City Of New Orleans

Kevin U. Stephens, Sr., MD, JD
Director, New Orleans Health Department


The City of New Orleans Health Department is concerned with the potential mental health and emotional status of our residents from the evacuation and re-entry back to New Orleans. These are tips which could be used by citizens to address preparedness, enhance resilience, and strengthen coping strategies in communities, families and children in the face of stress from the evacuation and re-entry.


Following the evacuation from Hurricane Gustav, many adults and children in our country will report significant fears and anxiety. Today these figures are likely to be even higher in light of the trauma from Hurricane Katrina. Almost all of us are experiencing worries and stress following the evacuation and subsequent re-entry. In the event of another storm or hurricane, these reactions may be heightened. However, under such difficult circumstances, these symptoms are normal and expectable and most people will cope well.


The New Orleans Department of Health is working actively with police officers, firefighters, emergency medical technicians, and other traditional and nontraditional responders as well as state and federal agencies to protect your safety. Responders can provide valuable information and instruction. Parents and responders can also do a great deal to ensure safety in their homes and strengthen the sense of well-being and security for children and families.


Normal reactions to traumatic events vary at different ages

Young children under five years of age may show

• Fears of being separated from their parents and clinging behaviors
• More aggressive behaviors, more crying or withdrawal
• Difficulties falling asleep, bedwetting, thumb sucking, fear of the dark or nightmares
• Reenactment of traumatic scenes in games
• More physical complaints such as stomach aches or headaches

• Whining, clinging, or acting like a younger child
• Increase in competitive or aggressive behaviors
• Decline in school performance or school avoidance
• Sleep problems, nightmares, and physical complaints like stomach pain, headaches, asthma
• Worries about criminals, safety, death or guilt

• Risk taking behaviors, agitation or apathy
• Nightmares, difficulties sleeping, nausea, headaches, diarrhea, or worsening of prior illnesses
• Angry outbursts, sadness, depression, mood swings or problems with concentration
• Increase in conflicts with the family, at school or delinquent behavior
• Decline in school performance

• Hypervigilance, excessive activity level, shock, disorientation or numbing
• Sadness, depression, angry outbursts, irritability and increase in problems at home or at work
• Nightmares, difficulties sleeping, nausea, headaches, diarrhea, or worsening of prior illnesses
• Anxiety, mood swings, difficulty concentrating or overprotecting others

• Withdrawal, isolation, pushing people away or difficulties with problem solving
• Obsessive worries about trivial things or health symptoms, apathy, suspicion, agitation, or anger
• Worries about death and of being a burden
• Confusion, disorientation, physical complains or worsening of prior illnesses
• Here are some age-specific tips for coping with the stress from evacuation

• Reassure children that they will be safe & that you and other people will protect them
• Be a good listener -too often we are inpatient, interrupt and try to soothe children
• Try to maintain usual routines for eating, sleep, play
• Follow the child’s lead: if the child wants to be picked up, do so
• Encourage your child to play or talk about their feelings
• Give simple answers to questions
• Be flexible, change your behaviors temporarily to accommodate the child’s needs
• If the child is clingy, be patient
• Help children identify and name their feelings
• Provide age appropriate activities

• Be patient, give additional attention and consideration
• Clarify the child’s distortions and misconceptions
• Give simple and realistic answers to their questions
• Be supportive and reassuring about any symptoms experienced
• Set gentle but firm limits for acting out behavior
• Provide age appropriate activities, physical activities, as well as structured and non-demanding tasks at home

• Encourage discussion of events, behaviors or trauma with peers and adults
• Give factual answers to questions
• Help link behaviors to feelings and events
• Encourage resumption of physical activities, community activities, and school events
• Encourage volunteering and involvement
• Set clear limits; address reckless and aggressive behaviors
• Involve the adolescent in emergency planning

• Return to routines and the usual structure of your days as soon as possible
• Take care of yourself; be aware of your feelings and find healthy ways of expressing them with friends and family without children present
• Spend time with others, seek support, volunteer
• Distract yourself, try to rest, eat healthy regular meals and sleep
• Give yourself permission to feel moody, nervous or blue
• Try not to make any major life changes during a stressful time

• Assure that physical and medical needs are met (water, food, cooling, warmth, medications)
• Provide frequent, simple and clear orienting information
• Assist in connecting with family and support systems
• Engage providers for transportation, chores, meals, home health and visits as needed
• Encourage discussion of events and feelings

• Reassure children that they are loved and that they will be safe
• Assure them that if there is a problem and police, firefighters, emergency medical technicians or other responders arrive on the scene, they are friends and are here to help
• Children should be limited in watching media coverage on TV, radio or the internet. If at all possible, it is better for you to watch media coverage with them and be able to answer questions and correct misconceptions after viewing
• Reassure children that most people throughout the world support our country. Promote tolerance and avoid negative, ethnic or religious generalization. Correct misconceptions
• Develop a safety plan with your family in case of an emergency. You and your family will feel better and will feel in control
• If possible, try to keep your family together or with a designated caregiver (you may include relatives, friends or neighbors)
• As part of the safety plan, include your children by assigning to them simple and concrete tasks
• Have a system for how your children and family can contact you during the day if you are not at home or work; have an alternate person/phone number for the children and family to contact
• You and your children should know the school’s emergency plans. Your children should know who to go to while at school if something happens. Discuss with the school plans for picking up your children during an emergency
• Volunteer with your community, religious institution and/or schools for emergency preparedness/response