Improving Disaster Mental Health Care in Schools

Abstract

Background Although schools are often the first institution to provide recovery efforts for children post-disaster, few studies have involved the school community in research to improve the delivery of these mental health services on campuses. This community partnered study explores post-disaster counseling services ten months following Hurricane Katrina. Methods In July 2006, nine focus groups, comprised of 39 school-based mental health counselors and 6 program administrators (10 men, 35 women), were conducted following a two-day clinical training regarding a youth trauma intervention following Hurricane Katrina. Participants discussed types of services they had been providing prior to the training and potential barriers to delivering services. Results Participants identified high mental health needs of students and described populations that did not seem to be adequately supported by current funding sources, including those with preexisting traumatic experiences and mental health issues, indirect psychological and social consequences of the storms, and those students relocated to less impacted communities. Participants also described the need for a centralized information system. Conclusions Participants described the need for greater organizational structure that supports school counselors and provides system-level support for services. Implications for next steps of this community partnered approach are described.

Exploring the Use of the Interactive Systems Framework to Guide School Mental Health Services in Post‐disaster Contexts: Building Community Capacity for Trauma‐Focused Interventions

“…In the wake of disaster, many mental health professionals described worsening personal stress levels (e.g., rebuilding homes, relocating, family and work stress, stress of living in a community with limited resources (Dean et al 2008;Kataoka et al 2009) that interfered with self-care. Independent providers indicated higher stress levels than those working in community mental health centers working collaboratively with and in schools, which tended to offer more supervision and support to their SMH providers (Kataoka et al 2009). Thus, some have suggested that disaster planning include provision of process groups for mental health professionals.…”

“…Specifically in relation to this article, schools have been also identified as strongholds in communities plagued with disaster. Schools offer a vehicle for distributing supplies and conducting town meetings, and are among the first institutions to re-open post-disaster (Dean et al 2008;Kataoka et al 2009). More importantly in terms of mental health services, schools are likely to re-open prior to the opening of local mental health centers in the wake of disaster (Dean et al 2008).…”

“…Looking toward lessons learned from post-Katrina schoolcentered interventions allows for identification of organizational factors that affect individual attitudes and motivation, which in turn affect intervention implementation (Cooke 2000;Osher and Hanley 2001). In the wake of disaster, many mental health professionals described worsening personal stress levels (e.g., rebuilding homes, relocating, family and work stress, stress of living in a community with limited resources (Dean et al 2008;Kataoka et al 2009) that interfered with self-care. As noted by one panel member, ongoing work related stressors since Hurricane Katrina, such as carrying large/burdensome caseloads of youth with many unmet needs, has contributed to the failure to grieve personal losses, and in turn, professional burnout.…”

The Practice of Evidence-Based Treatments in Ethnic Minority Youth

“…Just as service providers should partner with the community in selecting and implementing interventions, researchers should also develop such partnerships to guide their development and evaluation of the evidence base [68]. One method of balancing treatment fidelity and adhering to culturally-informed care is through a process of Community-Based Participatory Research (CBPR), in which there is equal partnership between community members and researchers from the inception of the intervention, through all stages of development, implementation, and evaluation of a treatment program[22, 69].…”

Persistence of Mental Health Needs among Children Affected by Hurricane Katrina in New Orleans

“…Most were considered hurricane-related. [20][21][22] At Louisiana school-based health centers during the 2007-2008 school year, mental health was second only to general preventive medicine as the reason care was sought. The trauma histories described by these patients are consistent with those described in a 2009 study funded by the National Institute of Mental Health.…”