Resilience in Katrina’s Children in the Aftermath of the Disaster

1. Resilience in Katrina’s Children in the Aftermath of the Disaster Joy D. Osofsky, Ph.D. Louisiana State University Health Sciences Center Louisiana Spirit September 22, 2006

2. Take Home Messages • Children of all ages were traumatized by the displacement, separation from family, & loss of homes & community • The extent of traumatization is related to the age and vulnerability of the child, amount of support from family, school, and community, and previous trauma and loss history

3. Take home messages • While most children will be resilient- especially with support from adults- prevention, it is crucial to build capacity and to provide intervention and supportive services in settings accessible to children and families (i.e. preschools, schools, community centers, clinics) to prevent both short and long term effects of traumatization

4. What We Have Been Seeing in Displaced Children -- Positives • Resilience - meaning the ability to cope successfully with adversity (especially if parent or caretaker is emotionally available) • Pleasure about returning to school and being with friends • Wish to resume life and normal pre-hurricane activities

5. Overall Problems we have been Seeing in Children • Increases in depression with devastation, slowness of recovery, and reality of losses • Anxiety and stress symptoms with increases during hurricane season and with anniversary • In young children, more clingy behaviors and more difficulty with separations • In older children, more difficulty concentrating, doing school work, & fighting • In adolescents, more risk taking behaviors

6. Mental Health Status of Older Children in Heavily Impacted Areas • Information gathered on 2200 children (ages 9-18 years) who were displaced and returned to schools in New Orleans Metropolitan area • The majority lost their homes and communities were destroyed; 28% are living in trailers

7. Need for Mental Health Services • Almost half of the children met the cut-off for mental health referral for evaluation based on their responses • 13% requested counseling • 37% reported experiencing previous loss or trauma (placing them at higher risk for problems following this traumatic event) • On a screening measure, almost 40% endorsed feeling depressed, angry, or sad

8. Children reported their Traumatic Experiences • 34% were separated from their primary caregiver while displaced • Some children attended up to 9 schools during the displacement; average=2 • Almost all children saw hurricane damage to their homes • 21% saw family members or friends injured • 14% saw family members or friends killed

9. Symptoms reported by Older Children • Many children reported posttraumatic stress symptoms with almost a third reporting conflicting feelings that included upsetting thoughts about the hurricane at the same as they tried not to think about it. • Almost half worried about the future • Even more children endorsed symptoms of depression with 40% reporting feeling sad, down, or depressed and almost a third reported difficulty with concentration

10. Mental Health Status of Younger Children • Data on 787 children (ages 3-8 years) reported by their parents • 32% met cut-off for mental health referral and almost 40% of parents said they wanted to have their child (or them) talk to a counselor • Within this group from heavily devastated areas, there was a very high level of unemployment for at least one parent which added stress to the family

11. Parents reported many traumatic experiences for younger children • Separation was a big issue during the hurricane with 14% separated from primary caregiver; 20% separated from pets • 63% lost their personal belongings • 10% witnessed family members injured and 4% witnessed death

12. Symptoms reported by Parents of Younger Children • Posttraumatic stress symptoms included being upset when thinking about the event and yet talking repeatedly about it. They also worried about the future • The symptoms of depression included being clingy (a reaction occurring more in younger children), worried about separation, feeling sad, down or depressed

13. The Importance of Supporting Resilience in Children • Resilience is the ability to manage successfully in the face of significant adversity, such as a disaster. Masten refers to it as “Ordinary Magic,” a surprising capacity to cope well.

14. Resilience building activities on the cruise ships for first responders families • Setting up child care programs for young children providing fun activities for them and respite for stressed parents • Celebration of family holidays such as Halloween and Thanksgiving to support both fun and traditional activities for families • Build resilience supporting family activities to make life seem more normal in an abnormal environment

15. Summer Leadership Program for Adolescents • Resilience enhancing and self efficacy program for 10th graders • Building leadership by helping them take responsibility in a number of areas – school, family, community • Important growth promoting program for adolescents after disasters

16. Lessons Learned • Children of all ages may be traumatized by a natural disaster • Some behavioral and emotional reactions to trauma may be “normal” or represent a new “normal” with wide spread disaster and continuing anxiety • It is crucial to recognize & address, in culturally sensitive ways, mental health needs of children of all ages and their families after a major natural disaster

17. Lessons Learned • It is important to build capacity putting in place services where children are to prevent more serious short and long term consequences of trauma exposure • The needs of parents, health and mental health professionals, teachers, volunteers - “compassion fatigue” and continual need for self care should be addressed

18. Contact information for Joy D. Osofsky, Ph.D. Professor of Pediatrics and Psychiatry Louisiana State University Health Sciences Center in New Orleans josofs@lsuhsc.edu (504) 296-9011 (cell) www.futureunlimited.org