The psychological trauma wrought by Hurricane Katrina is hardly receding -- it's still coming in waves. That's the finding of a report published earlier this month in the Journal of the American Medical Association (JAMA) entitled "Katrina's Impact on Mental Health Likely to Last Years." The authors add that among those hardest hit are children, who may not reveal their internal struggles until months from now.
A key source of the study was Burlington psychiatrist David Fassler, who works with young people coping with loss and trauma. He took some time to talk about how Katrina has affected kids both near and far from the Gulf Coast, and how adults can recognize children's symptoms of mental distress.
SEVEN DAYS: You mention in the JAMA study "There is an unprecedented number of people in this country whose lives have been traumatically disrupted by Katrina." Why has this been so hard on kids?
DAVID FASSLER: Coping with Katrina has been particularly difficult for children since it disrupted so many aspects of their lives. Homes, schools and entire neighborhoods were destroyed. Parents, children, siblings and other relatives were separated. Family pets and other cherished belongings were left behind. For many children, there was also an extended period of uncertainty due to the widespread and prolonged breakdown of communications systems.
SD: How is your approach to young survivors of Katrina, and even kids far away, such as those in Vermont, different from that following past disasters?
DF: As clinicians, we used to think it was important to rush in and encourage children to talk about their experiences following a trauma. However, the current understanding and approach focuses primarily on reestablishing a sense of stability and predictability, and on reinforcing the child's natural support systems. This often means working with and through the child's family, school and community. For example, after 9/11, there was an emphasis on getting kids back to school as quickly as possible. Instead of "debriefing" a large number of children, we worked with the parents and teachers and used them to help identify kids who were having particular difficulties.
SD: How does Katrina differ from 9/11?
DF: Katrina presents additional challenges, as so many children and families have been relocated to distant communities where they have few, if any, pre-existing connections or relationships. Immediate efforts have focused on reuniting families as quickly as possible. Clinicians have also emphasized helping children begin to re-establish familiar and predictable routines, including attending school, eating familiar foods, listening to favorite music, communication with friends and celebrating birthdays and other holidays. Kids also need honest and accurate information about what's happening next and when. They can adjust to lots of changes, but prolonged uncertainty is difficult for everyone.
SD: What are some signs that kids might be really suffering, mentally, from a recent trauma, whether it's close to home or far away?
DF: Some children who've been through a traumatic experience such as Katrina develop signs of post-traumatic stress disorder, or PTSD. In children and adolescents, these can include frequent memories of the event; upsetting and frightening dreams; acting or feeling like the experience is happening again; developing physical or emotional symptoms when reminded of the event; thoughts or worries about dying; loss of interest in activities; frequent headaches or stomachaches; problems falling or staying asleep; irritability or angry outbursts; problems concentrating; acting younger than their age; increased alertness to the environment; and repeating behavior that reminds them of the trauma.
SD: How long do these signs last, and what can help?
DF: The symptoms of PTSD can last from months to years. Treatment needs to be individualized to the child and family, but it will often include individual therapy as well as work with the child's parents and/or school. Behavior-modification techniques and cognitive therapy can help reduce fears and worries. Medication is also sometimes used to help address agitation, anxiety or depression.
SD: So what's the upside?
DF: Fortunately, most kids are actually pretty resilient. They generally pick up and go on with their lives, although living through a traumatic event such as Katrina can clearly have lasting emotional consequences.
The Champlain Valley Exposition in Essex Junction typically conjures up greasy visions of the fried dough, corn dogs and pizza that roll into town around Labor Day. So I was surprised to hear that the fairgrounds are hosting the "Everything Fit and Healthy Expo," this Saturday, October 22.
The name also seemed dubious: How could everything fit and healthy be corralled into a single location? But then I heard about the more than 50 exhibitors expected to set up booths at the Expo. Included among them are the American Diabetes Association, Catamount Outdoor Center, Curves, Local Motion, Pathways to Well Being, Special Olympics Vermont and the YMCA.
According to Beth Kuhn, director of the Champlain Initiative, this gathering of good-for-you groups was inspired by discussions preceding an October 31 statewide obesity summit. "It's great to have a room full of policy-makers who decide what the state needs to do on an important public-health issue," says Kuhn. "But we need to have the grassroots community able to talk about the same things."
Two "Speak Outs" at the expo will encourage conversations about obstacles to healthy lifestyles. "We're going to report out on what the community says at the [obesity] summit meeting," says Kuhn. "We're keeping our ear to the ground."
Nearly 300,000 visitors stroll through the Champlain Valley Fair at the end of every summer -- what sorts of numbers might the Everything Fit and Healthy Expo draw? "If we get a couple thousand folks to show up, we'll be in good shape," suggests Steve Mease, public relations director for the Champlain Valley Exposition. Plans are in the works for a free shuttle to pick up residents from the Old North End and other Burlington-area neighborhoods who might otherwise have trouble getting there.
To lure Chittenden County residents from their couches, organizers have posted flyers advertising winter conditioning tips, kick-boxing demos, hip-hop dance shows, health screenings and meal makeovers
Sounds like the bait will not include beefy cheeseburgers. Instead, a vendor will whip up healthy sandwiches, wraps and smoothies. "There will be no fried dough -- we've had many discussions about this," says Mease, pausing. "No deep-fried Snickers or anything -- it's 'lead by example.'"