A stepped-care model of post-disaster child and adolescent mental health service provision

McDermott, Brett M. and Cobham, Vanessa E. (2014) A stepped-care model of post-disaster child and adolescent mental health service provision. European Journal of Psychotraumatology, 5 SUPPL: 1-10. doi:10.3402/ejpt.v5.24294

Author McDermott, Brett M.
Cobham, Vanessa E.
Title A stepped-care model of post-disaster child and adolescent mental health service provision
Journal name European Journal of Psychotraumatology   Check publisher's open access policy
ISSN 2000-8066
Publication date 2014-07-11
Year available 2014
Sub-type Article (original research)
DOI 10.3402/ejpt.v5.24294
Open Access Status DOI
Volume 5
Start page 1
End page 10
Total pages 10
Place of publication Jaerfaella, Sweden
Publisher Co-Action Publishing
Language eng
Formatted abstract
Background: From a global perspective, natural disasters are common events. Published research highlights that a significant minority of exposed children and adolescents develop disaster-related mental health syndromes and associated functional impairment. Consistent with the considerable unmet need of children and adolescents with regard to psychopathology, there is strong evidence that many children and adolescents with post-disaster mental health presentations are not receiving adequate interventions.

Objective: To critique existing child and adolescent mental health services (CAMHS) models of care and the capacity of such models to deal with any post-disaster surge in clinical demand. Further, to detail an innovative service response; a child and adolescent stepped-care service provision model.

Method: A narrative review of traditional CAMHS is presented. Important elements of a disaster response – individual versus community recovery, public health approaches, capacity for promotion and prevention and service reach are discussed and compared with the CAMHS approach.

Results: Difficulties with traditional models of care are highlighted across all levels of intervention; from the ability to provide preventative initiatives to the capacity to provide intense specialised posttraumatic stress disorder interventions. In response, our over-arching stepped-care model is advocated. The general response is discussed and details of the three tiers of the model are provided: Tier 1 communication strategy, Tier 2 parent effectiveness and teacher training, and Tier 3 screening linked to trauma-focused cognitive behavioural therapy.

Conclusion: In this paper, we argue that traditional CAMHS are not an appropriate model of care to meet the clinical needs of this group in the post-disaster setting. We conclude with suggestions how improved post-disaster child and adolescent mental health outcomes can be achieved by applying an innovative service approach.
Keyword Disaster planning
Mental health services
Posttraumatic stress disorder
Randomized controlled trial
Quality of life
Hurricane Katrina
Anxiety disorders
Natural disaster
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Mater Research Institute-UQ (MRI-UQ)
Official 2015 Collection
School of Psychology Publications
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Citation counts: TR Web of Science Citation Count  Cited 4 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 8 times in Scopus Article | Citations
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