World Mental Health Day 2002

“We were all children once, and we are now the parents, grandparents, uncles and aunts of children. Children’s needs and wishes, hence, are not difficult to understand. They want, expect and have the right to the best possible start in life. We must do all we can to ensure that they, and the generations of children to come, receive this – a safer, fairer, healthier world.”

VIOLENCE AND TRAUMA: STRATEGIES TO REDUCE INCIDENCE AND PROMOTE RECOVERY

This call to action from the United Nations Secretary General’s Report, “We The Children,” effectively expresses the importance of providing our children a life free from violence and trauma. To achieve this safer world, we must:

• Support and educate families and caregivers;
• Use Conventions, Protocols and other policy initiatives to obtain reforms;
• Implement more effective legislation and policies in our own countries and communities to ensure that they put the rights and safety of children first; and
• Train health, mental health and other child workers to provide services effectively so that children can recover from their experiences of violence and trauma.

Following are model examples of successful programs as well as suggestions provided by several major organizations contributing substantially in this field.  This information is provided with the hope that other organizations will replicate these strategies where feasible. At the end of this section, we present tactics and tools for individuals and smaller groups, which can also contribute significantly in efforts to ensure that children grow up protected from violence and trauma.

WORLD HEALTH ORGANIZATION

The goal of the World Health Organization (WHO) is the “attainment by all peoples of the highest possible level of health”. Health as defined in WHO’s constitution is “a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity”. As the premier specialized agency of the United Nations for health, WHO promotes technical cooperation for health among nations, implements programs to control and eradicate disease and strives to improve the quality of human life.

The WHO Department of Injuries and Violence Prevention (IVP) leads global action to prevent injuries, including violence-related injuries, as major threats to public health. WHO defines violence as “the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community that either results in or has a high likelihood of resulting in injury, death, psychological harm, mal-development, or deprivation.” WHO’s mission regarding violence is to apply the insights and tools of public health to its prevention, in order to improve well-being and reduce the burden of disease.

With regard to violence-related injuries, IVP seeks to:

• Act as a facilitating authority for international science-based efforts to prevent violence.
• Promote and facilitate international violence prevention research.
• Promote improved standards of teaching and training for violence prevention.
• Foster multi-disciplinary collaboration between relevant global, regional and national stakeholders.
• Compile and disseminate best practices for violence prevention and control.
• Facilitate implementation of violence prevention and control at country level.
• Collate, analyze and disseminate global data on violence-related injuries.

A few of WHO’s violence prevention activities include:

• World Report on Violence and Health. To be released in October 2002, the Report describes cross-national patterns of violence; summarizes existing information on risk factors and prevention approaches; and includes recommendations for future public health action.
• Global Violence Prevention Framework. The Framework is a structure to improve the co-ordination of violence prevention activities across all levels and sectors in all regions and countries of the world. The Framework will include methods to collect data on violence; strategies to plan programs and monitor and evaluate their effectiveness; best practice models for violence prevention; and guidelines to manage the consequences of violence.
• Database of Good Practices for the Prevention of Interpersonal Violence. This project began with development of a handbook specifying criteria for the identification of good practices for interpersonal violence prevention. This handbook is being used to collect information about exemplary programs for the prevention of interpersonal violence, which will be regularly updated, collated and published.
• Contribution of International Legal Instruments toward the Prevention of Interpersonal Violence. The goal of the project is to systematically assess the prevention potential of existing international legal and human rights instruments, and to increase their impact by raising awareness of their existence and improving their implementation.
• Curriculum Development. This two-year project aims to develop guidelines for injury and violence prevention curricula in schools of public health, medicine, nursing and allied health.  
• Guidelines for Improving Health Sector Responses to Sexual Violence. Following a June 2001 expert consultation on health sector responses to sexual violence, this project involves the preparation of guidelines for country-level actions to strengthen policies and implement improved health and medico-legal services for victims of sexual violence.
• Guidelines for the Prevention of Child Abuse and Neglect. With the International Society for the Prevention of Child Abuse and Neglect, WHO is developing a set of multi-sectoral guidelines for the primary, secondary and tertiary prevention of child abuse and neglect. Sectors include: Health, Social, Legal, Education, Policy Makers, Media, NGOs, donors and the community.
• Surveillance. Through its country offices, WHO provides technical assistance to the governments of Ethiopia, Mozambique and Uganda in the design and development of national injury and violence surveillance systems. The objective is to develop systems for the epidemiological surveillance of fatal and non-fatal injuries due to violence and unintentional causes, as a basis for the design and evaluation of prevention policies and programs.
• National Violence Prevention Strategies. WHO provides technical support to governments in designing national policies and facilitates their collaboration with municipalities to organize local violence prevention coalitions. The aim is to promote the formation of multi-disciplinary coalitions to plan and implement violence prevention initiatives, develop laws to reduce the likelihood of violent events, and facilitate structural reforms to prevent violence among young people.

UNICEF

UNICEF’s goal is to create a world where human rights are secure and people can thrive without injustice, poverty and disease.

Promoting child development:  According to UNICEF, healthy development is a major factor that improves the resilience of children and lessens the effects of exposure to violence and traumatic events. Throughout the world, parents and local health, nutrition and education workers are making progress in ensuring that children have a good start in life. Thousands of communities have found ingenious ways to provide access to education for all children, such as multi-grade classrooms, cluster schools and education by radio.

Establishing and improving schools:  More than 130 million children do not attend school because schools or teachers are unavailable, transportation is not possible or tuition and fees are too expensive. For many of the children who do attend school, teachers are poorly trained or curricula are irrelevant. UNICEF promotes the need for major improvements to be made in these areas.

Creating child-friendly schools:  A school is child-friendly when both girls and boys find it a safe and welcoming environment centered on the rights of a child, where teachers respect their rights and where learning is a source of joy. Such initiatives have helped narrow gender gaps in primary school education in sub-Saharan Africa, the Middle East, North Africa and South Asia. (UNICEF)

Protecting rights:  UNICEF actively promotes ensuring the rights of adolescents through the Convention on the Rights of the Child. In some societies, children are married or parents themselves; in others they are isolated from the adult world or in need of special protection from sexual exploitation or recruitment into armed combat.  Many countries are establishing programs to improve these conditions, including efforts to impact age of marriage and child-bearing, girls school enrollment, nutrition, family separation, child military recruitment, sexual abuse and exploitation, and female genital mutilation.

Involving children in programs specifically designed for them:  This approach empowers youths by developing their talents and bolstering confidence. One inner-country project to promote the rights of adolescents is under way in 13 countries – Bangladesh, China, Cote d’Ivoire, the Democratic Republic of Congo, Egypt, Ghana, Jamaica, Jordan, Malawi, Mali, Mongolia, the Russia Federation and Zambia. The project focuses on many key issues such as youth-friendly health services, access to education, peer counseling, freedom from exploitation and abuse, and safe spaces for meetings and recreation.

UNITED NATIONS

Like UNICEF, the United Nations also believes that improving the lives of children is linked to promoting and strengthening the role of the family. The United Nation’s World Summit on Children’s Plan of Action states:

“For the full and harmonious development of their personality, children should grow up in a family environment, in an atmosphere of happiness, love and understanding. Accordingly, all institutions of society should respect and support the efforts of parents and other care-givers to nurture and care for children in a family environment.”    

Many countries provide public services for needy families, including but not limited to health care, education, nutrition, and day care.  However, many countries provide little or no support for families, and the children are often at high risk as a result. The United Nations Summit, We the Children, recommends the following actions as priorities for ensuring the health of families:

• Strengthen programs to support families in their child-rearing responsibilities, including parent education and counseling.
• Develop comprehensive national programs for the prevention, detection and treatment of neglect and physical or sexual abuse of children.
• Ensure that all children deprived of a family environment have access to appropriate forms of alternative care where their rights are safeguarded.

The United Nations also supports countries revisiting their legislation, regulations, policies and programs to ensure that they incorporate the rights guaranteed in the Convention on Rights of the Child. Many countries have made good progress toward this goal, but additional reforms are still needed.

SAY YES TO CHILDREN

The Bangladesh Rural Advancement Committee, Netaid.org Foundation, PLAN International, Save the Children, UNICEF and World Vision are building a Global Movement for Children. The movement, launched in April 2001, has asked people of all ages and from every part of society to declare their support for a future where children’s lives and opportunities are not threatened by war, disease, poverty, discrimination or abuse.  Say Yes has traveled in caravans, spread through schools, marched through city streets and teamed up in door-to-door campaigns, crossing borders of rural and urban, and reaching both young and old, to raise awareness and encourage activism.  It has rallied human rights activists, parliamentarians, students, grassroots action groups, community leaders and entire families around a common hope for the world’s children.  This campaign is gaining momentum in mobilizing support for a 10-point agenda that aims to “change the world with children” and encourages everyone throughout the world to, “Say Yes to Children.” This agenda includes:

1. Leave No Child Out
2. Put Children First
3. Care For Every Child
4. Fight HIV/AIDS
5. Stop Harming and Exploiting Children
6. Listen To Children
7. Educate Every Child
8. Protect Children from War
9. Protect the Earth For Children
10. Fight Poverty: Invest in Children

To show your support and Say Yes to the children of the world, log onto www.gmfc.org and submit a pledge form to join the Global Movement for Children. 

CHILD HEALTH INTERNATIONAL LARGE SCALE DISASTER NETWORK

The American Academy of Pediatrics (AAP) created the Child Health International Large-scale Disaster Network, CHILDisaster Network, to identify child health professionals who are willing and qualified to respond to disasters as short-term volunteers.   These volunteer professionals contribute a great deal during a disaster by:

• Providing high-quality acute care for children affected by humanitarian emergencies.
• Identifying and implementing preventive health strategies for children in disaster settings.
• Improving medical and psychological health outcomes for those affected by disasters.
• Reducing long-term costs to individuals and society via prevention of late-onset problems.
• Establishing long-term, collaborative relationships with local health professionals.

To learn more about this program or to apply as a volunteer professional, please visit the AAP website at www.aap.org/disaster.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

The U.S. Department of Health and Human Services has launched the Child Traumatic Stress Initiative to address child trauma issues by providing federal support for a national effort to improve treatment and services for child trauma, to expand availability and accessibility of effective community services and to promote better understanding of clinical and research issues relevant to providing effective interventions for children and adolescents exposed to traumatic events. 

INTERNATIONAL SAVE THE CHILDREN ALLIANCE

Located in the United Kingdom, The International Save the Children Alliance is a network of 32 independent organizations that fight for children’s rights and deliver immediate and lasting improvements to children’s lives worldwide.  Save the Children is the largest independent movement for children with programs in over 100 countries.   The aims of Save the Children’s programming can be explained through five broad areas of work: education, HIV/AIDS, exploitation and abuse, conflict and disaster, and the rights of the child.  To learn more about their programs and find a national office near you, go to www.savethechildren.net/members.

NATIONAL MENTAL HEALTH ASSOCIATION

The National Mental Health Association (NMHA) is one of the most influential players in mental health in the United States.  NMHA is dedicated to promoting mental health, preventing mental disorders and achieving victory over mental illness through advocacy, education, research and services.  NMHA believes that children are the key to our future – the better we take care of them now, the better our world will be.   Specific programs and initiatives NMHA is engaged in to achieve these goals and promote child well being include:

Safe Schools/Healthy Students Action Center:  NMHA in partnership with the National Association of School Psychologists operates this project.  This Center works to assist federal safe schools initiatives throughout the United States by replicating best practices and promoting mentally healthy communities.  It also provides families with resources and materials to enhance their own abilities to prevent school violence and enhance resilience.

15+ Make Time to Listen, Take Time to Talk: NMHA is working with the US Federal Government on this national multimedia campaign to encourage parents to spend 15 minutes or more listening to and talking with each of their children, each day.  Research shows this can have a strong impact on a child’s mental health, emotional growth and self-confidence – helping to counteract potential trauma and violence in a child’s life. 

Juvenile Justice:  NMHA’s juvenile justice initiatives highlight the critical unmet needs of the thousands of young people with mental health and substance abuse disorders in America’s court system.  This program is committed to helping states and communities develop policies and services for vulnerable young people, rather than punishing them.  By raising public awareness, NMHA is helping to build the capacity of states and communities to better, and more appropriately serve these youth and their families.

Children’s Mental Health Matters Campaign:  The Children’s Campaign is a comprehensive, national grass roots initiative geared towards educators, primary care providers and families to increase their understanding that children’s mental health disorders are real, common and treatable.  The campaign aims to increase public awareness, combat the stigma and myths that surround these disorders, and improve the detection and treatment of children’s mental disorders.      

What You Can Do

To guarantee a safe world for our children, a wide range of stakeholders must play a part, including governments, private institutions, community leaders, corporations, media, childcare workers, teachers, administrators, parents and general society.  Below are some practical suggestions of ways these various stakeholders can take effective action.

Suggestions and action tools for improving children’s rights:

Governments and Private Institutions

• Base policy and budgetary decisions on what is best for the child.
• Give special attention to children’s programs when developing budgets.
• Make developing a high quality and safe educational system a high priority. Research shows that abused children who have had positive school experiences have significantly lower rates of adult difficulties. (National Child Protection Clearinghouse.)
• Aim to improve self-esteem, promote vocational pursuits and improve the child’s social networks through prevention and early intervention strategies. These strategies also should involve parents.
• Implement policies that ensure adequate health care for children, including mental health services.
• Give children an identity by registering them at birth on a national registry.
• Pass legislation aimed at ending violence against children, including prohibiting corporal punishment in schools.  Implement procedures to catch and prosecute violators.

General Society

• As feasible in your country, urge appointment of a minister of nonviolence. This person would be responsible for working with media industry professionals, health organizations, law enforcement agencies, educational groups, parents, concerned citizens and others to organize the resources and programs dedicated to nonviolence.
• Use the media to draw attention to the problems and rights of children. UNICEF has a variety of available tools, including videos and public service announcements.
• The United States has not ratified the Convention on the Rights of the Child (CRC). If you live in the United States, you can help move the CRC closer to ratification by
  • Contacting local groups and mobilizing them to support the CRC.
  • Organizing informational meetings or distributing materials about the CRC.
  • Contacting local newspapers with letters to the editor and opinion articles in support of the CRC.
  • Organizing a letter-writing campaign in support of the CRC.
  • Promoting the CRC in your newsletters and other materials.

Human Rights Watch suggests that you:

• Write to your country’s ambassador at the United Nations and encourage support for the General Assembly to initiate an international study on violence against children.
• Write to your Minister of Justice or member of Congress or Parliament on behalf of legislation prohibiting all forms of violence against children, including the use of corporal punishment in schools and institutions, and instituting effective mechanisms to investigate perpetrators and bring them to justice.
• Write to your Minister of Education and local school board to support policies to ensure that schools are safe places for all children and youth.
• Write to your Minister of Health and Social Services to urge special training and enable medical personnel, social workers, childcare workers and other professionals to recognize and respond to violence against children.
• Work with local cable access channels and radio stations to air public service announcements promoting nonviolent behavior. Celebrities with whom young people identify could do these.

Suggestions and action tools regarding family and community violence:

Governments

• Put the child’s needs first in situations of family violence.
• Ensure that laws protect girl children from “traditional” practices that subject them to violence.
• Implement programs to educate parents about violence, as well as provide them with social support as a means to end the cycle of violence that continues for several generations.
• Ensure health professionals in communities are trained to be sensitive to signs of family violence.
• Invest in community services, including schools, recreational programs and safe housing efforts.
• Restrict access to both alcohol and firearms.
• Recognize the value of preventative measures in social policy to deter violence.

Childcare workers, Teachers and Administrators

• Lobby for violence prevention policies and other related improvements in your school.
• Ensure that teachers and childcare workers receive adequate training and support to recognize and intervene appropriately when there are warning signs of potential violence.
• Implement a special recognition program for students who solve conflicts nonviolently or deter others from using violence. Promote it in the school and in newspapers.
• Help a multicultural group of students write, produce, act and stage a play advocating nonviolent situations. The production would emphasize anger management, and conflict resolution skills, and promote understanding between ethnic groups. It could travel from school to school and also be tailored to fit a particular school’s composition and environmental characteristics.
• Organize a classroom-writing project to research a group of stories about individuals who have used nonviolence to solve difficult problems. These stories could feature local heroes and community leaders with whom kids could identify.  Look for ways to publish the stories in the media.
• Declare “red ribbon week.” Help students make, design and wear the ribbon, which show a commitment to make the community and schools a less violent place. Try to involve the community in your campaign through letters to community leaders.
• Sustain or create a democratic classroom with participator decision-making. Make the room safe for discussion of conflicting ideas.
• Create opportunities for cooperation in the classroom.
• Involve parents as partners. Keep them informed and invite them to participate in your efforts.
• Initiate classroom activities that reinforce the message that one person can make a difference to help and heal.
• Be sensitive to cultural differences.

Suggestions and action tools for lessening the effects of community & family violence & trauma:

Parents and Caregivers

• Teach your child a sense of community through active participation. Join activities to keep your neighborhood safe and to prevent violence.
• Give your children opportunities to play with other children and to interact with people of all ages.
• Give children your time – play together, eat together, watch their activities, work on projects together.
• Teach children to never touch a gun, a bullet or a knife. Let them know that if they find one, they should not touch it but tell a trusted adult about it.
• If you own a gun, never leave it where a child might get it. Lock your unloaded guns and bullets separately in secure places that children cannot reach.
• If you think your child has been abused, do not confront the abuser yourself. Call local professionals and law enforcement officials. If your child mentions the abuse to you, be sure to let him or her know that he/she is not to blame and let him know that he/she was right to talk to you about it.
• Teach your child to feel comfortable in refusing to do anything that is wrong or frightens him or her.
• Talk to your child about sex. Help him or her understand the private parts of the body. Be positive. Children should feel proud of their bodies and not ashamed. If, as a parent, you feel embarrassed talking about sex with your child, ask your health provider to help you, or ask about a parenting group you can join.
• Explain the difference between “good” and “bad” secrets. Explain that having a secret about a surprise birthday party is all right, but having a secret about something that makes a child feel uncomfortable or unhappy is not.
• Take action to keep your child away from the abuser and to obtain medical attention and counseling for your child, if needed.
• Be sure to take care of your own feelings. You may be confused and upset as well, but you must learn how to react in such a way as to not further upset your child.

The National Mental Health Association suggests that Advocates for Children can:

• Work toward an integrated system of care, in which children are served by a comprehensive and holistic system, rather than in isolated “silos.”  Child advocates can encourage necessary collaboration, communication, and coordination across healthcare, child welfare, juvenile justice, mental health, substance abuse, and other such child-serving systems, to ensure that children receive the most appropriate care.
• Promote the integration of prevention into a system of care for children, so that enhancing children’s strengths and competencies, and therefore building their resilience, prior to the occurrence of a mental health problem is of equal importance to treating mental health problems.
• Increase attention to the importance of identifying risk factors and intervening early with youth at-risk for developing mental health problems.  Drawing attention to the prevention of mental illness and the promotion of mental health in youth is paramount to reducing unnecessary suffering among children.
• Raise awareness about the solid body of scientific research showing the effectiveness of prevention and early intervention programs for youth.  Supporting the widespread replication of evidence-based programs with children and adolescents can greatly impact the incidence of youth violence, mental illness, substance abuse, and other related problems.

Suggestions and action tools on ways to end or lessen the impact of media violence:

Parents and Caregivers

• Take charge of the media in your child’s life. Limit viewing, provide choices and talk about what is being shown.
• Set clear limits. Limit daily TV viewing and video game playing time to one or two hours a day or less. Consider investing in an electronic device that limits television watching.
• Do not use the TV as a babysitter.
• Do not make TV the focal point of the home. Do not place the TV in the most prominent location in the home. Keep TV sets out of children’s rooms.
• Offer other fun activities such as reading, music making, hobbies, sports and social activities.
• Ban unacceptable programs. Teach children critical viewing skills and be clear about why you avoid certain programs, movies and video games. Make your own actions consistent and be ready to give up programs that you may enjoy to model the right behavior for your children.
• Identify and watch high-quality programs with your children.
• Know what your children are watching. Watch at least one episode of your children’s favorite programs. Ask the children what they like about the programs.
• Discuss media violence. Talk with your children about how TV and movie characters solve their problems. Ask children to come up with more realistic or nonviolent solutions. Talk about the violence promoted in video games your children play. Discuss alternative ways to resolve conflict.
• Have a voice in local programming. Call or write local stations to express your approval or disapproval of children’s program. Get involved with local organizations and coalitions. You can also write directly to producers and advertisers to let them know about which shows you like and which you do not.
• Suggest that you and your children all play the “Let’s Count the Acts of Violence” game as you watch. Compare totals at the end. Do they differ? Where and why?
• When you see a violent incident, ask your children what they believe caused the character to act in a violent way. Challenge them to think of other ways to react.
• Help children learn alternatives to violence for settling conflict. Encourage children to discuss positive experiences they have had with people different from themselves.
• Start early influencing your children’s exposure to television since enforcing rules is easier with younger children than older ones.
• Do not panic. Watching one TV show will not irreversibly damage your child. The cumulative effect is what makes the difference. Some experts suggest putting the whole family on a TV “diet” by approaching TV consumption in much the same way that you approach food consumption.
• Use TV constructively either to stimulate conversations about topics that can be difficult to discuss, such as divorce, appropriate sexual behavior and consequences of violence. Or use it as a springboard for other learning experiences such as going to the museum or library.
• If you are watching negative news coverage with your child, make sure you have time and a quiet place to talk about questions the child might have.

General Society

• Work with your local TV station or cable access channel to develop projects that explore alternatives to violence in films and television.
• Work with local cable access channels and radio stations to start a pilot program to encourage nonviolent behavior through public service announcements. Music Television (MTV), for example, has aired a 15-second animated spot called “Silence the Violence” in which marching machine guns are turned into flowers. Call MTV in New York at (212) 258-8000 or find your countries local branch. 
• Work with local television stations to develop and implement a community-based public service communications code.
• Promote a violence tax, or an extra tax, for producers of violent films.
• Try not to support violent movies, TV shows, and video games.  Without consumer support, these industries would have to change their ways.
• Work with your local school to organize a youth advisory panel on the media. Such a board would get children involved in the business of media and help ensure that messages are appealing to the target audience.
• Organize a community gathering with nonviolent activities.  Invite an atmosphere of education and finding ways to work together.
• Involve local businesses in exploring the development of new programs to reduce violence in the media.
• Use the media to highlight a historical figure or personality whose use of nonviolence serves to inspire others. Children could be included by having them interview neighbors or family members about heroic actions they have performed or witnessed.
• Use the media to disseminate information to the public on the consequences of violence to victims, as well as recommendations about where to turn for help.
• Develop media efforts targeted at influencing policymakers and/or voters.
• Have a youth group, class or after-school club rewrite and replay an “action” show with different members assuming different roles. Action and drama shows often feature only one point of view, usually that of “good guy” who overcomes obstacles to defeat a “bad guy.”  This technique creates a false sense of needing to create an enemy that justifies the use of violence. Switching protagonist and antagonist roles and highlighting different perspectives could help children understand all sides of an issue before resorting to violence.
• Work with children by discussing and understanding their responses.  Children will sometimes mimic without totally understanding what they are doing.  Show them other ways of handling violent situations that they have viewed

Suggestions and action tools regarding children and armed conflict:

Governments

• Protect children in armed conflict situations and strictly adhere to the provisions of international humanitarian law.
• Protect children from recruitment as soldiers, and ratify and implement the Optional Protocol to the Convention on the Rights of the Child on the involvement of children in armed conflict, which establishes a minimum age of at least 18 for voluntary recruitment into national armed forces.
• Ensure that refugee camps are located in secure, accessible areas to protect children from cross-border attacks and possible recruitment by armed groups.
• Implement programs and policies to protect the rights of refugee and displaced children, including training for those who work with these children. Ensure that teachers from within the refugee population are adequately trained to organize classes in the camps.
• Consider applying communications technology to help reunite lost refugee children with their parents. The United Nations has developed a global database that collects and disseminates such information.
• Invest money, staff and other resources in child and maternal support systems and programs.
• If your country has not already done so, consider ratifying the International Criminal Court. (it currently requires four more countries to ratify it to become law.)  Grave forms of sexual violence against children during war constitute war crimes within the jurisdiction of the International Criminal Court.  Prosecute war crimes against children.  Human Rights Watch has a manual available on implementing the International Criminal Court at its Web site at: www.hrw.org./campaigns/icc.

General Society

• Encourage officials in your country to sign or ratify the Optional Protocol. Currently, 15 countries have signed and ratified the protocol. Countries that have signed but not ratified the protocol should be encouraged to ratify. These countries are: Cambodia, Colombia, Ireland, Jamaica, Jordan, Mali, Mexico, Morocco, Nepal, the Philippines, Sierra Leone, the United States and Uruguay. Priority countries to sign the protocol are Algeria, Eritrea, Fiji, Ghana, Japan, Mozambique, Qatar, Thailand and Yemen. Visit the Human Rights Watch Web site for updates, www.hrw.org/campaigns/crp.  If your country has signed, but not ratified, write a letter to urge ratification. If your country has not signed, write a letter to urge signing. Sample letters can be found in the resource section.
• Organize informational meetings in your community about the Protocol and work with local churches and schools to encourage grassroots support.
• Help children and youth find a course of action.  One important way to reduce stress is to take action.
• Sign on to child rights petitions.  Every person, every voice and every signature counts.

Suggestions for lessening the trauma from being displaced from your home/country:

Parents and Caregivers

• Take time to connect with your children. Assure them they are safe.
• Parents should be careful about watching their regular news broadcasts in the presence of children.  Children under six should not be exposed to coverage of violent attacks or disaster at all.
• Try to help children understand that the tragedy was not their fault. Be patient. Because children’s lives are centered on how they interpret their own experiences, it may take some time for them to get the message.
• Encourage children to talk about what happened. If children do not want to talk, that is all right too. Provide another activity that will give an opportunity to express emotions.
• Provide a consistent, predictable pattern for the day.
• If children have lost favorite toys, allow them to grieve.
• Try to spend extra time together as a family to begin to replace fears with pleasant memories.
• Encourage your teen to delay making big decisions right after a tragedy

Suggestions and action tools for lessening the trauma from natural disasters or violent attacks:

Childcare Workers, Teachers and Administrators

• Plan age appropriate activities to provide tension release and props that children can use to play out the event dramatically. These might include play dough, clay, water and sand play, painting and drawing as well as doctor, nurse, firefighter dolls, fire trucks and small family figures. Large muscle activities are often effective for helping children to get rid of some of the stress they are feeling.
• Listen to children without judgment.
• Rearrange the room to allow for a “safe” corner, with pillows, a couch and other inviting pieces of furniture. Allow/encourage children to use the place when they particularly need to relax rest and renew themselves.
• Make food available throughout the day, fixed in attractive ways, in small enough pieces that children can eat it easily. This is important because in times of disaster children may not eat well, or families may not be able to prepare nutritious food.
• Be especially sensitive and responsive to health needs.
• Be particularly aware of traumatic reminders for children. These are things that happen that may remind the child of a disastrous event. If a child has experienced a flood, for example, he may experience stress when it begins to rain.
• Ensure that all staff and volunteers who work with children receive appropriate training. Bus drivers, cooks, janitors and administrators should know how to apply their usual skills to trauma situations.
• Provide space for parents to talk about the event with other adults and meet with outside experts who can advise them about how to comfort their children.
• If you are a leader, ensure that your staff has been given the opportunity to talk about their experiences. Frequent staff meetings to work through some of these issues formalize the healing process and let staff know they are being supported.
• Consider reducing homework for a time until students heal from a recent trauma. Realize that a brief decline in student performance might occur.
• Expect angry outbursts from students. Try to catch them before they act out by taking them aside and helping them calm down and regain control of their behavior.

Parents and Caregivers

• Encourage children to develop coping and problem-solving skills.
• Realize that as children try to cope with trauma, they may use regressive behaviors such as thumb-sucking or bed-wetting. Do not punish or scold the child for this; instead try to help him put his feelings into words.
• Be honest with children about what has occurred. Children usually know when something is being sugarcoated. Also be sure to give answers appropriate to a child’s developmental level. Some young children may not need to know full details.
• Practice tolerance. Teach children that stereotyping and prejudice is wrong. Be a model for respect for diversity. Expose children to other cultures through books, media and personal experiences.  Banish teasing or rejection based on gender, race, ethnicity, religion, size or physical characteristics.
• Avoid unnecessary separations from your child.
• Avoid introducing new experiences with preschool children until after the violence or trauma has passed.
• Help children learn words to express their feelings about a tragedy or violent or traumatic experience.
• Let children have some control such as choosing what outfit to wear or what meal to eat.
• Re-establish contact, if possible, with extended family members.
• Help children learn to trust adults again by keeping promises.
• Be sure to get needed health care for your children, and give them balanced meals and appropriate rest.
• Spend extra time with children at bedtime.
• Develop positive anniversary activities to commemorate the event. These events might bring back tears, but also are a time to celebrate survival and the ability to get back to a normal life.
• Allow children to cry or be sad.
• Do not be afraid to admit you do not know the answer to a child’s question. When answering questions you do know, be careful to use words that describe the event but do not overwhelm them with information. Young children may be satisfied with a very minimal answer.
• Include children in recovery activities, giving them chores that are their responsibility.

Suggestions and action tools for workers in charge of a disaster scene:

Early intervention at a disaster scene is critical to reducing exposure to trauma, as well as promoting more rapid recovery. The (U.S.) National Center for Post-Traumatic Stress Disorder of the Department of Veterans Affairs recommends that workers in charge of a disaster scene should:

• Find ways to protect children from further harm and from further exposure to traumatic stimuli. If possible, workers should create a safe haven for them and protect them from onlookers and the media.
• Kindly, but firmly, direct children who are able to walk away to leave the site of violence and destruction.
• Stay with those in acute distress, which includes panic (marked by trembling, agitation, rambling speech, becoming mute or erratic behavior) and intense grief (marked by loud crying, rage or immobility.)
• Be supportive and compassionate and remember to address your own needs, too.
• Establish rapport.  Rapport refers to the feelings of interest and understanding that develop when genuine concern is shown.  Conveying respect and being nonjudgmental are necessary ingredients for building rapport.
• Active listening.  Workers listen most effectively when they take in information through their ears, eyes, and “extrasensory radar” to better understand the survivor’s situation and needs.
• Reassurance.  Let children know that their reactions and feelings are normal to a disaster.  Things may never be the same, but they will get better.  

When parents should seek professional help for their children:

Most children and adolescents who display symptoms of suffering from trauma will recover within a few weeks if the proper steps are taken. However, some will not. Experts suggest that parents seek professional mental health help for their children if they have prolonged or severe reactions.  Studies have shown that children who witness parental homicides or sexual assaults, or who have been sexually abused themselves; often have the highest rates of post-traumatic stress syndrome.

You Can Make A Difference

Widespread global prevention and service reform that will significantly reduce violence and trauma for children, as well as improve interventions, requires a serious commitment from political leaders, policy makers, program designers, healthcare providers, mental health and social workers, parents, police, teachers and others.  However, regardless of where you live in a large, developed state or small, rural country, you can make a difference in children’s lives.  The anthropologist Margaret Mead said, “Never doubt that a small group of committed people can change the world; indeed it is the only thing that ever has.”