Learning From The Past and Planning For The Future
MENTAL HEALTH MOMENT August 22, 2003 "Every man's life lies within the present; for the past is spent and done with, and the future is uncertain." - Marcus Aurelius
Short Subjects
LINKS Rocky Mountain Region
Disaster Mental Health Institute
CONFERENCES AND WORKSHOPS:
Extension Disaster Education Network (EDEN)
September 30 - October 4, 2003
Denver, Colorado
THIRD ANNUAL
CRITICAL INCIDENT STRESS MANAGEMENT
WORKSHOP SERIES
Rocky Mountain Region
Disaster Mental Health Institute
Dates & Locations:
Laramie, WY: November 12-15, 2003
Casper, WY: November 19-22, 2003
Contact: George W. Doherty
Box 786
Laramie, WY 82073
Email: rockymountain@mail2emergency.com
Download FlierThe Australasian
Critical Incident
Stress Association Conference
The Right Response in the
21st Century
Location: Carlton Crest Hotel
Melbourne Australia
Friday October 3, 2003 thru
Sunday October 5, 2003
For further information
please contact the conference organisers:
ammp@optushome.com.au
Conference Website:
http://www.acisa.org.au/ conference2003/6th Annual Conference
The University of South Dakota
Disaster Mental Health Institute
"Innovations in Disaster Psychology:
Time for a New Paradigm?
Reflecting on the Past:
Looking to the Future"
Radisson Hotel
Rapid City, SD
September 18-20, 2003
8TH International Conference
on Family Violence
September 16 - 20, 2003
Location: San Diego, California, USA
Contact: "FV Conference 2003"
Attn: Lisa Conradi
Conference Co-Coordinator
6160 Cornerstone Court East
San Diego, CA 9212, USA
Phone: +1-858-623-2777 ext. 427
Email: fvconf@alliant.edu
Middle East/North Africa Regional
Conference of Psychology
December 13 - 16, 2003
Location: Dubai, United Arab Emirates
Contact: Dr. Raymond H. Hamden
MENA RCP, PO Box 11806
Dubai, United Arab Emirates
Phone: +971-4- 331-4777
Fax: +971-4-331-4001
E-mail: menarcp@hotmail.com1st International Conference on
Psychophysiology of Panic Attacks
September 5 - 8 2003
Location: London, UNITED KINGDOM
Contact: stonesa@wmin.ac.uk
European Society for Cognitive Psychology (ESCoP)
September 17 - 20, 2003
Location: Granada, SPAIN
Society for Judgment and
Decision Making Annual Meeting
November 10 - 11 2003
Location: Vancouver, CANADA
Society of Australasian
Social Psychologists 33rd Annual Meeting
April 15 - 18, 2004
Location: Auckland, NEW ZEALAND
27th National AACBT Conference
(Australian Association for
Cognitive and Behavior Therapy)
May 15 - 19, 2004
Location: Perth, Western Australia
AUSTRALIA
DHS AWARDS NEARLY $1.2 MILLION IN ADDITIONAL GRANTS TO REDUCE RISK THROUGH PRE-DISASTER PLANNING
The Department of Homeland Security (DHS) announced that six more states have received grants to help state, local and tribal governments protect lives and property by developing multi-hazard mitigation plans. These plans, funded through the Federal Emergency Management Agency's (FEMA) Pre-Disaster Mitigation program, will soon be a prerequisite for receiving certain types of mitigation funding and disaster assistance. For the complete story, go to: http://www.fema.gov/news/newsrelease.fema?id=4001
FEMA REDESIGNS CHER-CAP INITIATIVE
The Federal Emergency Management Agency (FEMA) has initiated a major redesign of the Comprehensive HAZMAT Emergency Response - Capability Assessment Program (CHER-CAP) to expand the scope of the highly successful community-based initiative. The new CHER-CAP will allow communities to apply the process to any hazard. For the complete story, go to: http://www.fema.gov/news/newsrelease.fema?id=4087
‘The ache in our souls is almost too much to bear,’ Annan tells grieving UN staff
Declaring “the ache in our souls is almost too much to bear,” Secretary-General Kofi Annan sought today to console the grief of the United Nations family worldwide with a message of sheer determination to carry on undaunted by the deadly terrorist bombing Tuesday of UN headquarters in Iraq. Full Story at: http://www.un.org/apps/news/story.asp?NewsID=8039&Cr=iraq&Cr1=
Annan and Powell discuss increased security after Baghdad terrorist bombing
Determined to boost the safety of United Nations staff and stay the course in Iraq despite Tuesday’s deadly terrorist bombing, Secretary-General Kofi Annan discussed additional security measures today with United States Secretary of State Colin Powell. For the full story, go to: http://www.un.org/apps/news/story.asp?NewsID=8038&Cr=iraq&Cr1=
No End In Sight For Western Wildfires
Low Humidity and High Temperatures are a bad mix for residents of Western states threatened by wildfires. In Montana, several new blazes are reported daily, and residents of several communities have been evacuated. The fire season will likely continue through the first snowfall. For the Full Story, go to: http://www.fema.gov/press/ap/ap082103.shtm
Disaster Aid In Northeastern Ohio Continues To Climb More Than 11,000 Register For Assistance
Last week's power blackout did little to slow down registrations for disaster assistance in northeastern Ohio, according to figures released today by federal and state officials. "More than 11,000 people have registered for help with the Federal Emergency Management Agency (FEMA) following the flooding that began July 21," said Ron Sherman, federal coordinating officer. "We already have approved $13.9 million in grants for housing and other needs and expect that figure to continue to climb." Fo full story, go to: http://www.fema.gov/news/newsrelease.fema?id=4096
THE MEDICAL MINUTE: BASIC ROUTINES CAN AID SEARCH FOR SLEEP
Because the catch-all term "insomina" really covers a multitude of sleeplessness-causing factors and their related symptoms, just taking a sleeping pill is often not the correct treatment when the problem strikes. According to the latest edition of the Medical Minute, a service of the Penn State Milton S. Hershey Medical Center, one third of the general population and as many as nine out of 10 older Americans have trouble getting enough sleep. Insomnia can be divided into trouble falling asleep or difficulty staying asleep and can be short term or chronic. Fortunately, most common sleep dysfunction can be prevented or managed with an understanding of how to get a good night's sleep, for which maintaining a routine is a good start. Read the full story at http://live.psu.edu/index.php?cmd=vs&story=3756
Childhood Functional Status, Family Stressors, and Psychosocial Adjustment Among School-Aged Children With Disabilities in the United States Witt WP, Riley AW, Coiro MJ
The authors of this study sought to examine the association between child, maternal, and family factors and the psychosocial functioning of children, aged 6 to 17 years, with disabilities. Identification of these interconnections could help clarify specific needs and guide clinicians toward effective interventions and treatment. The study population included 3362 children and was derived from the 1994 and 1995 National Health Interview Surveys, Disability Supplement. This was a US Census Bureau Survey that included disability-related questions asked of all household members with a subsequent interview to assess limitations in activity, impairments, activities of daily living, specific developmental disabilities, and special health needs. Children with 2 or more "disability hit flags" met criteria for disability. Archives of Pediatric & Adolescent Medicine. 2003;157(7):687-695. For more, go to: http://www.medscape.com/viewarticle/459775_3
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.
Both the 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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REFERENCES
To search for books on disasters and disaster mental
health topics, leaders, leadership, orgainizations,
crisis intervention, leaders and crises, and related
topics and purchase them online, go to the following url:
https://www.angelfire.com/biz/odochartaigh/searchbooks.html
RECOMMENDED READING
Messages to Ground Zero: Children Respond to September 11, 2001
by Shelley Harwayne
Book Description
This inspiring book brings together letters, poems, and artwork by children from New York City and across the country in response to the September 11th tragedy.
Additional Readings at: The Day That Was Different: September 11, 2001: When Terrorists Attacked America in the search engine. Also try looking here for The Day Our World Changed: Children's Art of 9/11.
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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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George W. Doherty
Rocky Mountain Region
Disaster Mental Health Institute
Box 786
Laramie, WY 82073-0786
MENTAL HEALTH MOMENT Online: https://www.angelfire.com/biz3/news
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