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Helping Children Heal Project: A School Based Mental Health Recovery Effort

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  1. Helping Children Heal Project: A School Based Mental Health Recovery Effort Leslie E. Lawrence, M.D. Tulane University School of Medicine Department of Psychiatry and Neurology

  2. Helping Children Heal ProjectIntroduction • An innovative school-based community research developed post Hurricane Katrina • Survey Type Research • Medical Students, Residents, Faculty • To assist in the post-disaster mental health recovery of children

  3. Helping Children Heal Project Introduction • Arnold P. Gold Foundation: advances humanism in medicine • Katrina Assistance Fund Grant (2005): Mark Viron, M.D. and Janet Johnson, M.D. • Mercy Corps- My personal Story of Hurricanes Katrina and Rita.

  4. Helping Children Heal Project Introduction • Monday, August 29, Hurricane Katrina made landfall in New Orleans metro area • Levees Failed---Horrific Aftermath • Submerging 80% of New Orleans • One of the Greatest Tragedies in United States History

  5. Helping Children Heal Project Introduction • In Louisiana alone, over 1,000 people lost their lives • Countless others lost their homes, their jobs, and their way of life • Katrina left the people of New Orleans scattered across the country, with many, including school-age children, now in Houston, Texas

  6. Helping Children Heal Project Introduction • American Psychiatric Association and the Campaign for Mental Health Reform noted: • “For an estimated 30 % of hurricane victims and relief workers, the magnitude and duration of the traumas they are experiencing place them at great risk for developing post-traumatic stress disorder (PTSD), other anxiety disorders (e.g. panic disorder), severe depression and other mental and emotional disorders.”

  7. Helping Children Heal ProjectIntroduction • September, 2005, recognizing need and importance of providing continued education for the children of New Orleans • Knowledge Is Power Program (KIPP) • Teach for America • Houston Independent School district

  8. Helping Children Heal ProjectIntroduction • New Orleans West College Preparatory School (NOW) • K-8 charter school in Houston exclusively for children displaced from New Orleans

  9. Helping Children Heal ProjectIntroduction Student Population of NOW: • 100% African-American • Historically impoverished areas of New Orleans • Homes destroyed by Katrina

  10. Helping Children Heal ProjectIntroduction • Administrators of NOW: • Structure • Stability • Support

  11. Helping Children Heal Project Introduction • Risk Factors for Children at NOW school: • Witnessed Traumatic Events • Trapped • Lost their homes, belonging, pets, friends and family • At the very least, all must start life over at a new school in a new city

  12. Helping Children Heal Project Introduction • Problem: • Increased number of behavioral and emotional problems • NOW administrators contacted Tulane University Department of Psychiatry & Neurology* • Requested assistance in dealing with the psychological effects of Katrina

  13. Helping Children Heal Project Introduction • NOW administrators • Teachers • Tulane University Dept of Psychiatry & Neurology • Helping Children Heal (HCH) project.

  14. Helping Children Heal ProjectResearch (NOW) OBJECTIVES: • Determine the prevalence of PTSS among the children of a middle school in post-Katrina New Orleans • Evaluate the effect of a guided-workbook intervention

  15. Helping Children Heal ProjectResearch (NOW) METHODS: • The National Child Traumatic Stress Network Custom screening Tool • The University of California at Los Angeles Child Post-Traumatic Stress Disorder Reaction Index (PTSD-RI) • My Personal Story about Hurricanes Katrina and Rita: A Guided Activity Workbook for Children by Gilbert Kliman, et al.

  16. Helping Children Heal ProjectResearch (NOW) • RESULTS: For grades 6-8, post-traumatic symptom level scores declined 18.75% compared with pre-assessment scores (median of 32 to 26). This was statistically significant (p=.0001).

  17. Helping Children Heal ProjectResearch (McDonogh #15) • Same Research • Different Location; New Orleans • Same Administrators • Different Population

  18. Helping Children Heal ProjectResearch (McDonogh #15) • Objective • Methods* • Community Education on PTSD • Results • Arnold P. Gold Foundation; Poetry Books

  19. Helping Children Heal ProjectResearch (McDonogh #15) OBJECTIVES: • Determine the prevalence of PTSS among the children of a middle school in post-Katrina New Orleans • Evaluate the effect of a guided-workbook intervention

  20. Helping Children Heal ProjectResearch (McDonogh #15) METHODS: • The National Child Traumatic Stress Network Custom screening Tool • The University of California at Los Angeles Child Post-Traumatic Stress Disorder Reaction Index (PTSD-RI) • My Personal Story about Hurricanes Katrina and Rita: A Guided Activity Workbook for Children by Gilbert Kliman, et al.

  21. Helping Children Heal ProjectResearch (McDonogh #15) • COMMUNITY EDUCATION: • PTSD • Types of Stressors: • During the Hurricane(Trapped In Superdome) • Afterwards (Living in a trailer) • PTSD Treatment

  22. Helping Children Heal ProjectResearch (McDonogh #15) • RESULTS: Before the workbook, the median RI score was 24, and 54 students (46%) displayed moderate to severe PTSS. Post-workbook, 43 students (37%) displayed moderate to severe PTSS, and the median RI score decreased by 17% to 20 (p=.0096).

  23. Helping Children Heal ProjectResearch Conclusions • Guided workbook may be a simple and effective intervention to reduce post-traumatic stress in children exposed to hurricanes • Numerous confounders need to be considered • Home Environment • Classroom • Resilience of Each Child • Supportive Factors • Passage of Time

  24. Helping Children Heal Project “Tell me and I’ll forget. Show me, and I may not remember. Involve me, and I’ll understand” • Lakota Sioux

  25. Helping Children Heal ProjectReferences • Pynoos R, Rodriguez N, Steinberg A, Stuber M, Frederick C: The UCLA PTSD Reaction Index for DSM IV (Revision 1). Los Angeles, UCLA Trauma Psychiatry Program, 1998 • Kliman G, Oklan E, Wolfe H, Kliman J: My Personal Story about Hurricanes Katrina and Rita: A Guided Activity Workbook for Middle and High School Students. San Francisco, The Children's Psychological Health Center, 2005 • Mishkin, AD, Viron M, Lawrence LE, Johnson JE, Samples G, Kliman G. Reducing Post-Traumatic Stress after Hurricane Katrina: A School-Based Intervention. Poster presented at the 59th Institute on Psychiatric Services Annual Meeting, New Orleans, LA, October 11-14, 2007 • Lawrence LE, Viron M, Johnson JE, Hudkins A, Samples G, Kliman G: A school-based mental health recovery effort. Poster presented at the 58th Institute on Psychiatric Services Annual Meeting, New York, NY, October 5-8, 2006