Whenever there’s a disaster, there’s a rush on hospital admissions for psychiatric problems. But on the whole, the illness is already there.
Emergencies naturally provoke delusions and the emergency efforts, for mania. Obviously, there are direct mental health consequences – a small rise in post-traumatic stress disorder inevitably follows disaster. This correlates with the severity of the consequences of the disaster (loss of family, friends, animals and property).
And there’s usually a big rethink, with about a third of those affected leaving the area permanently. But, for the most part, this isn’t driven by mental health issues, it results from the very real fears about whether living in a disaster zone is worth it.
Resilience and Weakness
In terms of mental health, the real effect of disasters is surprising. When handled well disasters are an opportunity for communities and people who are directly involved to come together, and this appears to fight against mental illness by strengthening social bonds, and feeding a sense of purpose and meaning.
Another surprise is the flipside – an inexplicable rise in the mental illnesses that affect the elderly. Those who are frail and are unable to get involved may feel they are ultimately only a burden. Such people suffer terribly from mental illness as a result of disasters. The big rise in mental health admissions after disaster happens in this group – its first presentations of dementia and senile degeneration is many times higher than with any other mental illness.
The complexity of social, environmental and psychological dynamics during an emergency cannot be underestimated. With normalcy going with the first evacuees, the strength of “all that is good” becomes the new foundation. As the National Strategy for Disaster Resilience points out, the power of the community (people you never met before come out of the woodwork to help), and the abiding dedication of the emergency services can be truly inspiring. And this is just the thing for building physical and mental resilience.
A useful way to understand this effect is through a theory called salutogenics. The theory rests on a relative sense of coherence that’s built by fostering three things – manageability, comprehensibility and meaning. Conversely, the sense of coherence is depleted by anything that rattles the ability to cope – not only a lack of resources required to manage; a lack of knowledge needed to comprehend circumstances, or a lack of meaning in life, but more general forces like the deterioration of age and time.
While emergencies inevitably attack the ability to manage, they allow for meaning by providing clear answers to life’s big question – what are you here for? Getting involved in an emergency effort gives the answer – I’m not a parasite, I’m here to save people. I’m a contributor.
The formation of beliefs like these has been shown to assist in the best of health outcomes, not only in mental health. Recent research has also identified the effect of improved meaning and comprehensibility in conditions as diverse as heart disease and cancers. Surprising as it is, disasters can actually improve health if people find a way to get meaningfully involved in the disaster response effort.
Perceiving is Believing
Reading this, you might think a flood or hurricane is a wonderful thing. But there’s a big caveat – in emergencies, the perceptions of those involved are critical. Good interpersonal connections create meaning, but the lack of structure within emergency situations also provides opportunities for selfishness and even criminality. And these inevitably lend themselves to atrocious outcomes (consider Hurricane Katrina).
Good information improves comprehensibility, but in an emergency, information may be hard to come by and is frequently manipulated. What’s more, people might not have the heart to be honest when it matters most.
An under-promise allows low expectations to be exceeded, and this allows for a powerful message of hope and the belief that everything ultimately works out well. On the other hand, disappointment is easily taken as betrayal.
Disaster victims should be expected to make unreasonable demands. Victims may, for instance, extract promises that are difficult or impossible to keep. Who, after all, wants to deny someone who is desperate and might have his life in danger? Who wouldn’t prefer to lie and say, “Don’t worry. Everything will be fine”?
But a hastily made guess that “someone will be there to help in a couple of hours” can start doing damage at 120 minutes and one second. The reason is because the promise suddenly becomes questionable, and at this point, comprehensibility collapses and meaning starts to erode. What could be more destructive mentally?
- This article – the first of a three-part series – was reported by The74Million.org, a nonpartisan education news nonprofit, in partnership with the Guardian
- From Los Angeles to Miami to New York, dozens of school districts are vowing to shield students and their families from immigration authorities
It’s been an excruciating six months since 14-year-old Fatima Avelica watched, sobbing, as immigration agents picked up her father on their way to school.
Fatima’s father, Rómulo Avelica-González, who immigrated illegally from Mexico in the 1990s, had driven Fatima and her 12-year-old sister, Yuleni, to school in Los Angeles every morning for years, despite a deportation order hanging over his head. But a month after Donald Trump took office as president and called for ramped-up immigration arrests, US Immigration and Customs Enforcement agents pulled over the family’s car.
The wrenching video of the arrest that Fatima took from the backseat went viral, capturing a moment that would come to symbolize the anguish of schoolchildren who have seen their families torn apart by aggressive immigration enforcement, as well as the anxiety of others who worry their families could be next.
For many of the estimated 1 million undocumented children in the US — and the roughly 4.5 million young people, like Fatima and Yuleni, born here and with at least one undocumented parent (like Fatima and Yuleni) — anxiety travels with them from home to school, creating a climate of fear in which learning is disrupted and classrooms are destabilized.
As Trump tightens immigration enforcement, education officials across the country are launching a national resistance movement, declaring their schools “sanctuaries” from Trump’s immigration policies. Superintendents and school board members from districts as diverse as Miami, Milwaukee, Chicago, New York City, Des Moines and Portland,
Oregon have created or revised “sanctuary school” resolutions, vowing to shield students’ personal data from immigration authorities and block federal agents’ access to school property unless they present a warrant.
California — where about 250,000 undocumented children are enrolled in public schools and 750,000 have at least one undocumented parent — is at the forefront of the movement. Statewide, about 60 schools and county education offices have adopted resolutions to safeguard undocumented students. Lawmakers are also debating a “sanctuary state” bill that, in part, takes aim at potential data mining that could use students’ personal information to uncover their immigration status.
“It’s not that the public school necessarily has a file that says, ‘These kids are undocumented’ and ‘These kids aren’t undocumented,’” said Adam Schwartz, an attorney at the Electronic Frontier Foundation, a nonprofit group that fights for online privacy. Rather, schools collect all kinds of personal information about students, including addresses and languages spoken at home. “One database by itself might not tell you anything,” he said. “But when you sew it all together, when this mosaic comes together, a motivated party could use this to begin to identify who undocumented immigrants are.”
All children living in America have the legal right to attend public schools, regardless of their immigration status, due to a 1982 Supreme Court decision. And since 2011 Immigration and Customs Enforcement has maintained a policyof avoiding enforcement activities at schools. In a statement, agency spokeswoman Jennifer Elzea said the policy remains in effect under the Trump administration, adding that the Department of Homeland Security is “committed to ensuring that people seeking to participate in activities or utilize services provided at any sensitive location are free to do so without fear or hesitation,” though she added that authorities “will no longer exempt classes or categories of removable aliens from potential enforcement”.
Still, many immigrant families worry that enrollment in school could create data and paper trails that expose them to possible enforcement action. And Trump’s executive orders on immigration encourage collaboration between federal and local authorities, triggering concern that local police officers stationed inside schools might share information with federal immigration agents.
In the first 100 days after Trump signed executive orders ramping up immigration enforcement, federal agents arrested more than 41,000 people for civil immigration offenses, a 38% increase over the same period in 2016. His proposed 2018 budget, which faces an uphill battle in Congress, calls for the hiring of an additional 1,500 immigration agents at a cost of $300 million and earmarks $1.5 billion for expanding detention and deportation efforts. On 2 August, Trump announced a proposal that would halve the number of legal immigrants admitted to the country over the next decade.
The heightened enforcement has brought heightened anxiety. After the recent presidential election, some schools saw marked drops in attendance as immigrant parents, afraid of exposing their children to the authorities, kept their kids at home.
Schools in Las Cruces, New Mexico, saw a 60% spike in absences following a local immigration raid in February. That coincided with a national Day Without Immigrants protest when several districts across the country reported a surge in absences; but many students didn’t return to class for a month or longer. Now as schools begin their academic year, the Las Cruces district is opening “international welcome centers” at four high schools to better serve students who are new to the US, said Roberto Lozano, the district’s chief officer of equity, innovation and social justice.
Some sanctuary school policies represent symbolic actions to show families that schools are on their side and educate them about their rights. Earlier this month, Los Angeles, where Fatima and Yuleni still attend school, rolled out the “We Are One” campaign. Online resources offer students and their families a list of local immigration attorneys and advice should they encounter federal authorities. They also recommend creating a family preparedness plan and designating a trusted adult to care for a child if an emergency arises.
Coincidentally, in the days after LA superintendent Michelle King announced the campaign, Fatima and Yuvelina received some good news. On 10 August, an immigration appeals court threw out their father’s deportation order. He could be released on bond by the end of the month, though deportation proceedings could take years.
In Oakland, California schools have new posters — in multiple languages — that proclaim: “Oakland schools are sanctuary schools, you are welcome here.”
“Walls speak,” said Nicole Knight, executive director of the district’s English language learner and multilingual achievement office. “When the community comes in and this is one of the first messages that they see, that’s comforting to them. They know that the school has their back.”
Francisco Negrón, chief legal officer at the National School Boards Association, said he fielded questions from education leaders after the election about the legality of sanctuary resolutions. His advice: be cautious, because “sanctuary” is not a legal term and is, in some instances, “politically loaded”. In those conversations, Negrón said, he warns districts to not “overpromise” the protections they can provide to undocumented families.
Though they don’t always carry much legal weight, sanctuary school resolutions help ease parents’ and children’s anxiety by ensuring that teachers and principals know how to respond if immigration agents go to a school or request student information.
A new sanctuary school policy in Portland, Oregon reminds staffers they may not disclose the immigration status or other personal information about students, citing the Family Educational Rights and Privacy Act. In Oakland, school administrators received training this month on what to do under the district’s sanctuary resolution should enforcement activity occur at or near a school.
The resolutions can also help counter fear generated by heated political rhetoric and misinformation. In a television interview earlier this year, Mike Ritze, a Republican member of Oklahoma’s House of Representatives, said the cash-strapped state spends $60m to educate non-English-speaking students and officials should “identify them and then turn them over to ICE to see if they truly are citizens, and do we really have to educate non-citizens?”
Ritze later said he was referring to non-English-speaking students with criminal records. “If they’re a criminal, they should be turned over to ICE,” he said. “Murder trumps educating a 16-year-old.”
That sort of talk, some school officials say, is why sanctuary resolutions are so important.
Involved in, or witnessed, a traumatic event?
When you’re dealing with trauma, you may be experiencing an array of frightening symptoms. This page is here to give you a brief oversight of trauma, including:
- timing of symptoms
- traumatic events
- and treatment
If you’ve landed here because you feel traumatised at the moment, I really want you to know that you have every chance of getting better. And I so hope I can help you to get there. If you’re suffering from Post-Trauma Symptoms or PTSD, recovery really doesn’t have to mean years of therapy either.
Timing of the trauma and its symptoms
If you were involved in – or witnessed – a traumatic event, your reaction may depend to some extent on when it exactly happened.
If you’ve very recently been traumatised, there’s every hope that you’ll begin to feel better within 2 – 4 weeks, if not before. Whatever you’re feeling now is very likely to be absolutely normal.
If it happened 4-6 weeks ago and you’re still really upset about it, now is the time to seek help. Trauma counselling can help you to deal with it and overcome the distressing symptoms of post traumatic stress disorder.
PTSD is diagnosed by a mental health professional.
If you were fine before the event and you haven’t suffered any mental health problems before, you may only need two or three sessions. However, please don’t be disappointed if it does take a little longer.
If you went through quite a traumatic time as a youngster, your recent trauma may re-awaken old memories. Whether you’re suffering from the results of past trauma or recent post-traumatic stress/PTSD, you can recover!
What kind of events can be considered potentially ‘traumatic’?
What is considered a ‘traumatic’ event is to a large extent very personal. However, this list identifies the most commonly recognised potentially traumatic events:
- industrial accident
- road traffic/car accident
- Traumatic Birth
- fighting a war
- reporting on a war
- terrorist attack
- hostage situation
- watching your child receive traumatic medical treatment
- work-related incident (e.g. fire and rescue, police, ambulance, medical)
- traumatic medical treatment, stroke
- witnessing a traumatic event, particularly if you are/were close to the victim/casualty
- victim of crime
Witnessed a traumatic event?
Witnessing a traumatic event can be just as difficult as directly experiencinga traumatic event. A witnessed incident is potentially traumatic if there’s some element of it that personalises it for you, for example if it involved:
- a child of the same age as yours
- someone doing the same job as you
- someone driving the same car as you
- somone who is the same age as your brother
- someone with similar circumstances to you, and so on
If you’ve witnessed a traumatic event – particularly if it involved people close to you – the above symptoms time-scale is relevant for you too.
You get up every day, you do your job, you do with the children and the chores – YOU HAVE COURAGE!
Is debriefing needed?
‘Emotional debriefing’ (as opposed to operational debriefing, for example as used by the police) is now not considered helpful – at least not in individual sessions. There appears to be little agreement on whether it’s useful in groups.
On the whole, debriefing is not often needed: as human beings, we can generally come to terms with even significant traumatic events quite naturally – in a supportive environment.
We usually adapt to, absorb and/or manage the changes that have taken place as a result of a trauma. Those changes can be external, or internal – ‘inside our head’. Supportive people around us, rest and the natural passage of time all help.
The aftermath – anything positive?
It’s possible that when you’re over the horrible symptoms brought about by a trauma, you can begin to see that in some way, some good has come of it.
I’m almost biting my lip as I write this, because the experience of trauma is so personal. If you’re reading this soon after a traumatic experience I can totally understand if you want to take issue with me on that statement!
However, you may begin to feel that you’ve overcome something, and that you’ve survived. You may even feel pleased about the way you acted at the time, or the way that you’ve dealt with the difficulties post-incident.
When you’re beginning to recover, try to discover any positive aspects of what’s happened. For example, you might have an increased appreciation of personal relationships, you may have discovered a new zest for life, or even a feeling of strength.
Can trauma counselling help?
If you’re left with frightening symptoms – even many years after the event – ‘trying to forget’ and ‘pulling yourself together’ just don’t work.
If this is your situation, I suspect you’ve given yourself a hard time for not being able to get on top things. You may also have become increasingly isolated.
Trauma counselling really can help if you’re struggling in your own situation. However, it’s worth being aware that your counsellor needs to be skilled in trauma work specifically.
Your memories don’t have to be your taskmasters
Your traumatic memories can be treated, maybe even in just a few sessions – even if the event happened years ago. The memory can be de-traumatised with a safe, non-intrusive and reliable technique.
- Visual Kinaesthetic Dissociation (VKD), often called the ‘rewind’ technique (but really being what’s called: trauma-focused ‘imaginal exposure’ with guided relaxation) doesn’t require you to tell your counsellor any details about the trauma if you don’t want to talk about it.
- Eye Movement and Desensitisation and Reprocessing (EMDR) too is a well-recognised, and often very effective, treatment for PTSD.
- Emotional Freedom Technique (EFT) involves tapping on acupuncture points. I personally have had some great results with that too.
- Counselling for PTSD can help you to move on with your life. It can give you the opportunity to consider how you’ve lived with the trauma. It can also show you how you’ve adapted your life to try and avoid being confronted by any reminders of the trauma.
You may find that several aspects of your life have been impacted… and that you were completely unaware of those effects.
Treating any post-traumatic stress or PTSD
PTSD can be treated quickly and effectively in the majority of cases. Whilst excellent results can often be obtained within just a few sessions, sometimes a longer course of counselling may be helpful – particularly if the trauma is related to years of abuse.
The most important message I want you to take away from this article is that you can recover, and you can get your life back together again. I have every confidence in you.
Happy Summer!! This is a video that comes straight from the heart! I love to find ways to inspire those who seek it. Remember that we are only as limited as we allow ourselves to be! Be the change within yourself….
“You may not control all the events that happen to you, but you can decide not to be reduced by them.”
― Maya Angelou, Letter to My Daughter
Until next time…
So many have asked about how best to deal with our new generation of children. Most important of course is our desire and ability to be present. It takes so more than our own parents had to deal with when we were young but we can do it! Here is a brief video giving some very basic ideas! Until next time….
By Jennifer L.W. Fink, RN, BSN
Did you know anxiety disorders affect one in eight children? Everyone experiences anxiety and worry sometimes, but for kids with anxiety disorders, the world can seem scary and overwhelming. Without treatment, kids with anxiety disorders are likely to struggle in school and in life, and are at increased risk for substance abuse.
The good news is anxiety disorders are manageable. Whether you’re a parent, teacher, family member or friend, here’s what you need to know about anxiety disorders in children.
Symptoms of Anxiety Disorders
Kids almost never say they’re anxious. They show their anxiety in other ways. One of the most common symptoms of anxiety in children is frequent physical complaints and avoidance of activities, such as school or extracurriculars. Headaches and stomachaches are two common physical symptoms of anxiety.
A child who is experiencing anxiety may have a hard time falling asleep at night, or may wake up at night. A child who has been contentedly sleeping alone may ask to sleep in your bed or bedroom. Some kids eat more or less than usual when they are anxious.
Crying and clinging—especially upon separations—can be another symptom of anxiety. Temper tantrums and frequent irritability might actually be signs of anxiety, not anger or disobedience.
Other symptoms of anxiety include persistent negative thinking (“I’ll never be any good at this,” “No one likes me”), difficulty concentrating, and excessive worry.
Of course, all kids exhibit these symptoms sometimes. But when these symptoms are commonplace and interfere with the child’s functioning, they may be a sign of an anxiety disorder.
Common anxiety disorders in children include:
Generalized Anxiety Disorder (GAD): Perhaps best explained as excessive worry about a lot of things, generalized anxiety disorder affects between 3 and 5% of kids and teens. Children with GAD are often perfectionists who think something bad will happen if they don’t get perfect grades or perform perfectly in sports or at home.
Panic Disorder: Panic disorder is diagnosed in kids who have had at least two unexpected panic or anxiety attacks, followed by at least one month of fear or concern that another attack could happen at any moment. Panic attacks can be particularly scary to kids, as they may not understand what’s going on. Because many of the symptoms of a panic attack are physical—pounding heartbeat, shortness of breath, sweating, difficulty breathing—the child may fear he or she is dying.
Social Anxiety Disorder: Kids who have social anxiety disorder (also called social phobia) are very fearful of being placed in the spotlight. They may be reluctant to speak in class and may avoid social interactions.
Separation Anxiety Disorder: Separation anxiety—intense feelings of distress upon separation from familiar caregivers—is common in children between the ages of 18 months and 3 years. At this stage, it’s a very normal part of development, and rarely a big problem. However, older children who became extremely upset at the thought of leaving you, or who cannot handle separations without substantial distress, may have separation anxiety disorder. Separation anxiety disorder affects about 4% of children and is most common in children ages 7 to 9.
Selective Mutism: A child who refuses to speak to others may have selective mutism. Many of these kids talk normally at home or with friends or family members, but clam up in other environments.
Phobias: An irrational fear of something specific—clowns, closed spaces, spiders— is actually a form of anxiety disorder.
Risk Factors for Anxiety Disorders
Anxiety affects everyone sometimes, but some people have an increased risk of anxiety disorders. A child who has a family history of anxiety disorders, panic attacks, and depression is more prone to an anxiety disorder than kids from families with no history of anxiety. (Experts think the family connection may be part biology and part sociology. Kids may inherit genes that increase the likelihood of an anxiety disorder. They may also learn anxious behaviors and thinking from family members.)
A history of trauma—such as abuse, natural disaster or war—increases a child’s risk of anxiety disorders. So does chronic exposure to stress, whether that stress is poverty, an unsafe neighborhood, or parental fighting.
Treatment for Anxiety Disorders in Children
Treating anxiety disorders allows affected children to grow and develop without being hindered by fear and worry. The two most common treatments include psychotherapy and medication.
Therapy helps children cope with their fears. It may include exposure therapy, or gradual exposure to feared objects or situations, and cognitive therapy, which teaches children how to replace unhelpful thoughts that feed their anxiety. Look for a therapist who has experience working with children with anxiety disorders.
In some cases, medication may be used, often as a complement to therapy. Both antidepressants and anti-anxiety medications can help children with anxiety disorders. It can take a few weeks for medication to be effective. A child who is taking medication for an anxiety disorder should see a healthcare provider on a regular basis to monitor its effectiveness, along with any side effects.
Learning to recognize and manage anxiety disorders in children can be a challenge. Be kind to one another, and be patient. With time and support, most families find anxiety disorders very manageable.
As we continue to struggle with what daily challenges our World places in front of us, let’s take a minute to reflect on what is important.