levels of clinging behavior. Parents of these
children may need the short-term support of the crisis
worker. For example, parents would be helped by learning
that their children have greater need for reassurance so
that they can anticipate and be tolerant of the increased
demands. The parents would also benefit from a crisis
group with other parents of exceptional childre. Special
education teachers can be a source of assistance for the
children. In as much as they are persons familiar to the
families and children, they can be very effective in
assisting both.
Planning in advance for the needs of children in
residential settings, such as treatment centers for
mentally ill, mentally retarded, or physically
handicapped children, and for day programs for children,
such as childcare centers and schools, should have high
priority. These agencies should all have their own plans
that include staff deployment, evacuation to alternate
settings, and ways to contact and inform families of
the well-being and location of their children.
2. The Injured or Ill Children
Like any children who undergo medical procedures,
children who have been physically injured in a disaster
or who have become ill and have been brought to the
hospital or the doctor's office will be less traumatized
by the injury if the medical procedures that are about
to occur are explained to them. In most up-to-date
hospitals this is part of the hospital routine.
Consultants can inquire about the local hospital and
professional associations and involve them in crisis
planning. Every effort should be made to have a member
of the immediate family remain with the child during
hospital stays and to be present when the child receives
medical care. This is reassuring to the family and to
the child.
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For further information in books and self-help books on
this topic, go to the following and use the search engine
to look for books, etc. in this area. Start by using
descriptors such as Children and Grief, Death, Losses,
Disaster Mental Health, Mourning, Exceptional Children,
child behavior problems and disasters, suicide, illness,
injuries in disasters, 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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