Japan must not overlook mental health of children in disaster zone
There are many elementary school children making the rounds of disaster evacuation shelters to look for their missing parents. Others are searching the rubble of collapsed buildings for mementos such as photos as well as their belongings. Some children were seen to smile during their school graduation ceremonies. People across the country are trying to cheer up these children in quake- and tsunami-hit areas.
More than 10,000 people have been confirmed dead and some 16,000 others remain missing following the March 11 Great East Japan Earthquake. Facing this unbelievable reality, anybody would want to encourage child survivors to help them conquer hardships already experienced and those sure to come.
However, children are already doing their best. Even though they do not understand what has happened to them as much as adults and cannot express their feelings, they can also suffer from disaster trauma and become overwhelmed with grief after losing their family members, their homes or both.
Rather than simply urging children to overcome the disaster, what is needed is to look for subtle changes in their emotions and provide appropriate psychological support.
Children who have experienced such a massive disaster tend to complain of insomnia and loss of appetite, act infantile, be frightened by loud sounds, easily lose their temper, have nightmares and refuse activities they enjoyed before the traumatic event.
If children begin to show these symptoms, adequate care should be provided to them, such as telling them, "You're all right," and avoiding letting them sleep alone, in order to reassure them.
Some children repeatedly talk about what they saw and experienced in the disaster, but adults around them should understand this as a sign that they are trying hard to accept the shocking reality and patiently listen to what they have to say.
Pep talks like, "Never say die" and "There are some other people who are in more difficult situations. Overcome this hardship," must be avoided. Adults may say these things to children to encourage them, but they can be counterproductive, driving a child into a psychological corner.
Some children are afflicted with survivor's guilt when the rest of their families lost their lives in the disaster. They should rather be convinced that they do not have to hide their tears or their feelings.
The Japanese Association of Clinical Psychology and the National Center of Neurology and Psychiatry (NCNP) have guidelines on their respective websites on dealing with children who have experienced a massive disaster.
Mental health experts are working in quake-hit areas, but they cannot look after all the children who need their care. Academic societies specializing in children's mental health are providing telephone and e-mail counseling, and such services should be fully utilized.
Children can initially endure the harsh living conditions at shelters because they maintain a sense of tension after the disaster. If their evacuation is prolonged, however, they may suffer from sudden depression or feel physically ill. Minor symptoms that children show immediately after a disaster can be dealt with if adequate care is provided. However, post-traumatic stress disorder should be suspected if children continue to show such symptoms for more than a month. In that case, expert treatment is required.
Even children who did not experience the quake could show symptoms such as insomnia if they repeatedly see shocking images of the disaster on TV. There are reportedly some cases where children who were not hit by the disaster complain they feel anxious and suddenly begin to cry in class. Close attention should be paid to subtle changes in children's words and deeds so as not to overlook any sign that they are developing psychological problems.
Efforts to provide mental care for children in quake- and tsunami-devastated areas have come to a crucial stage. The nation as a whole is urged to protect both the mental and physical health of children.
(Mainichi Japan) March 30, 2011
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