Supporting Children's Mental Health Needs in Disasters

Jennifer A. Hoffmann, Division of Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Alba Pergjika, Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Kimberly Burkhart, Division of Developmental-Behavioral Pediatrics and Psychology, Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio.
Christopher Gable, Division of Emergency Medicine, Department of Pediatrics, Children's National Hospital, The George Washington University School of Medicine, Washington, DC.
Ashley A. Foster, Department of Emergency Medicine, University of California, San Francisco, California.
Mohsen Saidinejad, The Lundquist Institute for Biomedical Innovation at Harbor UCLA, David Geffen School of Medicine at UCLA, University of California, Los Angeles, California.
Trevor Covington, Pediatric Pandemic Network, Western Regional Alliance for Pediatric Emergency Management, Washington, DC.
Desiree Edemba, Division of Emergency Medicine, Department of Pediatrics, Center for Translational Research, Children's National Hospital, Washington, DC.
Sara Mullins, Pediatric Pandemic Network, Washington, DC.
Merritt Schreiber, Department of Pediatrics, Harbor-UCLA Medical Center, Lundquist Institute, UCLA-Duke National Center for Child Traumatic Stress, David Geffen School of Medicine at UCLA, Los Angeles, California.
Lee S. Beers, Center for Translational Research, Children's National Research Institute, Children's National Hospital, Washington, DC.

Document Type

Journal Article

Publication Date

1-1-2025

Journal

Pediatrics

Volume

155

Issue

1

DOI

10.1542/peds.2024-068076

Abstract

Public health emergencies, including climate-related and manmade disasters such as active shooter incidents, occur regularly in the United States. A comprehensive approach is needed to ensure that children's mental health needs are adequately addressed following disasters. This article summarizes the latest evidence on how health systems can effectively address children's unique developmental, social, emotional, and behavioral needs in the context of disasters. To do so requires the integration of mental health considerations throughout all disaster phases, including preparedness, response, and recovery. We discuss the role of traditional emergency response systems and emerging models for responding to mental health crises. These include the national children's disaster mental health concept of operations and specific resources such as crisis lines, mobile crisis units, and telemental health. To achieve a broader reach in addressing children's mental health needs during disasters, health systems can foster a "pediatric disaster system of care" by partnering with community touch points such as schools, faith-based organizations, public health, and law enforcement. Unique considerations during disasters are required to maintain access to care for children with preexisting behavioral health conditions. During disasters, attention is needed to promote equitable identification of mental health needs and linkage to services, particularly for minoritized groups and children living in rural, frontier, and high-poverty areas. Strategies to address children's mental health needs during disasters include the provision of psychological first aid, screening for and triaging mental health needs, and stepped care approaches that progressively allocate higher-intensity evidence-based treatments to children with greater and enduring needs.

Department

Pediatrics

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