School reactivation programs after disaster: could teachers serve as clinical mediators?

Mental health interventions are known to prevent the progressive worsening of symptoms in young victims of disaster and, subsequently, to prevent a decline in their academic performance and self-esteem [8,46]. The tremendous needs that emerge after a disaster and the reluctance shown by most victims to seek professional help require mental health leaders to adopt a proactive stance and implement relief programs in the child's most natural setting. The school as institution and the teachers as empowered mediators offer the appropriate conditions for implementing an effective large-scale intervention program. Well-intentioned child professionals who deal with school administrators and teachers must take into account that, as stated by Pfefferbaum et al [25], "avoidance is at the core of the posttraumatic response, and it sometimes involves avoidance of treatment." For child mental health professionals, routine collaboration across systemic boundaries may prove critical for the rapid mobilization of resources during mass traumatic emergencies. Further studies are needed to identify the protective and risk factors that predict resilience and pathology, respectively, and factors that facilitate or aggravate factors that predict improvement, resistance, and deterioration in response to treatment.