A guide for health and social service workers: Supporting children’s mental health in the long term following a disaster

Practitioners are well placed to support children’s social and emotional wellbeing and mental health. Following a disaster, practitioners become even more critical in providing regular checks, support and advice to both children and their parents.

Children of all ages can be profoundly affected by natural disasters such as bushfires, floods, cyclones and severe storms. These events can produce trauma, grief, destruction of children’s sense of safety and security and loss of their home, school or social networks.

When disasters occur, parents need guidance, information and support for their own needs, so they can reassure and care for their children as effectively as possible.

To help with this support for families, practitioners themselves need to be professionally prepared to discuss the issue of disasters with their client families. They need to recognise the ways that disasters can affect the psychological health of children and families, particularly immediately after a disaster occurs.

Practitioners are in a unique position to help monitor their clients over time and see how they are doing. Practitioners can play a pivotal role in helping a community recover after a disaster.

The majority of children will see their symptoms decrease gradually over time and eventually resolve; however, for months and sometimes years following a disaster, families often continue to experience multiple stresses. Enquiring about the recovery of each family member is important. Parents might report after some months that their infant and children continue to show the effects of the disaster.

Children’s reactions vary depending on a constellation of factors at the time of the disaster such as the child’s age, temperament, their specific experience of the disaster and the significance of their losses, as well as previous history of trauma and disruption.

Children’s recovery is significantly influenced post disaster by:

• the extent of the ongoing disruptions they experience e.g. not being able to go home, return to school and usual life-routines, over-exposure
• how well parents and adult family members can support them
• access to quality support networks
• access to a developmentally appropriate explanation of what happened and what is happening.

Some children express their distress through physical symptoms and these physical symptoms may persist, like experiencing trouble sleeping or unexplained aches and pains. They may also be easily startled, feel anxious, appear withdrawn, show reluctance to do new activities, or engage in excessive repetitive play about the disaster.

Continue to assist parents to address priorities and employ achievable strategies that address the issues. It is not uncommon for parents to feel anxiety, helplessness and anger in addition to worrying about their children’s wellbeing.

Modelling optimism and encouraging them to see the strengths and coping skills they have and are using will allow them to feel a sense of control about the future.

Supporting parents

Support parents with their own needs about their experiences, given the disaster and their own trauma and grief; ensure parents are looking after their own safety and wellbeing:

1. Help them understand the connection between their infant/child’s emotion and behaviour.
2. Provide them with advice and information about children’s needs and how to support them. For instance, infants and children need:
   • an environment that is predictable, consistent and has reasonable expectations
   • reassurance
   • regular check ins and information to know that it can take a long time to feel better after a frightening event
   • help to manage fears
   • help to label their feelings and identifying them in their body
   • help to regulate their emotions
   • help to understand their thoughts
   • help to prepare for change and transitions
   • achievable goals and the steps to get there
   • adults they can speak to about how they are feeling and things they can do to help them. Sometimes children feel more comfortable speaking with adult’s other than their parents, particularly if they think talking about the event is upsetting for them
   • opportunities to make decisions and help plan for what they are involved in
   • to engage with extended family, friends and school community
   • music and dance
   • to do fun things, play games and expend energy.

A minority of children will need extra support by a skilled mental health professional who can provide specific assessment and care.

As noted above, infants and children who have experienced adverse childhood events and those with parents who have experienced numerous adverse events need to be especially monitored, as they are more at risk of developing poor health and mental health outcomes.

Infants and children who have not regained developmental milestones previously achieved, who continue to exhibit heightened distress or withdrawal, sleeping or eating difficulties, whose symptoms continue to disturb daily life and are not progressing developmentally, are redflags and need special attention.

A minority of people including children may develop post-traumatic stress disorder (PTSD) from the event.

Self-care for practitioners

It is important that you attend to your self-care and that of your family. Putting in place strategies for self-care is essential for practitioners working in trauma and post disaster.

Some essential tools for this include linking into peer supports, ensuring you receive regular supervision, engaging in stress reduction activities and seeking opportunities to reflect on your experiences with your professional colleagues.

This resource was reviewed and updated in 2018, it is based on a resource originally authored by the Australian Child and Adolescent Trauma, Loss and Grief Network . Ruth Wraith OAM; MCPP