CARING FOR THE FORGOTTEN CHILDREN: REBUILDING PUERTO RICO AFTER HURRICANE MARIA, EARTHQUAKES, AND COVID-19

Abstract

The objectives of this session are as follows: 1) to appreciate the experience and vulnerabilities of communities experiencing recurrent disaster events; 2) to understand the circumstances faced by already-disenfranchised communities when impacted by multiple natural disasters and to learn about disparities in the ability to recover among different sectors of the population; 3) to learn about actions and strategies taken by child and adolescent psychiatrists and other child mental health professionals to mitigate the ill effects of a disaster on communities in Puerto Rico (PR) and to facilitate recovery and resilience; and 4) to learn about engagement of community stakeholders to promote acute and long-term recovery peridisaster, and how to provide mental health support and clinical expertise to these groups. Throughout the session, multimedia (audio/music, video, photos, and newer technologies as appropriate) will be used to help the audience engage in the presentations. Also, audience members will have the opportunity to share their own disaster-related stories/cases/experiences and contribute to discussions in response to the faculty presentations and live stream session. Linda Chokroverty, MD, will present the audience with her experience as a deployed mental health clinician/child and adolescent psychiatrist after recent earthquakes and more recent follow-ups during the pandemic, in advocating for the needs of children/adolescents, an often-neglected group in the peridisaster period. Karen G. Martinez, MD, MSc, will describe efforts by the local academic and clinical community in PR to provide multilevel peridisaster mental health care to the most impacted residents of PR over the last several years. Rosaura Orengo-Aguayo, PhD, and Regan Stewart, PhD, will describe collaborations between the Medical University of South Carolina and island-based partners in providing a multitiered approach (including telehealth) to support the mental health of children, teachers, parents, therapists, and general community members in PR at different stages following Hurricane Maria, earthquakes, and now COVID-19. Laura Gonzalez-Conty, MD, will present her experience in establishing a telepsychiatry service in the disaster-affected earthquake zone and the subsequent disruptions and challenges in implementing the provision of clinical consultation during the pandemic. New innovations in telepsychiatric applications during the pandemic-related lockdown in PR will then be described, especially with regard to at-risk children/families and caregivers. Finally, Melissa Brymer, PhD, PsyD, an expert in disasters and traumatic stress, will provide a synthesis and important observations noted in the presentations/discussions, and make further recommendations on how best to help repeatedly affected youth and the community in PR. The audience will become informed of evidence-based and trauma-informed interventions in PR that clinicians and program developers have implemented to help children and caregivers cope psychologically in the face of recent disasters, and have the opportunity to make their own contributions to the dialogue of postdisaster care in this region. Following recurrent disasters in PR, efforts by child and adolescent psychiatrists and mental health experts must include a variety of approaches to engage stakeholders and facilitate the best mental health outcomes for youth and families.