Hoffmann Jennifer A, Pergjika Alba, Burkhart Kimberly, Gable Christopher, Foster Ashley A, Saidinejad Mohsen, Covington Trevor, Edemba Desiree, Mullins Sara, Schreiber Merritt, Beers Lee S
Division of Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Pediatrics. 2025 Jan 1;155(1). doi: 10.1542/peds.2024-068076.
Public health emergencies, including climate-related and manmade disasters such as active shooter incidents, occur regularly in the United States. A comprehensive approach is needed to ensure that children's mental health needs are adequately addressed following disasters. This article summarizes the latest evidence on how health systems can effectively address children's unique developmental, social, emotional, and behavioral needs in the context of disasters. To do so requires the integration of mental health considerations throughout all disaster phases, including preparedness, response, and recovery. We discuss the role of traditional emergency response systems and emerging models for responding to mental health crises. These include the national children's disaster mental health concept of operations and specific resources such as crisis lines, mobile crisis units, and telemental health. To achieve a broader reach in addressing children's mental health needs during disasters, health systems can foster a "pediatric disaster system of care" by partnering with community touch points such as schools, faith-based organizations, public health, and law enforcement. Unique considerations during disasters are required to maintain access to care for children with preexisting behavioral health conditions. During disasters, attention is needed to promote equitable identification of mental health needs and linkage to services, particularly for minoritized groups and children living in rural, frontier, and high-poverty areas. Strategies to address children's mental health needs during disasters include the provision of psychological first aid, screening for and triaging mental health needs, and stepped care approaches that progressively allocate higher-intensity evidence-based treatments to children with greater and enduring needs.
公共卫生突发事件，包括与气候相关的灾害以及诸如主动射击事件等人为灾难，在美国时有发生。需要采取综合方法来确保在灾难发生后儿童的心理健康需求得到充分满足。本文总结了关于卫生系统如何在灾难背景下有效满足儿童独特的发育、社会、情感和行为需求的最新证据。要做到这一点，需要在灾难的所有阶段，包括准备、应对和恢复阶段，都纳入心理健康考量。我们讨论了传统应急响应系统的作用以及应对心理健康危机的新兴模式。这些包括国家儿童灾难心理健康行动概念以及诸如危机热线、移动危机处理小组和远程心理健康等特定资源。为了在灾难期间更广泛地满足儿童的心理健康需求，卫生系统可以通过与学校、基于信仰的组织、公共卫生机构和执法部门等社区接触点合作，建立一个“儿科灾难护理系统”。对于已有行为健康问题的儿童，在灾难期间需要特别考虑以维持其获得护理的机会。在灾难期间，需要关注促进公平识别心理健康需求并与服务建立联系，特别是对于少数群体以及生活在农村、偏远和高贫困地区的儿童。在灾难期间满足儿童心理健康需求的策略包括提供心理急救、筛查和分类心理健康需求，以及采用逐步护理方法，即根据需求程度和持续性，为需求更大的儿童逐步分配强度更高的循证治疗。
