Hurricanes Katrina and Rita forever altered the lives of children in the Gulf Coast, who witnessed horrific deaths and crimes and were forced to evacuate their homes. As a result of enduring such trauma, many now suffer from an array of mental health issues including post-traumatic stress disorder, and are in urgent need of mental health assistance. This critical situation was highlighted in a recent New York Times article which revealed that “New Orleans is experiencing what appears to be a near epidemic of depression and post-traumatic stress disorders (PTSD), one that mental health experts say is of an intensity rarely seen in this country. It is contributing to a suicide rate that state and local officials describe as close to triple what it was before Hurricane Katrina struck and the levees broke....”

Members of the REACH Institute, Children’s Health Fund and Latham & Watkins LLP (a top-five global law firm) brought together a dedicated group of local stakeholder for a three day meeting in New Orleans on May 15-17, 2006. This meeting, entitled: Operation Assist: Children’s Mental Health brought together parents, advocates, academics, educators, state and local agencies, and mental health and primary care providers from Louisiana, Mississippi and Texas, as well as consultants from New York, Chicago, Washington D.C., and Utah, to explore ways to address the need for children’s mental health assistance in the wake of Hurricanes Katrina and Rita. Participants shared experiences illustrative of the critical state of a mental health care system that is overwhelmed, with caregivers far outnumbered by children in severe need of services. 

The major challenges and obstacles identified through Operation Assist include:

Lack of Centralized Information: Some child mental health entities appear to operate in isolation, often with little information about other mental health resources available.

Lack of Communication/Coordination: A deficit in coordination and communication has thus far impeded providers’ abilities to identify and assist children in need. 

Lack of Treatment Capacity and Qualified Staff: Resources in affected areas are stretched very thin. Reinforcements are needed because mental health service providers that were thinly staffed prior to the hurricanes suffered when many professionals did not return after evacuation.

The Solution: The K.I.D.S. Alliance

The overarching outcome of the meeting was the formation of the K.I.D.S Alliance (Kids in Disaster Situations) – a unique and historic partnership between Louisiana, Mississippi, and Texas that will identify and share needs, information and resources in order to bring immediate and sustained mental health relief and services to children in the Gulf States. As a partnership that includes local mental health providers, as well as the nation’s leading mental health organizations and practitioners, the K.I.D.S Alliance provides a mechanism for professionals, parents, advocates and academics to confront disparities, and share information and resources on four major fronts:

1. Technological Resources: 

Through the creation of a comprehensive K.I.D.S. Alliance website, REACH will organize, distribute and make accessible vital information on a centralized information system for all mental health providers and agencies in the affected area, the website will house a useful inventory of resources including:

• A web-based disaster response/resource;
• A database to ensure children with mental health needs are matched to corresponding resources;
• A database of contact information listing which entities, agencies, and/or individuals are performing what services, where, and the current availability of those services;
• Access to online discussion groups/chat rooms as an initial means for providers, parents, advocates, etc. to engage in conversations for emotional and resourceful support;
• A web-based portal to share models and best practices as related to the provision of children’s mental health needs (school-based health centers, certification and trainings, teen certification programs, etc.);
• Web-based storage and access for education and training resources (as described below).

It is hoped that this on-line forum will eventually lead to the sharing of resources and online discourse across state borders, connecting with people who are capable of helping during and following disaster situations. 

2. Education and Training Resources: 

The K.I.D.S. Alliance use a “train-the-trainers” approach, so that once trained, local stakeholders can train others within their own communities to maximize efficiency. Education and training initiatives will include:

Parent empowerment training that will enable parents and care givers who are grappling with the complexities of the mental health system to “take charge” of their child’s mental health care by increasing their skills and knowledge about the latest advances in diagnosis, treatment, services, and effective advocacy;

Primary care provider training in child mental health screening and “first responder” interventions so that pediatricians serving patients with mental health issues will recognize their needs and get them appropriate help;

Mental health clinician support and training so that mental health professionals will stay abreast of the latest evidence-based treatments for children;

Training in safe and effective pharma-psychotherapy for primary care prescribers when specialized mental health care is unavailable.

3. Human Resources:

The K.I.D.S. Alliance will seek to expand the numbers of trained professionals and volunteers serving in the Gulf region by recruiting, organizing and training:

New Professionals – utilizing the website and our network of connections to post formal (paid) positions to a nationwide audience and target graduate school programs. Recruitment efforts will be conceptualized as a public health initiative for those eager to serve children in greatest need;

Professional Volunteers – using the website and the K.I.D.S. Alliance’s combined resources to recruit, organize and train professional volunteers (pediatricians, school staff, etc.) who want to help but do not know how to get involved;

Parent/Family Mentors – connecting families who have learned how to navigate the field of children’s mental health care in order to get needed services for their child, with families who do not know where to turn or how to get appropriate mental health care;

Student Volunteers – using the website and the K.I.D.S. Alliance’s combined resources to recruit students working on advanced degrees in social work, psychology, or medicine to volunteer with children recuperating from trauma.

4. Financial Resources:

The K.I.D.S. Alliance will also serve as a vehicle for the funds which are critical to assist smaller local mental health agencies with their efforts to address children’s mental health issues. Sadly, REACH Board member Juli Wilson Marshall who helped found REACH and the K.I.D.S. Alliance, died as a result of a tragic mishap in May, 2007.  However, Almost 100 individuals, companies, and organizations made spontaneous donations to REACH and to the K.I.D.S. Alliance in Juli Wilson Marshall’s memory.  These funds will be used to establish a permanent scholarship fund as part of Juli’s legacy, focusing on empowering parents and families to effectively advocate for their children’s mental health needs in the wake of disaster situations. 

Despite the benefits that this fund will provide, there remains an immediate and urgent need for funds for children living in FEMA parks in unfamiliar neighborhoods, who have no sense of community or activities to cultivate mental health and post-trauma healing. The K.I.D.S. Alliance will assist participating organizations with identifying funding sources and writing grant proposals that form strategic partnerships and engage in joint fundraising to increase the effectiveness of resources, meet the comprehensive needs of multiple mental health care providers, and maximize donor impact.

Implications;