UK major incidents: helping children and young people cope

Dr. Ann York shares how to address major incidents with children and young people

The recent few months have been full of terrible events — the terrorist attacks at Westminster , Manchester Arena, London Bridge and most recently the Finsbury Mosque as well as the tragic fire at Grenfell Tower. Adults, children and young people have been caught up in these tragic circumstances and the impact has been much wider than the local area in which they happened.

Children and young people who experience a terrible event, either directly or as a witness, can suffer very similar feelings to adults, but it is important to be aware of the differences too.

The range of responses is wide and very young children may mainly show their distress in their behaviour and play. They are exquisitely sensitive to how the adults around them are feeling, despite when adults may be trying hard to protect their children from their own distress.

In the first few days it is very normal for children and young people to feel anxious, scared, sad and upset and have difficulty sleeping or start wetting the bed. They may complain of tummy ache, headache and go off their food. Some may suffer bad dreams or think a lot about what happened during the incident (pictures and memories may unexpectedly pop into their minds)- making it very hard to concentrate on school work. They may become irritable or aggressive or have tantrums.

Older teenagers may use alcohol, drugs, withdraw or want to go out more than usual. It may be difficult for them to talk about how they feel, either because they cannot find the words or because they want to protect their parents who may be suffering too.

Whilst forcing children and young people to talk is not helpful, being receptive and open if they want to talk about what happened is useful.

It can be difficult for adults to know what to say when children ask for reassurance or question why something happened. The world is a complex place and, as adults, we struggle to make sense of events, let alone know how to explain them to children.

Here are some tips about how to talk with children and young people. You are aiming to help them know having strong feelings about what has happened is normal and that it is okay to talk about it if they want to. Be open about your own feelings and that you are looking after yourself properly.

1. Let them know it is okay, and normal, to feel upset and scared, or whatever it is they are feeling.

2. Let them know it is okay to talk about it, if they want to, but if they don’t want to then that is okay too. Make sure you provide opportunities when they can talk if they chose to, but don’t force it. Younger children may want to play through what happened, or draw about it rather than talk. Let their teachers know what has happened and how they are. Make sure they know that they do not need to force your child to talk about it but neither should they avoid the subject. If you want to talk about what happened then do so- letting your children see that it is okay to talk about it is a good thing

3. Reassure them they are safe (this can be hard if you are not feeling this yourself- get support for yourself from family and friends so that you can support your children). Explain, truthfully, as best you can about what has happened and the reasons why. Sharing facts is very helpful, as is being honest about what you don’t know. It is not unusual for children to misunderstand things, or sometimes believe that they were responsible for things so letting them know what the truth is can be very helpful. Let them know that these things are very rare and so we do not need to feel unsafe all the time as the risk of something happening to us is very small. But also let them know it is natural to feel anxious that something may happen, but feeling this way does not make the risk greater. They can remind themselves, and you can remind them, that they are safe and the chances of anything happening again to them are very small.

4. They may find it helpful to think of how they could answer questions that may come from school mates or relatives.

5. Help them keep to their usual routine- bedtime, mealtimes, going to school, out of school activities. Doing normal things helps everyone feel more secure; familiar routines are comforting for everyone. If you are used to spending Friday nights with pizza and a film then try to still do that.

If the distress is still significant and affecting them day to day after 4 weeks then seek advice via your GP or school about the need for further help.

It is worth asking your child how they are feeling after a few weeks as it may not be immediately obvious that they are not okay.

Very occasionally children and young people can develop Post Traumatic Stress Disorder, but most do not. There are effective treatments available. The best preventative help is good support from understanding family, carers and teachers, so look after yourself. It will help your child.

Dr Ann York is the clinical advisor for the children and young people’s mental health programme in Healthy London Partnership. Her role is to support service improvement in young people’s mental health services in London through supporting clinical commissioning groups (CCGs) to deliver their local transformation plans for CAMHS.

Ann worked clinically as a consultant in NHS Tier 3 CAMHS from 1998 to May 2014. She now works full time in quality improvement, which is her absolute passion — to support services to develop into ones that are excellent for young people and their families and great places to work in. She has extensive experience in service development in her team and internationally.

She currently has a range of paid and unpaid roles. All are focussed on improving quality in services, through working with individuals, teams and organisations, to service review, national policy development and implementation, accreditation and inspection.

Ann is embedded nationally in Children and Young People Improving Access to Psychological Therapies (IAPT) implementation and CAMHS (Children and Adolescent Mental Health Service) transformation planning. She co-chaired the Data and Standards group of the national CAMHS Taskforce that produced Future in Mind.

Her clinical interests include neurodevelopmental disorders and depression. She has wide teaching and training experience.

Ann is resolutely committed to making a difference and creating change.