For children, the world can be a terribly traumatic place.
Aside from neglect, physical abuse, sexual abuse, community and school violence, war, medical issues, and other frightening events, natural disasters also can take their toll—and not necessarily in the same way those disasters would affect adults.
Certainly, various types of assistance are available; psychosocial care, for example, can incorporate emotional, mental, social, and spiritual components of health. Offering comfort might mean providing assurance through talking, re-establishment of routines, encouraging expression, and giving frequent attention. And more extensive mental health care might address deeper needs such as:
- low self-esteem;
- alcohol/drug abuse;
- out-of-place sexual behavior; and
- post-traumatic stress disorder (PTSD).
PTSD—a psychiatric disorder that leads people to re-experience traumatic events, show symptoms of avoidance and numbness, and remain constantly on high emotional alert—may be treated through cognitive-behavioral therapy, psychological first aid/crisis management, eye movement desensitization and reprocessing, play therapy, or other methods, according to the National Center for PTSD.
The challenge, however, is that much of what’s known about PTSD—and the way people respond to disasters in general—is still based on adult-centric research. It’s too easy, experts say, to simply think of children as “little adults” or—worse yet—to believe that because they’re still young and growing, they’ll be able to just “get over” anything that happens. Resiliency depends on a great variety of factors—and preparedness/prior psychological health are included.
Dr. Irwin Redlener, president and co-founder of the Children’s Health Fund and director of the National Center for Disaster Preparedness at Columbia University’s Mailman School of Public Health, speaks of the importance of “buffering adults.” These adults, parents or otherwise, are able to be key role models and help lessen the blow of catastrophic events.
“But if we say we’d like to train parents or other adults to be more effective buffers in disaster, we still don’t really know how to do that,” he says. Educated guesses can be made, but there’s still room for further study.
Katherine Wiebe, M.Div., Ph.D., executive director of the Institute for Congregational Trauma and Growth, also notes a need for an expanded definition of “long-term recovery” when it comes to children affected by disaster; the ground for increased research and engagement is fertile. Wiebe’s organization goes beyond first-response disaster relief to help congregations more effectively respond, and she urges a collaborative, interfaith, and inter-professional approach to help communities heal. Ideally, however, relationships are already in place before the storm arrives.
- Children are not just “little adults”—especially in response to disaster. Developing brains are vulnerable to longer-term impact in areas such as memory, regulation of emotions, and attention. Also, children may be especially impacted by trauma because they are less able to anticipate danger and may be less able to articulate how they feel. Children may blame themselves or others for not being able to prevent the disaster and keep them “safe.”
- Generic assumptions cannot be made about the way children will respond to disasters. “It’s very much an individual situation,” Redlener says. Some will have great tolerance and resilience, while others will be far more vulnerable. Factors at play include a child’s psychological makeup before the event, in addition to the presence or absence of a buffering adult. Wiebe notes that children tend to postpone aspects of processing traumatic events until they reach particular developmental stages; they respond age-appropriately, and that response will likely not be a one-time event. “Part of preparing for disaster response is recognizing that children and youth may relate with their ‘buffering adults’ for years to come,” she says.
- Some advances have been made in the field in children and trauma, but progress has been slow. In some cases, task forces have been formed and recommendations have been made, but those recommendations have not yet been funded to fruition.
- Culture, economic standing, and ethnicity can all play roles in how trauma and recovery are viewed. Vulnerable populations may face insensitivity, limited access to services, and additional barriers to receiving the help they need to recover fully.
- Preparedness efforts as a whole have been under siege due to budget cutbacks, and those aimed at lessening the impact of disasters on children are no different. As such, the rationale for support from private philanthropy continues to increase.
How to Help
- Support psychological first aid efforts for children and their families. Not enough workers have been trained to effectively help. Mental health providers, in turn, can work with other professionals in health care, schools, spiritual settings, and other areas to assist in noticing and treating symptoms of distress. Training should be both developmentally and culturally appropriate.
- Support services for those already at higher risk for mental disorders, such as those living in violent households. Those already in a vulnerable state will have fewer resources to draw from should a disaster occur.
- Fund studies that will establish best practices in assisting children pre- and post-disaster. Research could be done, for example, on the most effective ways parents and other adults can be buffers in disaster situations. Also of interest: the lasting effectiveness of commonly used treatment and intervention approaches.
- Support the dissemination of evidence-based tools for post-disaster assistance of children and their families. Medical professionals should have plans in place before a disaster occurs.
- Develop and convene leadership that can provide a holistic and collaborative view of clinical, policy, faith-based, and other assistance available to communities. At current, Wiebe notes, response tends to be siloed rather than networked. “There’s still a lot that can happen.”
What Donors are Doing
- In the aftermath of Hurricanes Katrina and Rita, the Irene W. and C.B. Pennington Foundation awarded funding to the Children’s Health Fund to help reform disaster case management in Louisiana. At that time, six years after the storms, anywhere from 10,000-20,000 children were not living in stable housing and lacked access to education and other essential social services, but without a case management system in place, no one knew for sure. Children’s Health Fund hosted a roundtable with key federal and state decision-makers and private-sector social service organizations, and the results reached beyond Louisiana’s borders. Among other successes, it led to a single federal model for disaster case management that assigns responsibilities to the U.S. departments of Homeland Security (DHS) and Health and Human Services (HHS), fully funded by the federal government.
- The Baton Rouge Area Foundation (BRAF) has supported the long-term recovery of children and families affected by Hurricanes Katrina and Rita, but also has been instrumental in helping victims of the 2010 Deepwater Horizon oil spill. BRAF’s Future of the Gulf Fund disseminated $18 million to four nonprofits, and has been tracking and documenting the longer-term effects of the disaster on families.
- Children’s Health Fund
- Institute for Congregational Trauma and Growth
- American Psychological Association’s Children and Trauma
- The New York University Child Study Center’s Caring for Kids after Trauma, Disaster and Death: A Guide for Parents and Professionals
- NATO’s Psychosocial Care for People Affected by Disasters and Major Incidents
- The National Child Traumatic Stress Network: How is Early Childhood Trauma Unique?
- Grantmakers in Health’s In Harm’s Way: Aiding Children Exposed to Trauma