disaster – Vista Hill Center for Child and Youth Psychiatry https://www.vistahillccyp.org Providing ready access to board-certified child and adolescent psychiatrists who complete timely psychiatric evaluations and, as clinically indicated, provide follow-up care, including prescriptions to medications that support the social and emotional health of our clients. Tue, 21 Jan 2025 23:38:21 +0000 en-US hourly 1 https://wordpress.org/?v=7.0.2 https://www.vistahillccyp.org/wp-content/uploads/2016/12/cropped-vh_site_icon_512x512-32x32.png disaster – Vista Hill Center for Child and Youth Psychiatry https://www.vistahillccyp.org 32 32 California Wildfires: Prepare, Watch and “Early Bird Evacuate” 1/22/25 https://www.vistahillccyp.org/california-wildfires-prepare-watch-and-early-bird-evacuate-1-22-25/ Tue, 21 Jan 2025 23:38:21 +0000 https://www.smartcarebhcs.org/?p=3448 Quick Tips:

  • PREPARE a “go bag”
  • WATCH closely for the risk of fires using https://www.alertsandiego.org/  and Watch Duty org apps
  • EARLY BIRD EVACUATE in the orange zone
  • Providers can learn Psychological First Aid, volunteer time and resources, and help patients and their families prepare and cope with the wildfires

As the wildfires continue to devastate Southern California, particularly the greater Los Angeles area, our thoughts are with the countless families affected by this disaster. We also want to extend our deepest gratitude to the first responders on the front lines.

While most San Diego residents have not been directly impacted by the fires at this time, many of us have friends, family, or colleagues who have been. Additionally, San Diego has been under red flag warnings, signaling critical fire weather conditions. As child and adolescent psychiatrists, we are especially mindful of the emotional toll natural disasters can have on youth and families.

Dr. Tyler Morrison, San Diego Region Liaison from the American Academy of Child and Adolescent Psychiatry Disaster and Trauma Committee, shares his expertise on how we can support ourselves, our patients, and our communities during this time of crisis.

Prepare, Watch, and “Early Bird Evacuate”
All residents in San Diego and Los Angeles are encouraged to take three critical steps: Prepare, Watch, and “Early Bird Evacuate.”

  1. Prepare: Have an emergency “go bag” ready. Your kit should include:
    • Water, non-perishable food, medications, and first aid supplies
    • Flashlights, a multi-tool, extra chargers and batteries
    • Blankets, clothes, and dust masks
    • Sanitary products and toilet paper
    • Printed copies of important documents (medical records, insurance cards, contact info)
    • If you have a disability, include assistive devices and health profiles.
  1. Watch: Stay informed about fire risks. Visit org to register for emergency alerts or download the SD Emergency App. You can also use the free WatchDuty.org app for real-time fire updates. Red zones indicate immediate evacuation orders, orange zones signal evacuation warnings, and pink areas highlight dangerous conditions.
  2. “Early Bird Evacuate”: If you’re in an orange zone, we strongly recommend evacuating early—before roads get congested and air quality worsens. Evacuating early helps ensure safer exits for everyone.

How Providers Can Help
As providers, we can play a crucial role in supporting our community during these challenging times. First, we can learn Psychological First Aid to offer immediate support to youth and families impacted by trauma. You can find more information in our recent newsletter here. Providers can also volunteer their time and resources to wildfire relief efforts. If you are able to volunteer, please coordinate with trusted organizations like the Red Cross or Vibrant ahead of time to avoid creating overcrowded or chaotic situations.

In our everyday clinical settings, we can educate patients and families about wildfire preparedness. Emphasize the importance of checking air quality using resources like AirNow.gov. Advise everyone to stay indoors when the Air Quality Index (AQI) exceeds 150, and limit outdoor activity when it surpasses 100. We can also guide parents in helping their children cope with disaster-related stress. Encourage parents to provide clear, age-appropriate information without unnecessary details. Limiting exposure to media coverage can also be helpful in reducing anxiety.

Additional Support
For those in need of further assistance, SmartCare Behavioral Health Consultation Services (BHCS) are available for both providers and families. Please refer to the resources below for additional support options. Thank you for your continued commitment to the well-being of our community during this crisis.

Resources: Hover next to title for hyperlink.

  AUTHORS:

Dr. Kristen Kim, MD

Child, Adolescent and Adult Psychiatrist

Vista Hill Foundation

Dr. Tyler Morrison, MD

San Diego Region Liaison from the American Academy of Child and Adolescent Psychiatry Disaster and Trauma Committee

]]> Psychological First Aid 11/20/24 https://www.vistahillccyp.org/psychological-first-aid-11-20-24/ https://www.vistahillccyp.org/psychological-first-aid-11-20-24/#comments Mon, 18 Nov 2024 17:29:27 +0000 https://www.smartcarebhcs.org/?p=3431 As primary care and mental health professionals, we are aware that we could be called on as part of an initial response team for a disaster or mass trauma. Psychological First Aid is a modular framework to help reduce emotional distress in the immediate aftermath of  disasters, mass violence and other crises.

Background

We know that a person who has gone through a traumatic experience is at higher risk for developing a mental health concern, like post-traumatic stress disorder. The risk of developing an anxiety or depressive disorder is higher than for developing PTSD. Studies have shown that 80-90% of individuals who have experienced a traumatic event will go back to their normal functioning over time. The amount of time can vary, based on their functioning before the event, whether the trauma was human-caused or a natural disaster and whether harm was intended. Some can go back to their normal functioning after 2-4 weeks and, for others, it can take much longer. Some people are even able to make meaning or create purpose from a trauma they experienced.

The basic premise of Psychological First Aid is to use a non-pathologizing stance with the assumption of adaption and not of disease development. The goal is for crisis support to help survivors move to the adaptive side. There are 8 basic core actions that focus first on providing safety and comfort followed by coping skills and resources. The foundation is making sure people who have gone through a trauma have access to social support.

Reg Flags

There are certain “red flags” to be aware of as concerns that something else might be going on and further assessment and intervention could be helpful. These include social isolation and withdrawal, extreme avoidance of thinking/talking about the event, feeling numb or not feeling at all, intrusive images/flashbacks, nightmares and poor sleep, anger or violence, and excessive use of alcohol and drugs.

Core Action Steps:

  1. Contact and Engagement

In the immediate aftermath of a trauma, people first need their basic needs met. Introducing yourself can help a person feel better connected.

  1. Safety and Comfort

After letting someone know you are there to help, it can be nice to offer basic comforts like water and food, a blanket, etc. If there are children in the group, toys and plushies can be additional comforts.

  1. Stabilization

People are understandably dysregulated after a trauma. There are some simple things that you can encourage someone to do to help him feel calmer and more regulated – deep breathing exercises, stretching and body movement. It can also help to validate how they are feeling and provide a quiet space.

  1. Information Gathering

It is important to keep in mind that you don’t need to know details of a traumatic experience in order to help reduce symptoms and provide comfort and coping skills. It is better to not prompt for details. This is especially true for children. Some children play out their feelings about a traumatic experience and others use play as distraction to not think about the trauma. Research has shown that talking repeatedly about a traumatic experience does not necessarily help with recovery and can actually cause unintended consequences.

  1. Practical Assistance

The next step is to help with basic needs including shelter, meals, etc.

  1. Connection with Social Supports

PFA focuses on establishing social supports based on a homogenous experience. With mass disasters, not everyone experiences the same thing.  It is important to limit exposure to details of a traumatic event for those who hadn’t experienced those details to begin with. So groups should be put together keeping these factors in mind. It can be helpful to train someone within a particular culture on the PFA principles so that they can overlap their understanding of cultural factors and the PFA response to trauma.

  1. Information on Coping

Basic CBT principles like reframing thoughts, focusing on doing enjoyable activities that bring happiness, and mindfulness practices can be useful coping strategies. Again one does not need to know the details of the trauma in order to be able to provide coping strategies.

  1. Linkage with Collaborative Services

It is important to be aware of local resources, like SmartCare BHCS here in San Diego,  for when someone could benefit from further assessment or intervention after a trauma.

Further Resources

If interested in learning more, the National Center of Trauma and Stress Network offers a 6 hour course on PFA:

https://www.nctsn.org/resources/psychological-first-aid-pfa-online

There are also wonderful resources about school based PFA on their website:

https://www.nctsn.org/resources/psychological-first-aid-schools

Here is another resource on PFA for healthcare workers:

https://www.ptsd.va.gov/professional/treat/type/SFA/docs/SFA_HCW_Manual_508.pdf

AUTHOR:

Charmi Patel Rao MD, DFAACAP

Co-Medical Director, Vista Hill Foundation

Health Science Clinical Professor, UCSD Department of Psychiatry

President, San Diego Academy of Child and Adolescent Psychiatry

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