Brief: Children's Mental Health & Terrorism

(This is one of a series of briefs written by NCSL, "Protecting Democracy: States Respond to Terrorism.")

Children's Mental Health and Terrorism

By Holly Kenny and Leah Oliver

An estimated 10,000 children lost a parent in the September 11 terrorist attacks. Thousands more have been affected--whether through the actual loss of a relative or loved one, graphic media coverage or sensing their parents' grief and uncertainty over the tragedy. Mental health professionals are preparing for a deluge of new patients suffering from anxiety disorder, depression or post-traumatic stress disorder. Often, these are not diagnosable immediately after a trauma, but become evident months or even years later. In addition, children with existing mental health needs face an increased risk of long-term psychological effects.

Even before September 11, Surgeon General David Satcher had identified a "crisis" in children's mental health in the United States--one in 10 children and adolescents suffers from mental illness, yet less than 20 percent receive treatment. Because there is no primary mental health care system for children, treatment and services often are fragmented among several systems: school, juvenile justice, child welfare, primary health, and state and local mental health. Medicaid and the State Children's Health Insurance Program cover mental health services for enrolled children who need them, but finding service providers is often a challenge.

Federal Resources for Hardest Hit Areas. Immediately following the attacks, the Department of Health and Human Services (HHS) and the Federal Emergency Management Agency (FEMA) coordinated emergency funding for mental health services for those states most immediately affected. The Substance Abuse and Mental Health Services Administration's (SAMSHA) Emergency Services and Disaster Relief Branch at HHS coordinated with FEMA to issue crisis counseling grants to states.

On September 13, HHS issued $1 million to New York City's community mental health centers. A federal $5 billion Emergency Response Supplemental Appropriations package passed shortly thereafter, and included $28 million for mental health disaster relief. Of that amount, $21.2 million supplemented existing mental health and substance abuse systems in disaster areas. On October 1, SAMSHA distributed the remaining $6.8 million to eight states and the District of Columbia for crisis mental health services as well as additional support for existing mental health and substance abuse systems. A second set of mental health grants--totaling $20.25 million--was awarded to states on October 30.

In addition, federal grant money was directed to states for special mental health disaster relief.

· $23.7 million from the public health and social services emergency fund to six states and the District of Columbia to cover social services for special populations, including children and individuals with developmental disabilities.

· $22.7 million from FEMA for Project Liberty to support immediate crisis needs through the New York State Office of Mental Health.

· $2 million from FEMA for crisis counseling for victims of the Pentagon attack and their families.

· $3.3 million from FEMA for ongoing services provided through the National Institute of Mental Health.

State Actions

States responded quickly to the attacks. In Connecticut, teachers and trained volunteers talked with children and their families about the tragedy. The Connecticut Commission on Children distributed literature on talking with children about death and violence and hosted a forum for parents, children and state leaders. The Department of Children and Families developed a mental health hotline, a new Web site and public service announcements.

The District of Columbia's Department of Mental Health provided crisis debriefings for mental health professionals who prepared teachers to talk with their students. Counselors were stationed in classrooms that lost teachers or students. The department set up two crisis hotlines--one for kids and one for adults--and distributed a flyer, "When Terror Strikes," to community health centers, schools and churches. The city convened a task force to update the crisis response policy and create a response plan.

New Jersey tailored its Traumatic Loss Interventions for Youth Project to fit the needs of young people affected by the terrorism. It coordinated efforts between the school system and the Department of Mental Health. Through these coalitions, trained mental health professionals identify and systematically address issues related to mental health emergencies for young people after trauma.

In New York, federal funding provided support for crisis counseling, education and referral services for people in New York City and surrounding counties. Counselors, coordinating with the state Office of Mental Health and the Department of Education, responded to children's mental health needs. Before the attacks, the office had published "Crisis Counseling Guide to Children and Families in Disaster," which is available on its Web site at: http://www.omh.state.ny.us/omhweb/emergency/.

The Virginia Department of Mental Health, Mental Retardation and Substance Abuse Services collaborated with local community service boards to support first responders and to provide outreach, intervention and crisis counseling to adults and children affected by the tragic events. The boards are publicly funded agencies established by local governments that provide mental health services.

Post-September 11 Major Federal Funding

State/ Jurisdiction	October 1	Oct. 30 (in millions)

Connecticut	$ 50,000	$0.85
Massachusetts	50,000	1.15
Maryland	50,000	0.95
New Jersey	50,000	4.8
New York	250,000	8
Pennsylvania	50,000	1.85
Rhode Island	50,000	0.35
Virginia	50,000	1.5
Washington, D.C.	50,000	0.8

Contacts for More Information

Holly Kenny
NCSL--Washington, D.C.
(202) 624-3579
holly.kenny@ncsl.org

Leah Oliver
NCSL--Denver
(303) 856-1525, ext. 275
leah.oliver@ncsl.org

American Academy of Pediatrics

American Academy of Child and Adolescent Psychiatry

CMHS Emergency Services and Disaster Relief Branch

FEMA Information for Children and Adolescents

National Center for Children Exposed to Violence

Other NCSL Resources:

Other NCSL Briefs "States Respond to Terrorism"

NCSL's Protecting Democracy Page

NCSL's 2002 Legislative Session Home Page

NCSL's Summary of Mental Health Laws