- Hidden mental health issues among children
As Sri Lanka struggles to recover from the disaster caused by Cyclone Ditwah, the main focus is on destroyed homes, submerged villages, and the rising death toll. However, behind the tangible devastation, another crisis is unfolding. This is quite silent, less visible, and far more lasting. This is the psychological toll on children.
In widely circulated footage from the disaster, including scenes of families walking through waist-deep water, children clasping their schoolbags soaked with mud, one emotion stands out distinctly. That is fear. The fear of rising water, losing loved ones, and the world is no longer a safe place.
While floodwaters may recede within weeks, the emotional scars left on children may last for months or even lifelong, if not addressed. Hence, the challenge is urgent
The silent suffering
Children experience disasters differently from adults. Their brains are still developing, and coping mechanisms are limited, and so is their understanding of danger. For them, the loss of the home, the daily routine, or even the loss of the toy that they cuddle while sleeping is quite traumatic.
During the recent floods, thousands of children were woken abruptly in the middle of the night as waters rushed into their homes. Many lost schoolbooks, uniforms, toys, and their treasured personal belongings. For them, these objects carry meaning far beyond their material value. Thus, it is not fair to underestimate their losses.
Children rarely articulate their distress. They show it quietly, indirectly, through behaviour. This is why the child mental health crisis remains largely invisible.
The emotional aftershocks: What happens over time
Childhood trauma does not disappear when the floodwaters recede. Its impact unfolds in layers. Often weeks, months, or even years after the event. Understanding these stages helps families, teachers, and communities respond with empathy and early support.
Short-term effects
In the immediate aftermath, a child’s nervous system remains on high alert. Their behaviour may seem unpredictable or exaggerated, but these reactions are normal responses to extreme stress.
- Fear of rain, darkness, or loud sounds: Anything that reminds them of the disaster may trigger panic or crying. Even small changes in weather can feel threatening.
- Physical complaints: Headaches, stomach aches, body pain, and sleep disturbances often surface as the body tries to process overwhelming fear.
- Irritability and emotional outbursts: Children may cry easily, cling to adults, or become unusually aggressive. These are signals of insecurity, not misbehaviour.
- Trouble focusing: Their minds remain occupied with memories of the event, making it difficult to concentrate on schoolwork or play.
Medium-term effects
As life begins to stabilise, deeper emotional and behavioural changes may emerge. These often appear once the child feels physically safe enough for psychological reactions to unfold.
- Reluctance to attend school: Children may fear leaving their caregivers or feel unsafe outside home. For some, schoolwork feels irrelevant compared to the trauma that they experienced.
- Separation anxiety: Even brief moments away from parents can trigger distress, nightmares, or panic.
- Decline in academic performance: Difficulties with memory, attention, and emotion regulation may affect learning.
- Social withdrawal: Children who were once playful may become quiet, withdrawn, or uninterested in interacting with peers.
These changes are not signs of laziness or stubbornness — they are indicators of a nervous system still recovering from shock.
Long-term effects
If children don’t receive timely emotional support, trauma can become firmly rooted, shaping how they see the world and themselves.
Unaddressed trauma may evolve into: Post-traumatic stress disorder (Persistent nightmares, flashbacks, avoidance of reminders, hypervigilance, and emotional numbness), and Anxiety or Depression (Ongoing worry, sadness, hopelessness, angry outbursts, sleep problems, or the loss of interest in daily activities.
These long-term effects can influence relationships, learning, and overall development, well into adulthood.
How communities and authorities can support child mental health
1. Provide psychological first aid
Teachers, public health staff, and youth volunteers can support them by listening, reassurance, and emotional stabilisation.
2. Create child-friendly spaces in shelters
Safe areas where children can draw, play, read, and interact help reduce stress and anxiety. Provide them with toys, story books and stationary.
3. Prioritise the reopening of schools
Even partial reopening, or learning under tents, helps re-establish their routines, which is crucial for recovery.
4. Support parents
Parents under heavy stress may struggle to support children emotionally. Counselling and stress-management sessions can strengthen family resilience.
5. Strengthen the mental health workforce
Counselling and school-based mental health programmes should be expanded in the affected Districts.
6. Promote compassionate media coverage
The media should avoid sensationalism and instead highlight available support systems, success stories, and community resilience.
The crucial role of teachers in emotional recovery
As school teachers will become central to children’s healing, their role in post-disaster recovery extends far beyond routine classroom teaching. Many affected children will return to school with nothing. Their uniforms may have washed away. Their books may have been lost. Some will arrive in borrowed or mismatched clothes. Others may simply stand at the doorway, overwhelmed by the thought of returning to routine while still carrying unseen emotional wounds.
This is why it is essential for teachers to welcome every child exactly as they are, without judgment or scolding.
A child who lost everything should never fear being scolded for not having a schoolbook.
A child wearing slippers instead of shoes should feel just as accepted as any other student.
A child arriving without homework, a bag, or even proper clothing should still be met with warmth, dignity, and unconditional acceptance.
Why this acceptance matters
- It restores dignity.
- Children who lost their belongings may feel embarrassed or inferior. Gentle acceptance reinforces their worth.
- Encourages school attendance.
- Fear of being scolded makes children avoid school. A welcoming environment ensures that they come back.
- Supports emotional stability.
- Familiar teachers and routines will make them calm down.
- Builds trust and healing.
- When teachers are patient and understanding, children feel safe enough to express their fears or needs.
- Promotes long-term resilience.
- Feeling supported during a crisis fosters emotional strength for the future.
Teachers can further support recovery by creating shared classroom materials, using art and play to allow expression, ensuring that no child is teased for their appearance, and coordinating with the principals to discreetly arrange donated uniforms and stationery. A child-centred, compassionate classroom can be one of the strongest therapeutic environments in the aftermath of a disaster.
With the right support, children can regain resilience and rebuild their sense of safety. Without it, the emotional aftershocks may persist long after the event is forgotten by the rest of the world.
The writer is a Medical Officer at the National Blood Transfusion Service. This article is based on a media briefing by the Consultant Child and Adolescent Psychiatrist at the Lady Ridgeway Hospital for Children, Dr. Darshani Hettiarachchi
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The views and opinions expressed in this column are those of the author, and do not necessarily reflect those of this publication