Pediatric Disaster Behavioral Health (PDBH) Toolkit

3. The Pediatric Disaster Behavioral Health Framework

3.2. Key Pediatric Disaster Behavioral Health (PDBH) Principles & Assumptions

This quick-reference guide is designed to highlight core considerations for pediatric disaster behavioral health preparedness, response, and recovery efforts. It presents planning assumptions and guiding principles to support planning and decision-making, informed by emerging research and lessons learned from deployed disaster behavioral health teams.

All recommendations in this toolkit should be interpreted within the context of these assumptions and guiding principles.

For an expanded reference including additional details and references, please see the Key Principles & Assumptions – Expanded Reference.

PDBH Planning Assumption	Recommended Approach
Disasters create a continuum of behavioral health needs, including short- and long-term. One size does not fit all.	Conduct early behavioral health impact assessments to match anticipated needs with available resources.
Reactions vary by prior experiences, direct exposure, and secondary impacts (social, economic, etc.).	Prepare a "menu" of supports across acuity levels and pediatric care systems.
Staff and clinicians are also affected by disaster exposure and proximity in addition to burnout, moral injury, and secondary traumatic stress.	Implement three-tiered support: individual plans, leadership training, and system-wide strategies.
Behavioral health needs evolve over time.	Monitor, evaluate, and adjust interventions continuously to meet changing needs.
Behavioral health services are chronically under-resourced and gaps widen post-disaster.	Prioritize care for highest-risk populations to maximize impact with limited resources.
Timely prioritization and/or triage influences long-term outcomes.	Use structured processes and/or triage tools to identify and prioritize high-risk individuals early.
Communities are unique and will have distinct needs, preferences, and resources.	Tailor interventions to community context, existing strengths, and varying acuity levels.
Behavioral health and physical health are interdependent.	Integrate behavioral health into all aspects of disaster response for coordinated, whole-person care.
Behavioral health needs will present across community touchpoints, likewise resources will be distributed across communities.	Collaborate and coordinate with other health care systems, providers, community organizations, and governmental structures.
Behavioral health impacts are often, but not always, delayed after a disaster.	Resources may need to be developed to prepare for a potential behavioral health surge in the months following the incident.