Course Pediatric Disaster Behavioral Health (PDBH) Toolkit

Patient-Centered Medical Homes (PCMHs) are a primary access point for pediatric mental and behavioral health, especially during disasters when specialty access is limited. Primary care clinicians (PCCs) screen, initiate brief interventions, manage medications as appropriate, and coordinate referrals²⁹ . 

Evidence shows the PCMH model improves outcomes, reduces hospitalizations, and is associated with higher patient/provider satisfaction. Approximately 1 in 5 U.S. youth ages 3 to17 meet criteria for a mental, emotional, developmental, or behavioral disorder^30,31,32,33 .

Context and Role of the Medical Home

• Increased accessibility: Many children receive behavioral health care in PCMHs due to workforce shortages and access barriers (geography, perceptual, structural).
• PCC scope: Screen and manage low to moderate-acuity behavioral health concerns, provide brief psychosocial interventions and medication management as indicated, and coordinate with behavioral health partners²⁹.
• Value of the model: PCMHs support continuity, navigation, and family-centered care across preparedness, response, and recovery³⁴ .

Preparedness: What PCMHs and PCCs Should Put in Place

• Engage families in readiness and resilience building.
  • Share and review family-facing toolkits: Disasters and Your Family: Be Prepared, Family Readiness Toolkit, and Emergency Information Form.
• Compile and maintain a behavioral health referral list.
  • Include local providers across ages, languages, modalities (in-person/tele), and insurance coverage for use in all disaster phases.
• Standardize screening and monitoring.
  • Adopt core screeners and workflows for initial screening and ongoing symptom tracking. These screeners should be normed for use in pediatrics or interpreted with significant caution: 
    • PHQ-9A (Patient Health Questionnaire modified for Adolescents, for 12+), C-SSRS (Columbia-Suicide Severity Rating Scale), GAD-7 (General Anxiety Disorder, not for use in children under 11), ASQ (Ask Suicide-Screening Questions), Primary Care PTSD Screen for DSM-5 (normed for adult population) or the CPSS-5 (Child Symptom PTSD Scale). For more information, please reference the Triage vs Screening vs Assessment in Disasters or Mass Casualty Incidents (MCIs) appendix for a review of these tools.
• Use American Academy of Pediatrics (AAP) disaster readiness resources.
  • Reference AAP: Disasters and Children³³ for practice-level recommendations, checklists, and family guidance.

Response and Recovery: How PCMHs Support Children and Families

• Promote stabilization and routine.
  • Coach families on establishing daily routines, regular physical activity, nutritious meals, sleep hygiene, positive activity engagement, and relaxation strategies.
• Provide timely triage and follow-up.
  • Triage behavioral health needs, initiate brief supports, and schedule monitoring visits; escalate when safety risks are identified.
• Consult and collaborate with schools/childcare and community partners.
  • Serve as a consultative resource on Psychological First Aid (PFA) –related practices and pediatric considerations. Gather information and awareness about current needs and trends among student populations. 
• Advocate for children’s needs.
  • Elevate pediatric considerations at local, state, and federal levels as issues emerge during recovery.
• Address suicide risk with established resources.
  • Use and share: ED STOP and CALM for identification, management, and lethal-means counseling. (Suicide is the second leading cause of death in youth ages 10 to 17.)