Helping Children Heal Project

Leslie E. Lawrence, M.D.

Tulane University School of Medicine

Department of Psychiatry and Neurology

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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

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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.

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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

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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

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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.”

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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

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New Orleans West College Preparatory School (NOW)

K-8 charter school in Houston exclusively for children displaced from New Orleans

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Student Population of NOW:

100% African-American

Historically impoverished areas of New Orleans

Homes destroyed by Katrina

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Administrators of NOW:

StructureStabilitySupport

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Risk Factors for Children at NOW school:

Witnessed Traumatic EventsTrappedLost their homes, belonging, pets, friends and family

At the very least, all must start life over at a new school in a new city

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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

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NOW administrators Teachers Tulane University Dept of Psychiatry & Neurology

Helping Children Heal (HCH) project.

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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

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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.

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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).

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Helping Children Heal ProjectResearch (McDonogh #15)

Same Research

Different Location; New Orleans

Same Administrators

Different Population

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Objective

Methods* Community Education on PTSD

Results

Arnold P. Gold Foundation; Poetry Books

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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

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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.

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COMMUNITY EDUCATION:PTSDTypes of Stressors:

During the Hurricane(Trapped In Superdome)Afterwards (Living in a trailer)

PTSD Treatment

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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).

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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 consideredHome EnvironmentClassroomResilience of Each ChildSupportive FactorsPassage of Time

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Helping Children Heal Project

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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

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Documents

Helping Children Heal Project