The Dialogue

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

2019 | VOLUME 15 | ISSUE 2 

Children and Disasters 
 

 

 

 

 

 

 

 

IN THIS ISSUE 

3 In This Issue 

4 Technical Assistance Snapshot 

5 Contributors 

7 Texas Child Specialists Serve Communities 

9 Preparedness and Recovery Resources for Children 

10 Colorado Spirit’s Approach to Helping Children Recover After a Disaster 

13 Spotlight on Disaster Behavioral Health Programs for Children 

14 Recent Technical Assistance Requests 

Jonathan Kirkpatrick of the Federal Emergency Management Agency (FEMA) 

Corps helps a young child understand the importance of emergency preparedness 

during an event in Missouri in April 2015. Photo by Steve Zumwalt/FEMA.

The Dialogue is a quarterly technical assistance journal on disaster behavioral health which 

is produced by the Substance Abuse and Mental Health Services Administration (SAMHSA) 

Disaster Technical Assistance Center (DTAC). Through the pages of The Dialogue, disaster 

behavioral health professionals share information and resources while examining the 

disaster behavioral health preparedness and response issues that are important to the field. 

The Dialogue also provides a comprehensive look at the disaster training and technical 

assistance services SAMHSA DTAC provides to prepare states, territories, tribes, and local 

entities so they can deliver an effective disaster behavioral health response. To receive The 

Dialogue, please go to SAMHSA’s home page (https://www.samhsa.gov), click the “Sign 

Up for SAMHSA Email Updates” button, enter your email address, and mark the checkbox 

for “SAMHSA’s Disaster Technical Assistance newsletter, The Dialogue,” which is listed in 

the Newsletters section. 

SAMHSA DTAC provides disaster technical assistance, training, consultation, resources, 

information exchange, and knowledge brokering to help disaster behavioral health 

professionals plan for and respond effectively to mental health and substance misuse needs 

following a disaster. 

To learn more, please call 1–800–308–3515, email dtac@samhsa.hhs.gov, or visit the 

SAMHSA DTAC website at https://www.samhsa.gov/dtac. 

The Dialogue is not responsible for the information provided by any web pages, materials, or organizations referenced in this publication. Although 

The Dialogue includes valuable articles and collections of information, SAMHSA does not necessarily endorse any specific products or services 

provided by public or private organizations unless expressly stated. In addition, SAMHSA does not necessarily endorse the views expressed by such 

sites or organizations, nor does SAMHSA warrant the validity of any information or its fitness for any particular purpose.
2019 | VOLUME 15 | ISSUE 2 | PAGE 3 

Produced by the SAMHSA Disaster Technical Assistance Center

 

 

In This Issue 

Disasters have the potential to affect the short- and 

long-term functioning, psychosocial adjustment, health, 

and the developmental trajectory of children. While 

all populations are affected during a crisis, children 

often react differently to disasters than adults and 

have varying needs before, during, and after disasters. 

Children are particularly vulnerable to separation 

from their parent or guardian, disruption of their daily 

routines, and other adverse events. According to the 

Federal Emergency Management Agency (FEMA), 

following Hurricanes Katrina and Rita in 2005, over 

5,100 children were separated from their parents. It 

took up to 8 months for the children to be reunited with 

their parents. Being prepared in case of a disaster can 

help limit the risk of separation and speed up recovery. 

Despite this knowledge, 18 states don’t meet basic 

emergency planning standards for schools and child care 

and less than half of families have an emergency plan 

(Save the Children). 

Disaster behavioral health professionals, communities, 

and families can take steps to help children prepare for 

and cope with their reactions to disasters. With proper 

planning, children can be resilient when faced with 

disasters especially if they are prepared or have talked 

to an adult about their thoughts and feelings as well as 

what they can do in the event of a disaster. Some steps 

to take with children to help them feel more in control is 

to make an emergency plan, practice it with your family, 

and encourage your children and their friends to make 

a “go bag.” Schools, local coalitions, and communities 

can also help children before, during, and following 

disasters by providing information to families, creating 

• Helping Children and Youth Cope in the Aftermath

of Disasters: Tips for Parents and Other Caregivers,

Teachers, Administrators, and School Staff podcast

helps identify common disaster reactions in children

and discusses their needs during immediate and longterm recovery.

• Behavioral Health Conditions in Children and

Youth Exposed to Natural Disasters Supplemental

Research Bulletin reviews research on mental health

and substance use issues and conditions in children and

youth after natural disasters.

• Talking With Children: Tips for Caregivers,

Parents, and Teachers During Infectious Disease

Firefighter hands holiday gift to a little girl who attended the Grand Three

Kings Celebration at the Humacao Arenas Coliseum in Puerto Rico. Photo 

by Andrea Bajandas/FEMA.

opportunities for children to express their feelings, and 

establishing a sense of normalcy following a disaster. 

For more information on children and disasters, please 

see the following resources from the Substance Abuse 

and Mental Health Services Administration (SAMHSA) 

Disaster Technical Assistance Center (DTAC): 

“In community samples, more than two-thirds 

of children report experiencing a traumatic event by age 16.” 

Source: 2008 Presidential Task Force on Posttraumatic Stress Disorder and Trauma in Children and Adolescents 
 

Produced by the SAMHSA Disaster Technical Assistance Center

 

Outbreaks provides strategies for helping children 

manage their stress during an infectious disease 

outbreak. 

Federal, state, and local professionals as well as 

community members all play an important role in 

incorporating and reaching children in disaster response 

and recovery. This issue highlights activities that Crisis 

Counseling Assistance and Training Program (CCP) 

grants have undertaken to successfully reach children. In 

the first article, several members of the Texas CCP Team

discuss steps they have taken to support children affected 

by Hurricane Harvey. Our second article showcases a 

program used in schools by a Colorado CCP grant. 

Has your program had success reaching out to children? 

Do you have suggestions or lessons learned from your 

experiences? We encourage you to contact us to share 

your recommendations. ■

Captain Erik Hierholzer, B.S.N. Program Management 

Officer, Emergency Mental Health and Traumatic Stress

Services Branch 

erik.hierholzer@samhsa.hhs.gov 

Nikki Bellamy, Ph.D. Public Health Advisor, 

Emergency Mental Health and Traumatic Stress 

Services Branch 

nikki.bellamy@samhsa.hhs.gov 

Shannon Loomis, M.A. Director, SAMHSA Disaster 

Technical Assistance Center 

dtac@samhsa.hhs.gov 

TECHNICAL ASSISTANCE SNAPSHOT 

CCP Assessment and Referral Tools 

CCP teams use these tools to collect data on people who are experiencing more serious reactions. Typically, they 

are recommended to be completed on the third or fifth or later visit. A crisis counselor may also complete the tools 

anytime they suspect the individual may be experiencing serious reactions to the disaster. Between September 

1, 2017, and August 31, 2018, 12 percent of assessments (101 of 863 assessments) were completed at the third 

visit and 3 percent (25 of 863 assessments) at the fifth or later visit. Over 65 percent of adult assessments (498 

assessments) and over 80 percent of child/youth assessments (96 assessments) were completed on the first visit.

FIRST VISIT 

90%

80%

70%

60%

50%

40%

30%

20%

10%

0%

SECOND VISIT THIRD VISIT FOURTH VISIT FIFTH VISIT or later 

Adult 

Child 

2019 | VOLUME 15 | ISSUE 2 | PAGE 4 
2019 | VOLUME 15 | ISSUE 2 | PAGE 5 

Produced by the SAMHSA Disaster Technical Assistance Center

 

Contributors 

Koral O’Brien’s career has 

been in public health. Of 

her 30 years at the Colorado 

Department of Public Health 

and Environment 17 years 

have been with the Office

of Emergency Preparedness and Response. Her 

expertise is in community engagement and in her role 

as Volunteer Coordinator she manages the statewide 

Colorado Volunteer Mobilizer. This program houses 21 

Medical Reserve Corps and the 539 volunteers within 

them providing redundant communications, training 

opportunities, and more. Ms. O’Brien also works with 

children throughout the state via the “I’m Not Scared 

When I’m Prepared” program. She has found a job she 

loves in working with her community. 

Chance A. Freeman is the 

Director of Disaster Behavioral 

Health Services at the Texas 

Health and Human Services 

Commission where he provides 

direction for the state’s Disaster 

Behavioral Health Services program and CCP. As the 

former Associate Director of School Safety Education 

at the Texas School Safety Center at Texas State 

University, he worked with a team that served as a 

clearinghouse for the dissemination of school safety 

and security information through research, training, 

and technical assistance for K–12 schools and junior 

colleges throughout the state of Texas. He began 

working in the field of disaster mental health in 1998

as an outreach/crisis counselor. Since that time, Mr. 

Freeman has responded to over 26 federally declared 

disasters and a variety of emergency events such as 

the Space Shuttle Columbia Recovery project, the 

West Fertilizer plant explosion, the church shooting 

in Sutherland Springs, Texas, the school shooting in 

Santa Fe, Texas, and local criminal events. As a result 

of his extensive experience with the FEMA CCP, Mr. 

Freeman has provided technical assistance and training 

on CCP grant development and management to a variety 

of states and federal agencies. Through his experience, 

Mr. Freeman has also provided training at FEMA’s 

Emergency Management Institute in Emmitsburg, 

Maryland. Mr. Freeman serves as Chair of Texas’ 

Disaster Behavioral Health Consortium. He assisted 

as a field reviewer for SAMHSA’s Disaster Planning 

Handbook for Behavioral Health Treatment Programs, 

TAP 34. Most recently, Mr. Freeman contributed to the 

book Integrating Emergency Management and Disaster 

Behavioral Health—One Picture Through Two Lenses 

by Brian W. Flynn and Ronald Sherman. 

Veronica Martinez served as 

Associate Program Director 

for the Hurricane Harvey 

Crisis Counseling Assistance 

and Training Program grant 

administered by Texas Health 

and Human Services. Mrs. Martinez served originally as 

a regional coordinator administering over Harris County 

and the Coastal Bend region. Previously, Mrs. Martinez 

worked in children’s behavioral health as a Certified

Family Partner for families of children with intense 

behavioral health needs. Mrs. Martinez also serves 

on the Texas Family Voice Network and other groups 

working to empower families of children with special 

needs, promote behavioral health initiatives, and help 

build more resilient communities. 
Produced by the SAMHSA Disaster Technical Assistance Center

 

 

Melissa Pattison served as 

Child Program Specialist 

for Hurricane Harvey Crisis 

Counseling Grant with the 

Texas Health and Human 

Services Commission. Ms. 

Pattison has 15 years of experience and a passion for 

working within Texas state agencies to improve the 

quality of systems of care for children, youth, and 

families in Texas. Ms. Pattison’s experience includes 

program management of a statewide teen pregnancy 

prevention program with the Lyndon B. Johnson School 

of Public Affairs at the University of Texas at Austin 

and the Texas Office of the Attorney General. She has

also worked within numerous positions to provide 

grant administration, policy analysis, and program 

administration for children and youth within the Texas 

Health and Human Services Commission. Ms. Pattison 

has extensive child abuse investigation experience, 

conducting high-profile child abuse investigations for

the Texas Department of Family and Protective Services, 

coordinating with all levels of law enforcement 

including local district attorneys’ offices, the Texas

Rangers, and the Federal Bureau of Investigation. Ms. 

Pattison is a native Houstonian, and her hometown and 

high school received catastrophic damage from 

Hurricane Harvey. Ms. Pattison was moved to use her 

professional knowledge of children’s services in Texas 

to lead the recovery process for children with the Crisis 

Counseling Assistance and Training Program grant. 

Ms. Pattison received a bachelor of science degree 

in sociology from Texas A&M University in College 

Station, Texas. 

Charles C. (Cory) Walton 

served as Communications 

Specialist for Texas Health and 

Human Services Commission’s 

administration of the Hurricane 

Harvey Crisis Counseling 

Program. Mr. Walton’s previous communications 

experience spans over 25 years and ranges from 

Fortune 500 corporations to local and regional business 

and non-profit organizations. He has developed

and managed strategic communications programs 

across media platforms for a wide range of industries 

including consumer goods and services, manufacturing, 

technology, municipal and public policy, medical and 

health care, financial, education, and entertainment.

FEMA Individual Assistance Task Force Lead Michelle “Chelle” Howard (L) and FEMA inspector Jeff Smith (C) are working with disaster survivor 

Mary Solomon on her losses associated with the severe flooding that has struck Fort Yukon, Alaska, July 7, 2013. Photo by Adam DuBrowa/FEMA.

2019 | VOLUME 15 | ISSUE 2 | PAGE 6 
2019 | VOLUME 15 | ISSUE 2 | PAGE 7 

Produced by the SAMHSA Disaster Technical Assistance Center

 

 

INTERVIEW 

Texas Child Specialists Serve Communities 

By Melissa Pattison, Veronica Martinez, Chance Freeman, and Cory Walton 

In August 2017, Hurricane Harvey 

moved through the Caribbean and 

made landfall in Texas as a category 

4 storm. Harvey set records for 

rainfall—27 trillion gallons in 6 

days—and flooding. With damages at

$125 billion, it is the second costliest 

U.S. hurricane in recorded history. 

Along with setting records, Harvey 

was notable for when it happened— 

it hit the United States at the start 

of the school year. As staff from 

Texas’s post-Harvey CCP reported, 

“It was traumatic for a lot of youth 

and families. In rural areas in 

particular, the school is kind of the 

cultural hub.” 

To meet the needs of children and 

youth, Texas’s Hurricane Harvey 

CCP, Texans Recovering Together, 

included child specialists as part of 

its team to provide resources, training 

and technical assistance, and other 

supports for children and youth. The 

Dialogue recently talked with the 

Texas CCP about the work they’ve 

done, what they’ve learned, and how 

best to reach young survivors. 

How many child specialists have 

worked under your CCP? 

Melissa Pattison: We have several. 

I’m the Child Specialist at the state 

level, and we have seven provider 

sites within the state, some with 

their own child specialists, to ensure 

outreach and best practices in 

working with children. 

Veronica Martinez: We have five

child specialists with Harris Center, 

a provider site in Harris County 

which includes Houston, and one of 

our local mental health authorities 

(LMHAs). 

What is the role of the child 

specialist? 

Melissa Pattison: I work with 

three of our LMHAs and our other 

providers, offer them technical 

assistance, help them troubleshoot 

barriers in providing support to 

children, and help address needs 

ranging from building issues to 

school supplies to assisting school 

counselors when they’re trying to 

get a handle on what kids need. 

What factors have contributed 

to the success of the child- and 

youth-focused parts of your CCP? 

Melissa Pattison: The key that has 

really made this project successful 

has been support from the Governor’s 

Hurricane Harvey Task Force on 

School Mental Health Support, and 

the Commissioners of the Texas 

Education Agency, and Texas’s 

Health and Human Services 

Commission. Also, for the first time 

in this grant, Texas brought on four 

of the state’s 20 Education Service 

Centers (ESCs) as providers. 

Chance Freeman: Traditionally 

our LMHAs host crisis counseling 

teams. Due to the impact of Harvey 

on our LMHA system, we looked to 

the ESCs as host sites because the 

LMHAs did not have the capacity to 

host teams. 

Cory Walton: The ESCs’ focus 

has always been in communities on 

student and parent populations, but 

they have had no prior experience 

in really focusing on mental health 

and substance use. The LMHAs 

have expertise in mental health and 

substance use but sometimes in the 

past have had trouble integrating 

with student and parent groups in 

the communities. With this program, 

there has been collaboration and 

integration of those two skill sets, 

Texas established ESCs 

to serve school districts 

throughout the state. Each 

ESC serves a specific region. 

They support schools in 

operations and in helping 

children succeed. You can 

learn more at https://tea.texas. 

gov/About_TEA/Other_Services/ 

Education_Service_Centers/ 

Education_Service_Centers. 
 

Produced by the SAMHSA Disaster Technical Assistance Center

which is turning out to be a real 

asset to the parties in the program. 

What are the benefits of having

child specialists in a CCP? 

Chance Freeman: The child 

specialist role helped us keep 

children, youth, and families at 

the forefront of strategic planning 

and program development, as 

well as a primary focus of service 

delivery. We are continuing to build 

resilience and have a culture shift in 

terms of educating youth on stress 

management techniques and coping 

mechanisms, so as they mature 

we’ve built a skill set and concepts. 

It’s an opportunity for us to mitigate 

stigma, educate kids, and teach them 

life skills. It’s also really beneficial

to have dedicated staff able to vet 

resources and interventions. This 

position can do that legwork so that 

providers hosting teams or programs 

delivering services at the local level 

don’t have to do that. 

How would you suggest other

states incorporate the use of 

child specialists into their CCP 

grant activities?

Melissa Pattison: It’s helpful 

to incorporate them from the 

beginning. It’s hard to gather and 

relay the information to someone 

else midstream. 

Chance Freeman: The child 

specialist is a great position to have, 

but it’s also helpful to have guidance 

in incorporating child specialists into 

CCPs. Other programs are welcome 

to contact Texas; please refer others 

to us with questions. State 

staff should sit down together and 

brainstorm what this position looks 

like for their state. Once they figure

that out, they need to think through 

how to implement it. We found 

someone with relevant skill sets who 

also understands the state system, 

knows the resources available, and 

can access those resources. 

Veronica Martinez: Specific goals

for the position might be helpful for 

some states. If they have a county 

they’re serving, what percentage of 

people served should be children? 

What is their goal for primary 

services for children? How many 

encounters would they like? There is 

not a lot of structure with any of these 

specialized positions in the CCP. 

Is there any type of background

or experience you look for from 

the individuals you have hired 

for this role? 

Melissa Pattison: Some sort 

of knowledge of state resources 

available for children and youth 

would be helpful. 

Veronica Martinez: They should 

have a good grasp of systems and 

the ability to do data analysis, be 

willing to travel, be people-oriented, 

and comfortable with community 

outreach. They should be creative and 

willing to take initiative. The ability 

to train others is another key skill. 

A child specialist should understand 

development and trauma, how to 

engage children at different levels, 

and how to engage children with 

special needs. ■

5 years 

Studies show that children 

may show symptoms of 

posttraumatic stress up to 

5 years following 

a natural disaster. 

Source: Furr et al., 2010 

Moore residents visit their tornado destroyed 

property as volunteers clean up the debris. 

The Moore area was struck by a F5 tornado 

on May 20, 2013. Photo by Andrea Booher/

FEMA.

2019 | VOLUME 15 | ISSUE 2 | PAGE 8 
2019 | VOLUME 15 | ISSUE 2 | PAGE 9 

Produced by the SAMHSA Disaster Technical Assistance Center

 

Preparedness and Recovery Resources 

for Children 

Staff in CCPs and other disaster 

mental health programs can use the 

following resources in their outreach 

efforts to children: 

American Red Cross 

Mickey and Friends Disaster 

Preparedness Activity Book 

Mickey and his friends provide 

emergency preparedness tips for 

children in this fun activity book. The 

activity book covers floods, tornadoes,

fires, winter storms, thunderstorms,

hurricanes, and earthquakes. 

https://www.redcross.org/ 

content/dam/redcross/atg/PDF_s/ 

Preparedness___Disaster_ 

Recovery/General_Preparedness___ 

Recovery/Home/MM_RedCross_ 

ActivityBook-English.pdf 

CDC’s Children in Disasters: 

Kids and Families 

This website provides children 

and their families with emergency 

preparedness tips through interactive 

games and activities. 

https://www.cdc.gov/ 

childrenindisasters/children.html 

FEMA’s Prepare with Pedro 

Disaster Preparedness 

Activity Book 

Pedro teaches children how to prepare 

for and be safe during disasters and 

emergencies. 

https://www.fema.gov/medialibrary-data/1529697264473-a5d 

b8ca59fe98c307545e5fbe5aba460/ 

FEMA_PrepareWithPedro_508.pdf 

Ready.gov 

Kids Information Website 

This website has preparedness 

tips, tools, and games for children, 

parents, and teachers. Information 

to help families respond to a wide 

range of disasters is provided. 

https://www.ready.gov/kids 

Ready Marine Corps Kids: 

Emergency Preparedness 

Program 

Use these activity sheets to build an 

emergency kit and develop a family 

emergency plan. 

https://www.ready.marines.mil/ 

Ready-Marine-Corps-Kids/FunActivities 

Sesame Street: Emergency 

Preparation Toolkit 

This toolkit provides fun games and 

resources caregivers, parents, and 

educators can use to help inform and 

prepare children for disasters. 

https://www.sesamestreet.org/ 

toolkits/ready 

The National Child Traumatic 

Stress Network (NCTSN) Books 

These books describe common 

reactions children may have to 

disasters and provide an opportunity 

to discuss any fears or questions. 

Each book covers a different type 

of disaster. 

Trinka and Sam: The Rainy 

Windy Day 

https://www.nctsn.org/resources/ 

trinka-and-sam-rainy-windy-day 

Trinka and Sam: The Big Fire 

https://www.nctsn.org/resources/ 

trinka-and-sam-big-fire

Trinka and Sam: The Day the 

Earth Shook 

https://www.nctsn.org/resources/ 

trinka-and-sam-day-earth-shook 

Trinka and Sam: The Swirling 

Twirling Wind 

https://www.nctsn.org/resources/ 

trinka-and-sam-and-swirlingtwirling-wind 

Too Much Weather: 

A Disaster Activity Book for 

Kids Prepared by Shenandoah 

Valley Project Impact 

This activity book provides activities 

designed to help children feel better 

after disasters. 

http://nhma.info/wp-content/ 

uploads/2012/03/508_Disaster_ 

Activity_Book_for_Kids_ 

English_20170907.pdf 
 

Produced by the SAMHSA Disaster Technical Assistance Center

Colorado Spirit’s Approach to 

Helping Children Recover After a Disaster 

By Koral O’Brien 

On June 23, 2012, the Waldo Canyon 

Fire broke out on the far western edge 

of Colorado Springs, Colorado. Over 

the next 18 days it moved into the 

city, consuming over 18,000 acres, 

destroying 346 homes, and requiring 

the evacuation of 32,000 residents. 

Following the implementation of the 

CCP and the return to the school year, 

the impact of this fire on children and

their families became crystal clear. 

The Colorado Spirit Team, the CCP 

associated with this disaster, realized 

that they would have to work to reach 

this special population. With funding 

from the Hospital Preparedness 

Program (HPP), the Colorado 

Department of Public Health and 

Environment’s Office of Emergency

Preparedness and Response and 

Colorado Spirit Team implemented 

the “I’m Not Scared When I’m 

Prepared” project in local schools. 

What Is “I’m Not Scared 

When I’m Prepared”? 

The program targeted children 

from kindergarten to sixth grade 

with a focus on addressing the fear 

and stress related to disasters by 

improving family preparedness. 

It helps parents and children 

become more aware of the need for 

preparedness, which may reduce the 

likelihood of stress during an event. 

The program began with two halfhour sessions, one week apart. The 

instructor, utilizing a preparedness 

“go bag” as a working prop, talked 

to the children and asked the 

following questions: 

1. What does being prepared mean

to you?

2. Why do you need to be prepared?

The presenter then showed the 

students the items in the bag and 

asked them to identify the item and 

the purpose of the item. After the 

discussion the students were given 

a packet of information and three 

activities to take home and complete 

with their parents. The activities 

included the following: 

• A family scavenger hunt for

preparedness items

• A word search

• A preparedness matching

activity game

Upon completion, the parents signed 

the verification form and returned it

to the school. When the presenter(s) 

returned usually a week later they 

talked again about being prepared, 

2019 | VOLUME 15 | ISSUE 2 | PAGE 10 

“Children and adolescents 

have likely comprised a 

substantial proportion of 

the nearly 2.5 billion

people affected worldwide by 

disasters in the past decade.” 

Source: 2008 Presidential Task Force on 

Posttraumatic Stress Disorder and 

Trauma in Children and Adolescents.

FEMA Disaster Survivor Assistance (DSA) team member gives snacks to a young girl in Jayuya, 

Puerto Rico, November 15, 2017. Photo by Andrea Booher/FEMA.
 

 

 

 

Produced by the SAMHSA Disaster Technical Assistance Center

 

Thirty-six months after 

exposure to the 2006 tsunami, 

one-third of schoolchildren 

continued to meet the diagnostic 

criteria for having a mental 

illness, and 18 to 27 months 

after Hurricane Katrina, 

 9.3 percent of children 

continued to experience serious 

emotional disturbance. 

Source: Ularntinon, 2008 

Thirty-six months 

18 to 27 months 

9.3 percent 

when the bags would be needed 

and why, what the students would 

receive in their bags, and what other 

items they needed to add. Those who 

returned the verification form were

provided a preparedness bag via a 

school assembly or a variety of other 

ways. The children got very excited 

and loved the bags. In fact, the bags 

have been seen with children at the 

zoo, parks, and other venues. 

Successful Partnership 

In partnership with the Medical 

Reserve Corps (MRC) of El 

Paso County, the Colorado Spirit 

CCP purchased 7,000 cinch 

bags labeled “I’m Not Scared 

When I’m Prepared.” Within the 

bags the following items were 

included: a large orange bandana, 

bandages, whistle, pump flashlight,

emergency blanket, and a plastic 

bag. The plastic bag held the child’s 

identification form (printed on

heavier brightly colored paper) with 

a family picture—including pets and 

a photo of the child which could be 

changed as the child grew. It also 

contained information about the 

child, such as allergies. This form 

was designed to help ensure children 

with special needs would be taken 

care of and to assist with family 

reunification should the parents and

child become separated during a 

disaster, as well as getting pets back 

to the correct owners. 

After they received their bag, the 

children were encouraged to add 

items such as water, granola bars, 

one of their favorite toys, and some 

clothing. In one case, the parent put 

certain items in a large Ziploc bag 

and told the child that they were to 

not take anything out of that bag 

but could change the other items 

(such as the toys and clothing) as 

they wished. 

The remaining 2,000 preparedness 

bags were shared with the other 

MRC units in Colorado to pilot the 

project in other parts of the state. A 

request for additional HPP dollars 

was made to purchase more bags 

which were given to the CCP groups 

to provide to victims of the floods

in El Paso County, Boulder County, 

Weld County, and Larimer County in 

2013 and for the Black Forest fire in

2013. Additional bags were given to 

MRC units to help prepare students 

in other areas of the state. 

Lessons Learned 

Overall, this program was well 

received and, if funding is available, 

would be used again during a CCP. 

It’s a great way to engage children, 

parents, and schools in a positive 

activity after a disaster while 

preparing children for possible 

future incidents. We found that there 

are several key ingredients for this 

program to be a success, the most 

important being developing strong 

partnerships with organizations that 

can step in and fill gaps in existing

recovery efforts. This program is 

an example of how partnerships 

can help in the recovery process 

and reach key special populations. 

Colorado Spirit was fortunate to 

have funding and the support of our 

senior staff and our HPP Project 

Officer for this project. Other items

to keep in mind when implementing 

this program include the following: 

• Secure funding to purchase

the cinch bags and associated

materials.

• Locate schools that are willing to

participate.

• Find the right staff to provide the

program, which is key.

The following page is an 

informational pullout poster that 

you can print and post. It provides 

information on possible disaster u

reactions in children and youth 

and how to get help. 

2019 | VOLUME 15 | ISSUE 2 | PAGE 11 
Have you and your family been

affected by a disaster? 

Children and youth react to disasters differently than adults. 

Adults need to know what type of reactions to look for and when

to seek additional help.

Here are some common reactions 

children may have to disasters: 

Preschool Children (0–5 years old) 

▪ Changing eating and sleeping habits

▪ Feeling general fear, uncertainty, and anxiety

▪ Experiencing sleep disturbances such as nightmares or

night terrors

▪ Showing aggressive or withdrawn behavior,

hyperactivity, speech difficulties, and disobedience

Children (6–10 years old) 

▪ Feeling concern over their own safety and the

safety of their family

▪ Engaging in reckless or aggressive behavior or

not acting their age

▪ Having trouble paying attention in school or not wanting

to go to school

▪ Experiencing difficulty falling asleep

or having nightmares

Youth and Adolescents (11–19 years old) 

▪ Withdrawing from family and friends

▪ Engaging in risky behaviors such as alcohol and drug use

▪ Experiencing unexplained aches and pains

▪ Resisting authority or starting arguments

If your child is experiencing any of the listed or 

other reactions 2–4 weeks after a disaster or if

signs suddenly start later after the disaster, 

you may want to seek professional support.

THERE ARE PLACES TO GO FOR HELP. 

Disaster Distress Helpline 

TOLL-FREE: 1-800-985-5990 

(English and español) 

TTY: 1-800-846-8517 

Mental Health Treatment 

Facility Locator 

TOLL-FREE: 1-800-789-2647 

(English and español) 

TDD: 1-866-889-2647 

National Suicide 

Prevention Lifeline 

TOLL-FREE: 1-800-273-TALK 

(1-800-273-8255) 

TTY: 1-800-799-4TTY 

(1-800-799-4889) 

Substance Abuse 

Treatment Facility Locator 

TOLL-FREE: 1-800-662-HELP 

(1-800-662-4357) 

(24/7 English and español) 

TDD: 1-800-487-4889 

FOR MORE INFORMATION on common disaster reactions in children as well as tips for

talking to children after a disaster, check out the Tips for Talking With and Helping Children

and Youth Cope After a Disaster or Traumatic Event: A Guide for Parents, Caregivers, and

Teachers at https://store.samhsa.gov/product/tips-talking-helping-children-youth-cope-afterdisaster-or-traumatic-event-guide-parents. Other disaster mental health resources are 

available on the Substance Abuse and Mental Health Services Disaster Technical Assistance 

Center website at https://www.samhsa.gov/dtac or call us at 1-800-308-3515.
 

Produced by the SAMHSA Disaster Technical Assistance Center

 

Spotlight on Disaster Behavioral Health 

Programs for Children 

The National Child Traumatic 

Stress Network (NCTSN) 

Created by Congress in 2000 as part 

of the Children’s Health Act, NCTSN 

is made up of a network of partners 

who seek to better the lives of 

children and families who experience 

or witness traumatic events. NCTSN 

works to accomplish this through 

improved standards of care and 

increased access to services. NCTSN 

provides information and resources 

to assist children before, during, and 

after disasters; acts of violence; or 

terrorism. Their website provides a 

wealth of information including tip 

sheets, apps, and trainings. 

Psychological First Aid Online 

is one of the many resources 

available through NCTSN. This 

interactive 6-hour online training 

course features activities, video 

demonstrations, and mentor tips 

from trauma experts and survivors. 

Check out additional resources at 

https://www.nctsn.org. 

Save the Children 

Save the Children works tirelessly 

to reduce the impact of natural and 

human-caused disasters on children. 

Their team works with communities 

to develop child-focused emergency 

plans and provide training and 

resources before disasters occur. 

One of their initiatives to reach 

children is called Journey of Hope. 

Through Journey of Hope, their team 

helps children of all ages as well as 

adults recover after a disaster. To 

accomplish this goal, the Journey 

of Hope program uses cooperative 

play, literacy, discussion, and art. 

Save the Children has been a part 

of the recovery efforts during 

numerous disasters including 

Hurricanes Irma, Maria, Florence, 

Harvey, and Michael. For more 

information on their programs and 

past activities, check out the Save 

the Children website at https:// 

www.savethechildren.org. 

The American Red Cross 

The American Red Cross is a great 

resource for schools to assist in 

preparing their staff and students 

for disasters. The website has a tool 

for schools to use to help determine 

their level of preparedness as well 

as resources for staff and activities 

for students. 

The Pillowcase Project, sponsored 

by Disney, is a customizable disaster 

preparedness program for third 

through fifth grade students. The

program, which is led by Red Cross 

volunteers, teaches children about 

personal and family preparedness 

and safety skills, local hazards, 

and basic coping skills. Check out 

the American Red Cross website 

for more information at https:// 

www.redcross.org/get-help/howto-prepare-for-emergencies/ 

resources-for-schools.html. ■

Six months following the 

September 11 World Trade 

Center terrorist attacks, probable 

depression was identified in 

about 8 percent of New

York City school children. 

Source: Comer et al., 2010 

8 percent 

Following the September 11 World Trade Center terrorist 

attacks, about 5.4 percent of New York City high school 

students reported initiation or increase of cigarette smoking, 

and 10.9 percent reported increased alcoholic beverage 

consumption. However, only direct exposure to the attack was 

significantly associated with increased alcohol consumption. 

Source: Pfefferbaum et al., 2015; Wu et al., 2006 

5.4 percent 

10.9 percent 

Approximately 14 percent

of children in the United 

States will experience a 

disaster in childhood. 

Source: Becker-Blease et al., 2010 

14 percent 

2019 | VOLUME 15 | ISSUE 2 | PAGE 13 
2019 | VOLUME 15 | ISSUE 2 | PAGE 14 

Produced by the SAMHSA Disaster Technical Assistance Center

 

Recent Technical Assistance Requests 

In this section, read about recent questions SAMHSA Disaster Technical Assistance Center (DTAC) staff have 

answered and technical assistance requests to which they have responded. Send your questions and comments to 

dtac@samhsa.hhs.gov. 

Request: SAMHSA DTAC received a request in the 

dtac@samhsa.hhs.gov email box from an individual 

looking for information on trainings for suicide 

prevention hotline workers. The hotline she works with 

is specifically for wildland firefighters to contact when

they become overwhelmed or are experiencing thoughts 

of suicide. 

Response: SAMHSA DTAC provided her with 

information about the following trainings and resources: 

1. Service to Self—This 1-hour online course is

accredited by the Commission on Accreditation for

Pre-hospital Continuing Education and is specifically

for fire and emergency medical services personnel.

The course addresses occupational stressors such as

substance use issues, depression, posttraumatic stress

disorder, and suicidality. To access and participate in

the course go to: https://www.samhsa.gov/dtac/

education-training.

2. Publications and Resources on Suicide Prevention

—This SAMHSA web page provides several

trainings, toolkits, and resources that may be helpful

to educate hotline workers on suicide prevention. The

web page can be found at: https://www.samhsa.gov/

suicide-prevention/publications-resources.

3. National Suicide Prevention Lifeline—The National

Suicide Prevention Lifeline can be reached at 1–800–

–8255 and more information can be found at: https://

suicidepreventionlifeline.org/.

Request: SAMHSA DTAC received a request in the 

dtac@samhsa.hhs.gov email box from a Hurricane 

Harvey survivor who was still experiencing reactions 

and wanted to be connected to services. 

Response: SAMHSA DTAC will share her 

information with the crisis counseling program serving 

Hurricane Harvey survivors. Resources provided 

include the following: 

■ Behavioral Health Treatment Services Locator—

This SAMHSA resource allows individuals looking for

treatment facilities for substance misuse, addiction,

and mental health issues to locate a provider near

them. It can be accessed at: https:// indtreatment.

samhsa.gov.

■ Disaster Distress Helpline—SAMHSA’s Disaster

Distress Helpline provides crisis counseling and

support to people experiencing emotional distress

related to disasters. It is a 24/7, 365-day-a-year

helpline and can be reached at 1–800–985–5990. More

information can be found at: https://www.samhsa.

gov/ ind-help/disaster-distress-helpline.

Request: SAMHSA DTAC received an email from 

a representative of a community-based mental health 

treatment center who was looking for assessment tools 

related to disasters and resilience in order to identify 

strengths and challenges of communities faced by 

disasters. 

Response: SAMHSA DTAC sent her the following 

information on tools that can be used by her organization 

to assess the needs of community it serves: 

■ CCP Assessment and Referral Tools—The CCP

Assessment and Referral Tools are used by crisis

counselors in the field to identify survivors who may

be in need of more advanced mental health services.

The tools can be accessed at: https://www.samhsa.

gov/dtac/ccp-toolkit/ccp-data-forms-trainings.
 

Produced by the SAMHSA Disaster Technical Assistance Center

■ Communities Advancing Resilience Toolkit

Assessment—This theory-based survey instrument

assesses a community’s resilience and provides a

snapshot of strengths and challenges of the community

and participating organization. More information

can be found at: https://www.nctsn.org/measures/

communities-advancing-resilience-toolkitassessment-survey.

■ Community Assessment for Public Health

Emergency Response (CASPER)—The Centers for

Disease Control and Prevention (CDC) developed

CASPER to provide quick, low-cost information about

a community. The toolkit assists in determining the

health status, basic needs, practices, and knowledge or

attitudes of a community. More information and access

to the toolkit can be found at: https://www.cdc.gov/

nceh/hsb/disaster/casper/default.htm. ■

AGE 

RANGE 

(YEARS) 

COMMON REGRESSIVE 

REACTIONS 

COMMON PHYSIOLOGICAL 

REACTIONS 

COMMON EMOTIONAL AND 

BEHAVIORAL REACTIONS 

1–5

• Bedwetting in a child who before

the disaster was toilet trained

• Thumb-sucking

• Greater fear (of darkness,

animals, monsters, strangers)

• Loss of appetite

• Overeating

• Indigestion and other

digestive problems

• Nervousness

• Anxiety about being away from

parents or other primary caregivers

• Irritability and disobedience

5–11 

• Clinginess with parents or other

primary caregivers

• Crying or whimpering

• Requests to be fed or dressed

• Headaches

• Complaints of visual or

hearing problems

• Sleep problems and nightmares

• School phobia

• Social withdrawal

• Irritability and disobedience

11–14 

• Competing with younger siblings

for attention from parents or other

primary caregivers

• Failure to perform chores and

fulfill normal responsibilities

• Headaches

• Complaints of vague aches

and pains

• Overeating or loss of appetite

• Skin problems

• Sleep problems

• Loss of interest in activities

• Poorer school performance

• Disruptive behavior

• Resistance of authority

14–18 

• Resumption of earlier

behaviors and attitudes

• Decline in previous

responsible behavior

• Headaches

• Sleep problems

• Digestive problems

• Vague physical complaints

• Increase or decrease in

physical activity

• Depression

• Isolation

• Antisocial behavior

Source: Columbia University, Earth Institute, National Center for Disaster Preparedness 

2019 | VOLUME 15 | ISSUE 2 | PAGE 15 
2019 | VOLUME 15 | ISSUE 2 | PAGE 16 

Produced by the SAMHSA Disaster Technical Assistance Center

 

RECOMMENDED RESOURCES 

Tips for Talking With and Helping Children and 

Youth Cope After a Disaster or Traumatic Event: 

A Guide for Parents, Caregivers, and Teachers 

This tip sheet from the SAMHSA covers possible 

reactions to a disaster or a traumatic event from children 

from infancy to age 19 and how you can best support and 

comfort them, and know when it is time to get outside 

help. Learn more about how paying attention, allowing 

children to ask questions, and being a good model of selfcare can benefit the children in your life after a disaster.

Find the tip sheet at https://bit.ly/2AvZeDR. 

Psychosocial Issues for Children and Adolescents 

in Disasters 

This guide from SAMHSA was developed for anyone 

working with children after a disaster. It walks through 

common reactions children may display after a traumatic 

event and steps that can be taken in the process of 

supporting them. The guide also shares several stories 

that show children reacting after a disaster. They 

demonstrate how anxiety, disruptive behavior, and other 

emotions can display themselves and how you can help. 

Find the resource at https://bit.ly/2SCGnxX. 

Helping Children Cope 

This page from Ready.gov informs parents trying to 

properly care for their children after a disaster. It details 

several ways you can help make disasters less traumatic 

and shares a list of frequently asked questions from 

parents with children of a range of ages. Its answers in 

detail the best ways to approach different emotions and 

reactions after various disasters. 

Find the tip sheet at https://bit.ly/2CwdWNP. 

Age-Related Reactions to a Traumatic Event 

This tip sheet from NCTSN helps parents, schools, and 

communities develop a better understanding of how 

children of various ages may react to a traumatic event. 

Preschool children, school-age children, and adolescents 

can each be supported in a variety of ways to promote 

their emotional recovery after a disaster or traumatic event. 

Find the tip sheet at https://bit.ly/2A26UOq. 

For more in-depth research on children 

and disasters, check out the recent and upcoming 

SAMHSA DTAC Supplemental Research Bulletins. 

Behavioral Health Conditions in Children and Youth 

Exposed to Natural Disasters 

The September 2018 issue of the SAMHSA DTAC 

Supplemental Research Bulletin focused on mental 

health and substance use issues children and youth may 

experience after natural disasters. SAMHSA DTAC 

reviewed literature on the different issues and conditions 

that youth may present with after a disaster as well as risk 

and protective factors and possible interventions. 

To read the full issue, visit https://www.samhsa.gov/sites/ 

default/files/srb-childrenyouth-8-22-18.pdf. 

Mental Health Issues and Conditions in Children and 

Youth Exposed to Human-caused Disasters 

The upcoming issue of the SAMHSA DTAC Supplemental 

Research Bulletin reviews the literature on the mental 

health and substance use and misuse effects of humancaused disasters on children and youth. This issue begins 

by stating SAMHSA DTAC’s definition of human-caused

disasters. Then, as with the issue on natural disasters, the 

issue moves into a discussion of the conditions that may 

occur in children and youth after a human-caused disaster. 

The issue also highlights risk and protective factors and 

possible interventions. The full issue will be released later 

this year. 

Remember to check the SAMHSA DTAC website at 

https://www.samhsa.gov/dtac/disaster-behavioralhealth-resources/supplemental-research-bulletin. 
2019 | VOLUME 15 | ISSUE 2 | PAGE 17 

Produced by the SAMHSA Disaster Technical Assistance Center

 

REFERENCES 

Blake, E. S., & Zelinsky, D. A. 

(2018, May 9). National Hurricane 

Center tropical cyclone report: 

Hurricane Harvey (AL092017). 

Retrieved from https://www.nhc. 

noaa.gov/data/tcr/AL092017_ 

Harvey.pdf 

Dziuban, E. J., Peacock, G., & 

Frogel, M. (2017). A child’s health 

is the public’s health: Progress 

and gaps in addressing pediatric 

needs in public health emergencies. 

American Journal of Public Health, 

107(Supplement 2), S134–S137. 

Federal Emergency Management 

Agency. (2018). https://www. 

fema.gov 

Griggs, B. [Author], & Cai, L. 

[Designer]. (2017, September 1). 

Harvey’s devastating impact by 

the numbers [Infographic]. CNN. 

Retrieved from https://www.cnn. 

com/2017/08/27/us/harvey-impactby-the-numbers-trnd/index.html 

McDermott, B. M., & Cobham, 

V. E. (2014). A stepped-care

model of post-disaster child and

adolescent mental health service

provision. European Journal of

Psychotraumatology, 5(1), 24294.

https://doi.org/10.3402/ejpt.

v5.24294

National Hurricane Center. (2018, 

January 26). Costliest U.S. tropical 

cyclones tables updated. Retrieved 

from https://www.nhc.noaa.gov/ 

news/UpdatedCostliest.pdf 

U.S. Census Bureau. (2017). 

QuickFacts: United States. 

Retrieved from https://www.census. 

gov/quickfacts/fact/table/US/ 

PST045217 

Weather.com. (2017, September 2). 

Historic Hurricane Harvey’s recap. 

The Weather Channel. Retrieved 

from https://weather.com/storms/ 

hurricane/news/tropical-stormharvey-forecast-texas-louisianaarkansas 

The Dialogue is not responsible for the 

information provided by any web pages, 

materials, or organizations referenced 

in this publication. Although The 

Dialogue includes valuable articles and 

collections of information, SAMHSA 

does not necessarily endorse any 

specific products or services provided by

public or private organizations unless 

expressly stated. In addition, SAMHSA 

does not necessarily endorse the views 

expressed by such sites or organizations, 

nor does SAMHSA warrant the validity 

of any information or its fitness for any

particular purpose. 

The views, opinions, and content 

expressed in this publication do not 

necessarily reflect the views, opinions,

or policies of the Center for Mental 

Health Services (CMHS), the Substance 

Abuse and Mental Health Services 

Administration (SAMHSA), or the U.S. 

Department of Health and Human 

Services (HHS). 
Prepare • Respond • Recover

Inform • Assist

 

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please contact SAMHSA DTAC at dtac@samhsa.hhs.gov. 

ACCESS ADDITIONAL SAMHSA DTAC RESOURCES 

The SAMHSA DTAC Bulletin is a monthly e-communication used to share updates in the field, 

post upcoming activities, and highlight new resources. To subscribe, please enter your email 

address in the “SAMHSA DTAC Bulletin” section of the home page of our website at https:// 

www.samhsa.gov/dtac. 

The SAMHSA Disaster Behavioral Health Information Series contains resource collections 

and toolkits pertinent to disaster behavioral health. Installments focus on specific populations, 

specific types of disasters, and other topics related to all-hazards disaster behavioral health 

preparedness and response. Visit the SAMHSA DTAC website at 

https://www.samhsa.gov/dtac/dbhis-collections to access these materials. 

CONTACT US 

SAMHSA Disaster Technical 

Assistance Center 

Toll-free: 1–800–308–3515 

dtac@samhsa.hhs.gov 

https://www.samhsa.gov/dtac 

Prepare, Respond, Recover, Inform, Assist.