HJBR Nov/Dec 2021

HEALTHCARE JOURNAL OF BATON ROUGE  I  NOV / DEC 2021 57 Oosterhoff et al., 2018). Of particular rele- vance, youth who are most at risk for de- veloping PTSD after a hurricane are those who had experienced prior losses (Jaycox et al., 2010; Osofsky et al., 2009). All of these factors make children and adolescents across Louisiana especially vulnerable to mental health problems in the aftermath of Hurricane Ida. What can healthcare providers do to help? The good news is that there are some basic steps that healthcare providers can take to help alleviate children’s distress and provide guidance to parents in the con- text of environmental stressors, including traumas and losses. We refer to these as the Six S’s: • Safety and Security: During times of uncertainty, the ability to provide a sense of safety and security to our children becomes even more critical. It is helpful to make sure that youth are aware of what the adults in their lives are doing to protect them and keep them safe. In addition, adults can assist in helping children and adoles- cents identify what they can and do control. For example, while they may not be able to control what is happen- ing in their environment, youth can control their own proactive efforts to stop the spread of the virus through wearing a mask and handwashing. • Simple language: Adults tend to ei- ther err on the side of providing too much information to children, which can be overwhelming, or providing very little information, which sends the message that this is a taboo topic Julie B. Kaplow, PhD, ABPP Executive Director Trauma and Grief Center Children’s Hospital New Orleans and/or that it will be too distressing to handle. Meeting children on their level and using language they under- stand allows them to take in as much information as they need. It is best to let them guide the conversation by asking what questions or worries they have; they often intuitively knowwhat they can or cannot handle. • Supervision: Media outlets and the news can be overwhelming and/or frightening to adults and children alike, whether in reference to the hur- ricane or the pandemic. It is import- ant to monitor the type and quantity of information children are receiving and try as much as possible to keep it to a minimum. Parents can also watch the news with their children and teens, answer questions they may have, and turn it off if it becomes unhelpful or too distressing. • Structure: When the world outside feels chaotic and out of control, chil- dren benefit from having a familiar routine or structure to their day. It is obviously more difficult to do this when school routines are impacted by environmental events, but families can create their own schedules to- gether so that children know what to expect each day. Building in time for appropriate distractions and pleasur- able activities (e.g., watching a favorite tv show) is also key. • Social support: We know that social support is a powerful protective fac- tor during times of stress. Helping children find ways of connecting with friends and family, even if it is through On Sunday, August 29th, on the 16th an- niversary of Hurricane Katrina, Hurricane Ida made landfall in Louisiana, causing the destruction of more than one million homes and businesses throughout both Louisiana and Mississippi, leaving mil- lions of residents without power or water. Although the flood waters have receded and homes are being repaired and rebuilt, the mental health effects of such devas- tation can be significant and long-lasting, especially for children. In fact, consistent with studies of youth affected by Hurricane Katrina (e.g., Osofsky et al., 2009) mental health screenings up to one year following Hurricane Harvey indicated that approx- imately 24% of children and adolescents exposed to the hurricane had clinically sig- nificant symptoms of post-traumatic stress disorder (PTSD), and 31%had clinically sig- nificant symptoms of depression (Dodd et al., 2019). Even prior to Hurricane Ida, the traumas and losses associated with the pandemic have taken a major toll on children’s men- tal health. A recent study estimated that nine individuals are affected by every one person who dies of coronavirus (Verdery et al., 2020). This means that approximately 126,000 people across Louisiana, including children, have been impacted by the death of a loved one due to COVID-19. Even pri- or to the pandemic, research has shown that bereavement is both the most com- mon and most distressing form of trauma among U.S. youth (Kaplow et al., 2010). Bereavement is also the strongest predic- tor of poor school outcomes above and be- yond any other form of trauma (e.g., sexual abuse, physical abuse, domestic violence;