Pediatric disaster preparedness in the medical setting: Integrating mental health


  • Jeffrey I. Gold, PhD
  • Zorash Montano, BA
  • Sandra Shields, LMFT, ATR-BC, CTS
  • Nicole E. Mahrer, BA
  • Viktoria Vibhakar, LCSW, LMSW
  • Tanya Ybarra, MS, CCLS
  • Nancy Yee, BA
  • Jeffrey Upperman, MD, FAAP, FACS
  • Nancy Blake, RN, MN, CCRN, NEA-BC
  • Kathleen Stevenson, RN, BSN
  • Alan L. Nager, MD, MHA



pediatric, disaster preparedness, mental health


Introduction: The increasing prevalence of disasters worldwide highlights the need for established and universal disaster preparedness plans.The devastating events of September 11 and Hurricane Katrina have spurred the development of some disaster response systems. These systems, however, are predominantly focused on medical needs and largely overlook mental health considerations. Negative outcomes of disasters include physical damage as well as psychological harm. Mental health needs should be considered throughout the entire disaster response process, especially when caring for children, adolescents, and their families.
Objective: To provide an overview and recommendations for the integration of mental health considerations into pediatric disaster preparedness and response in the medical setting.
Methods: Recommendations were developed by a panel of disaster preparedness and mental health experts during the Childrens Hospital Los Angeles Pediatric Disaster Resource and Training Center: Workshop on Family Reunification in Los Angeles, California, March 31-April 1, 2008. Experts discussed the inclusion of mental health-specific considerations and services at all stages of disaster preparedness and response. Recommendations involve the integration of mental health into triage and tracking, the adoption of a child ambassador model, environment, and developmentally appropriate interventions, education, communication, death notification, and family reunification.
Conclusions: The inclusion of mental health concerns into pediatric disaster preparedness may help prevent further and unnecessary psychological harm to children and adolescent survivors following a disaster.

Author Biographies

Jeffrey I. Gold, PhD

Associate Professor of Anesthesiology and Pediatrics, Keck School of Medicine; University of Southern California, Los Angeles, California; Department of Anesthesiology Critical Care Medicine, Comfort, Pain Management and Palliative Care Program, Childrens Hospital Los Angeles, Los Angeles, California.

Zorash Montano, BA

Department of Anesthesiology Critical Care Medicine, Childrens Hospital Los Angeles, Los Angeles, California.

Sandra Shields, LMFT, ATR-BC, CTS

Emergency Medical Services Agency, Los Angeles County Department of Health Services, Los Angeles, California.

Nicole E. Mahrer, BA

Department of Anesthesiology Critical Care Medicine, Childrens Hospital Los Angeles, Los Angeles, California.

Viktoria Vibhakar, LCSW, LMSW

Threat Assessment, Public Health Emergency Preparedness Program, Los Angeles County Department of Public Health, Los Angeles, California.

Tanya Ybarra, MS, CCLS

California Hospital Medical Center, Los Angeles, California.

Nancy Yee, BA

Disaster Services Section, California Department of Social Services, Sacramento, California.

Jeffrey Upperman, MD, FAAP, FACS

Keck School of Medicine, University of Southern California, Los Angeles, California; Department of Pediatric Surgery, Childrens Hospital, Los Angeles, California.

Nancy Blake, RN, MN, CCRN, NEA-BC

Critical Care Services and Education, Childrens Hospital Los Angeles, Los Angeles, California.

Kathleen Stevenson, RN, BSN

Patient Care Services, Childrens Hospital Los Angeles, Los Angeles, California.

Alan L. Nager, MD, MHA

Keck School of Medicine, University of Southern California, Los Angeles, California; Department of Pediatrics, Division of Emergency and Transport Medicine, Childrens Hospital Los Angeles, Los Angeles, California.


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How to Cite

Gold, PhD, J. I., Z. Montano, BA, S. Shields, LMFT, ATR-BC, CTS, N. E. Mahrer, BA, V. Vibhakar, LCSW, LMSW, T. Ybarra, MS, CCLS, N. Yee, BA, J. Upperman, MD, FAAP, FACS, N. Blake, RN, MN, CCRN, NEA-BC, K. Stevenson, RN, BSN, and A. L. Nager, MD, MHA. “Pediatric Disaster Preparedness in the Medical Setting: Integrating Mental Health”. American Journal of Disaster Medicine, vol. 4, no. 3, May 2009, pp. 137-46, doi:10.5055/ajdm.2009.0022.




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