title: Pediatric disaster preparedness in the medical setting: integrating mental health.
abstract: BACKGROUND
  The increasing prevalence of disasters worldwide highlights the need for established and universal disaster preparedness plans. The devastating events of September 11 and Hurricane Katrina have spurred the development of some disaster response systems. These systems, however, are predominantly focused on medical needs and largely overlook mental health considerations. Negative outcomes of disasters include physical damage as well as psychological harm. Mental health needs should be considered throughout the entire disaster response process, especially when caring for children, adolescents, and their families.
  
  
  OBJECTIVE
  To provide an overview and recommendations for the integration of mental health considerations into pediatric disaster preparedness and response in the medical setting.
  
  
  METHODS
  Recommendations were developed by a panel of disaster preparedness and mental health experts during the Childrens Hospital Los Angeles Pediatric Disaster Resource and Training Center: Workshop on Family Reunification in Los Angeles, California, March 31-April 1, 2008. Experts discussed the inclusion of mental health-specific considerations and services at all stages of disaster preparedness and response. Recommendations involve the integration of mental health into triage and tracking, the adoption of a child ambassador model, environment, and developmentally appropriate interventions, education, communication, death notification, and family reunification.
  
  
  CONCLUSIONS
  The inclusion of mental health concerns into pediatric disaster preparedness may help prevent further and unnecessary psychological harm to children and adolescent survivors following a disaster.
authors.affiliation: Keck School of Medicine, University of Southern California, Los Angeles, USA.
authors.forename: Jeffrey I
authors.initials: JI
authors.lastname: Gold
authors.forename: Zorash
authors.initials: Z
authors.lastname: Montano
authors.forename: Sandra
authors.initials: S
authors.lastname: Shields
authors.forename: Nicole E
authors.initials: NE
authors.lastname: Mahrer
authors.forename: Viktoria
authors.initials: V
authors.lastname: Vibhakar
authors.forename: Tanya
authors.initials: T
authors.lastname: Ybarra
authors.forename: Nancy
authors.initials: N
authors.lastname: Yee
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Upperman
authors.forename: Nancy
authors.initials: N
authors.lastname: Blake
authors.forename: Kathleen
authors.initials: K
authors.lastname: Stevenson
authors.forename: Alan L
authors.initials: AL
authors.lastname: Nager
mesh_terms: D000293:Adolescent; D002648:Child; D002669:Child Welfare; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D004189:Disaster Planning / Q000458:organization & administration*; D004632:Emergency Medical Services / Q000458:organization & administration*; D006801:Humans; D033183:Interdisciplinary Communication; D008605:Mental Health Services; D010372:Pediatrics / Q000458:organization & administration*