In the past month, Hurricanes Harvey, Irma and Maria have seriously impacted the lives of millions of Americans whose homes lay in their paths. Mexico is reeling from two major earthquakes. How can we help children affected by these natural disasters process their emotions?
During the early stages of a natural disaster, the focus of rescuers is on ensuring the physical safety of people in affected areas. But long after the immediate physical danger is over, the effects of trauma and dislocation continue to impact mental health. Children and adolescents are particularly vulnerable to the psychological impact of trauma. While children tend to openly show signs of fear and distress and seek comfort from adults, adolescents who are overwhelmed by intense emotions may feel reluctant or unable to discuss their feelings with others. It is therefore imperative that parents and adults in helping roles stay attuned to the emotional well-being of adolescents and offer support when needed.
Adolescents who are already struggling with mental health issues are the most vulnerable during a natural disaster. Even well-adjusted people living far from Texas shuddered at post-Harvey scenes of people wading through sewage-contaminated water past floating islands of treacherous fire ants. For Houston adolescents with anxiety disorders, their actual experience of this likely overwhelmed their coping mechanisms. At this crucial time, they also temporarily lost access to their therapists and medications. Far from the predictable environments of their homes, they shared crowded shelter space with strangers, many of whom were emotionally overwhelmed themselves. When they return to their homes, these adolescents will require significant psychological support.
Many children and adolescents without pre-existing mental health disorders also struggle psychologically during and after natural disasters. Studies have shown that in the year following a large-scale disaster, up to 40% of previously mentally healthy children assessed show diagnoseable symptoms of anxiety, depression, or post-traumatic stress disorder.
During the first hours of a disaster, children may be exposed to traumatic scenes of devastation and loss, and may experience direct threats to the safety of themselves and their families. Once they are safe, they must cope with the secondary effects of disaster. Their homes and personal property may be gone, and their daily lives become unpredictable without the normal rhythms of school and community. In their changed circumstances, teenagers may have difficulty pursuing the normal developmental tasks of adolescence. At a time when they are primed to move out and explore the world independently, they discover that the world is dangerous and unsafe. The friends and social networks which are so important to their identities are temporarily unavailable. The parents and caregivers to whom they turn for reassurance may themselves be stressed and grieving, preoccupied with efforts to return the family to pre-disaster living conditions.
Individual adolescents show symptoms of psychological trauma in different ways. It is common to see traumatized teens regress, acting like much younger children. Some may act out aggressively or become involved in risk-taking behaviors such as alcohol or drugs. Others may become withdrawn and fearful. Some adolescents may act indifferent and unaffected, but may have trouble sleeping or experience psychosomatic physical symptoms such as headaches and stomach aches.
Though the Red Cross typically sends mental health workers in after a large scale disaster, many affected children and adolescents are not reached or identified by these professionals. It is therefore important that parents and other available adults recognize that by virtue of their own maturity and life experience, they are competent to offer “psychological first aid.” By staying calm themselves and setting up predictable routines, adults can help children and teens cope more effectively. Studies show that following even insignificant seeming patterns such as washing faces each night before sleeping in a shelter helps alleviate anxiety in children. It also helps them to hear adults discuss their own feelings about the disaster while still expressing hope for things to improve in the future. Finding age-appropriate ways for adolescents to help out during the recovery period can help them combat feelings of helplessness.
Once life has returned to normal for families impacted by disaster, parents and teachers must be aware that many children and adolescents are still experiencing the psychological impact of trauma. Unfortunately, parents often hesitate to seek mental health assistance for their children because they underestimate symptoms, or they assume the children are just having normal reactions to abnormal events and professionals would not be interested.
David Schonfeld, director of the National Center for School Crisis and Bereavement, observed at a recent NIMH conference that stigma related to mental health is still a barrier, even in times of national crisis. It is critically important that children and adolescents with mental health needs be identified and treated in the aftermath of large-scale natural disasters.
For more information on helping children and adolescents cope during disasters, the following on-line resources are available: