Toward the Way Forward: The National Children's Disaster Mental Health Concept of Operations

Abstract

<jats:title>ABSTRACT</jats:title><jats:p>Although increasing evidence suggests that children are at particular risk from disasters and evidence-based practices have been developed to triage and treat them effectively, no strategy or concept of operations linking best practices for disaster response is currently in place. To our knowledge, this report describes the first effort to address this critical gap and outlines a triage-driven children's disaster mental health incident response strategy for seamless preparedness, response, and recovery elements that can be used now. The national children's disaster mental health concept of operations (NCDMH CONOPS) details the essential elements needed for an interoperable, coordinated response for the mental health needs of children by local communities, counties, regions, and states to better meet the needs of children affected by disasters and terrorism incidents. This CONOPS for children proposes the use of an evidence-based, rapid triage system to provide a common data metric to incident response and recovery action and to rationally align limited resources to those at greater need in a population-based approach.</jats:p><jats:p>(<jats:italic>Disaster Med Public Health Preparedness</jats:italic>. 2012;6:174–181)</jats:p>

Improving adjustment and resilience in children following a disaster: Addressing research challenges.

“…First, prospective research that incorporates known risk factors is needed to determine who is at risk following a disaster over time. Triage at the time of the event, for example using the PsySTART Rapid Mental Health Triage System (Schreiber, Pfefferbaum, & Sayegh, 2012; Thienkrua et al, 2006), has been demonstrated to predict risk for PTSD and depression using information on exposure, associated physical injuries, illnesses, deaths, severe peritraumatic reactions, and ongoing adversities such as home loss and displacement Although this is a promising strategy, how to connect rapid triage risk data and timely intervention requires further research.…”

Toward the way forward: building an emergency mental health system for Israel

“…These include the use of Internet based interventions [ 33 ] and other interventions for definitive clinical depression and PTSD, which already exist. Provision of care either in the home via tele-health or Internet based interventions or in more routine “disaster systems of care” [ 26 , 34 ] would further extend the reach that has been so challenging in disasters.…”

“…Challenges such as timing, service delivery settings, models of care, payor/funding and coordination issues were reviewed. As the program moves forward into the future, recommendations include broader inclusion of “disaster systems of care” [ 26 , 27 ] to include re-engaging the emergency medical system and hospitals, schools, child care, disaster relief, first responders, and emergency management across all sectors of government. Recommendations also include an increasing focus on populations beyond an exclusive focus on symptomatic individuals, to sub-populations including all children impacted by conflict, those with prior trauma or mental health history, traumatic exposure, communities vs individuals, and responders broadly conceived.…”

“…Recommendations also include an increasing focus on populations beyond an exclusive focus on symptomatic individuals, to sub-populations including all children impacted by conflict, those with prior trauma or mental health history, traumatic exposure, communities vs individuals, and responders broadly conceived. An adult and child emergency mental health CONOPS continuum of care approach, that better integrates preventative efforts, acute phase response coupled with rapid triage in primary touch points or disaster systems of care and access to evidence based treatments for adults and children [ 26 , 27 ] is recommended for consideration, as the program moves forward into the future.…”