1. Psychosocial Needs Assessment of the Haitian children in the Child in Hand Affiliated Orphanages.
Srihari Cattamanchi1,2
, Moira Hennessy2
, Sara Carson2
, Majed Aljohani1,2
,
Abdulrahman S. Alqahtani1,2
, Michael S Molloy1
, Gregory R. Ciottone1,2
OBJECTIVES
1.Harvard Affiliated Disaster Medicine Emergency Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA
2.Department of Emergency Medicine, Beth Israel Deaconess Medical Centre, Boston, MA
RESULTS
METHODS
Official hospital of
the
Boston Red Sox
• An observational study, conducted at 6 CiH affiliated orphanages in
August 2012.
• Quantitative and qualitative data was gathered from children,
caregivers and orphanage managers.
• We employed the Strengths and Difficulties Questionnaire (SDQ), to
assess the presence of mental health problems and prosocial behavior;
the Perceived Social Support Scale, to evaluate the experience of social
support by vulnerable youth; and the Kidcope Questionnaire, to assess
the use and helpfulness of coping techniques used by children.
• Key informant interviews were conducted with staff and management
at each site.
CONCLUSION
RESULTSINTRODUCTION
• Psychosocial distress and mental illness impacts the health around the
world, affecting the well-being and productivity of people,
communities and societies.
• Mental health vulnerability is high for people and communities
experiencing crisis/disaster, particularly for vulnerable groups such as
children and orphans who rely heavily on adult others and community
stability to support their resilience and coping
To create and evaluate the mental health profile of the vulnerable youth in
post disaster Haiti.
• Substantial mental health concerns were detected, yet a majority of
children also showed helping or pro-social behavior.
• Confidants were most often friends, but also included teachers, family
members, staff and community members, as illustrated in Figure 2.
• With regard to social support, 85% of children had a confidant who
they would be able to talk to about things happening in their personal
life.
• Perceived social support was absent for a minority (15%) of children,
further detailed in Table 1.
• It is concerning, however, that 30% of children reported that
caregivers (as well as friends) do not have confidence in them or let
them know that they are worthwhile.
• Sleep disturbance, enuresis and social isolation seem to be priority
areas of intervention.
• A high-level of trauma exposure was detected among 80% of children.
• Children described a wide range of coping behaviors (i.e. distracting,
self-blame, and expressing emotion, social withdrawal, and social
support).
• However these were inconsistently used / helpful for children.
• Findings from the staff interviews support quantitative findings, which
indicate that an important subgroup of children are experiencing
emotional, behavioral or interpersonal difficulties.
• Beginning to intervene by targeting concerns shared by staff is
recommended.
• Specifically, education and intervention for staff surrounding
bedwetting; the use of ritual and mood regulation practices to support
healthy sleep practices; and providing adequate access to feminine
hygiene products is suggested.
• Notably, in order for staff to begin to address these concerns they must
be supported and empowered to do so.
• Collaborating with management to establish self-care and support
activities for staff is recommended (In conjunction with self-care
education workshops).
• Capacity building seminar to enhance awareness and understanding of
child mental health, child development and communication is
recommended (and requested by staff).
• Priority areas to address include staffing policies that support best use of
staff strengths and allow for self care, practices that allow for regular
one-on-one interaction with children when possible, and aging-out
expectations and services for older youth.
• With regard to child participants, approximately 56% of participants
were male and 44% were female.
• Mean age of 11.49 years (SD, 3.26; range 3-19 years of age).
• Strengths and Difficulties Questionnaire (SDQ), found 15% of the
children having clinically elevated emotional distress in past month.
• Conduct Problems were found in 26% of the children, experiencing
clinically significant behavior problems during past month.
• About 16% of children endorsed clinically significant problems with
peers during the past month, as illustrated in Figure 1.
• Overall 20% of children had significant overall distress or impairment
in functioning.
• In terms of prosocial behavior, 77% of children engaged in adaptive
normal prosocial behavior over the past month and only 3% of
children were in a high risk range in this area.