AbstractClimate change is disproportionately impacting youth mental health around the world. Using a Community-Based Participatory approach, three universities (one in South Carolina and two in Puerto Rico) partnered after the devastation of Hurricane Maria in 2017. We offered culturally and linguistically tailored trauma and disaster-informed mental health awareness training (e.g., Psychological First Aid (PFA), Trauma Informed Care (TIC), & Suicide & Crisis Management) to 9236 individuals and 652 Puerto Rican youth were identified and referred to mental health services as a result.

摘要气候变化对全世界青年心理健康的影响不成比例。2017年飓风玛丽亚（Maria）肆虐后，三所大学（南卡罗来纳州一所，波多黎各两所）采用基于社区的参与式方法开展了合作。我们为9236名个人提供了针对文化和语言的创伤和灾难知情心理健康意识培训（例如，心理急救（PFA），创伤知情护理（TIC）和自杀与危机管理），结果确定了652名波多黎各青年并将其转介给心理健康服务机构。

The US Surgeon General featured our program as a promising model to help disaster-affected youth..

美国卫生部长将我们的计划描述为帮助受灾青年的有前途的模式。。

According to the World Health Organization, climate change is one of the greatest threats to public health in the twenty-first century1. Climate change has been identified as a contributor to the increasing frequency of severe weather-related events and natural disasters (e.g., hurricanes, floods, wildfires, tornadoes, earthquakes, tsunamis), which in turn can lead to loss of life, infrastructure, safety, and adverse mental and physical health outcomes1,2.

据世界卫生组织称，气候变化是21世纪公共卫生面临的最大威胁之一1。气候变化已被确定为与恶劣天气相关的事件和自然灾害（如飓风、洪水、野火、龙卷风、地震、海啸）频率增加的原因之一，而这些事件和自然灾害又可能导致生命、基础设施、安全的损失，以及不利的身心健康结果1,2。

Nearly 1 billion children worldwide are at an ‘extremely high risk’ of the physical, psychological, and social impacts of climate change3. For example, natural disasters increase the risk of exposure to potentially traumatic events for youth4. Exposure to traumatic events, in turn, increases the risk of developing posttraumatic stress disorder (PTSD), depression, substance use disorders, suicidal ideation/self-harm, and adverse physical health outcomes that can last a lifetime5,6.

全球近10亿儿童处于气候变化对身体、心理和社会影响的“极高风险”3。例如，自然灾害增加了青少年暴露于潜在创伤事件的风险4。反过来，暴露于创伤事件会增加患创伤后应激障碍（PTSD），抑郁症，药物使用障碍，自杀意念/自我伤害以及可能持续一生的不良身体健康结果的风险5,6。

Addressing the mental health impacts of climate change for children through innovative and evidence-based approaches is imperative.Puerto Rico, a Caribbean Island and territory of the United States has experienced back-to-back natural disasters, including devastating hurricanes, earthquakes, and the COVID-19 pandemic7.

通过创新和循证方法应对气候变化对儿童心理健康的影响势在必行。波多黎各是加勒比海的一个岛屿和美国领土，经历了接二连三的自然灾害，包括毁灭性的飓风、地震和新型冠状病毒肺炎7。

In September 2017, Hurricane Maria destroyed the island’s electrical, communications, and agricultural infrastructure and resulted in school closures, loss of life (over 4,000 deaths directly or indirectly related to the hurricane), financial impacts (over $90 billion in damages), and population displacement (123,000 Puerto Ricans permanently relocating to the U.S.), an additional source of grief and loss for affected families8,9.

2017年9月，飓风玛利亚摧毁了该岛的电力、通信和农业基础设施，导致学校关闭、生命损失（4000多人死亡，与飓风直接或间接相关）、财务影响（900多亿美元损失）和人口流离失所（123000名波多黎各人永久迁往美国），这是受影响家庭的另一个悲痛和损失来源8,9。

Youth were significantly impacted as a result of the storm, with an estimated 30% reporting perce.

风暴对年轻人产生了重大影响，估计有30%的人报告了这一点。

1.

1.

Psychological First Aid (PFA) webinar in Spanish (filmed for Puerto Rico) available for free as a 3 CE course through the National Child Traumatic Stress Network (also funded by SAMHSA) https://learn.nctsn.org/course/index.php?categoryid=11.

西班牙语心理急救（PFA）网络研讨会（为波多黎各拍摄）通过国家儿童创伤压力网络（也由SAMHSA资助）作为3 CE课程免费提供https://learn.nctsn.org/course/index.php?categoryid=11.

2.

2.

Skills for Psychological Recovery (SPR) webinar in Spanish (filmed for Puerto Rico) available for free as a 3.5 CE course through the National Child Traumatic Stress Network (also funded by SAMHSA) https://learn.nctsn.org/course/index.php?categoryid=11.

西班牙心理康复技能（SPR）网络研讨会（为波多黎各拍摄）通过国家儿童创伤压力网络（也由SAMHSA资助）免费提供3.5 CE课程https://learn.nctsn.org/course/index.php?categoryid=11.

Pivoting from teleconsultation to telepsychiatry direct service provisionWe piloted the telepsychiatry consultation program in Nov-Dec of 2019. Graduate students and teachers liked being able to consult on cases, and psychiatrists appreciated participation in a multidisciplinary, school-based team. Challenges included difficulty with the internet/Wi-Fi (which was unstable at times) and teachers being able to find time in their busy schedules to connect with the psychiatrist.

从远程会诊转向远程精神病直接服务提供我们于2019年11月至12月试点了远程精神病咨询计划。研究生和教师喜欢能够就病例进行咨询，精神科医生也喜欢参与多学科的校本团队。挑战包括难以使用互联网/Wi-Fi（有时不稳定），以及教师能够在繁忙的时间表中抽出时间与精神病医生联系。

Graduate students also reported being unsure about what they could and could not consult with a psychiatrist- signaling the importance of educating psychologists in training in this important skill of professional communication.We hoped to expand the program in January 2020, but due to the earthquakes that occurred in the Southwest part of the island (where our grant was located), schools in our catchment area were closed until they passed a building infrastructure inspection.

研究生还报告说，他们不确定自己可以和不能咨询精神病医生的意见，这表明教育心理学家培训这种重要的专业沟通技能的重要性。我们希望在2020年1月扩大该计划，但由于该岛西南部（我们的赠款所在地）发生地震，我们集水区的学校在通过建筑基础设施检查之前一直关闭。

We were hopeful the program would start by March 2020, but then COVID-19 resulted in an island-wide lockdown. Given the mandate for schools to transition to fully virtual instruction and new local legislation allowing telehealth delivery of mental health services across the island during the emergency (Ley 48-2020 Para Regular la Ciberterapia en Puerto Rico28), we pivoted and re-purposed the telehealth equipment by giving it to graduate students to offer therapy appointments via telehealth to students in need of services.

我们希望该计划将于2020年3月启动，但随后新型冠状病毒导致全岛范围的封锁。鉴于学校有权过渡到完全虚拟教学和新的地方立法，允许在紧急情况下在全岛范围内提供心理健康服务（Ley 48-2020 Para Regular la Ciberterapia en Puerto Rico28），我们通过将远程医疗设备提供给研究生，通过远程医疗为需要服务的学生提供治疗预约，从而改变了远程医疗设备的方向。

Graduate students on the island benefited greatly from having been trained in using this telehealth equipment before the pandemic, and the Albizu University mental health clinic, was able to transition more swiftly to offering telehealth services as a result. Due to the new telehealth legislation, psychiatris.

该岛的研究生在大流行之前接受了使用这种远程保健设备的培训，因此受益匪浅，阿尔比祖大学心理健康诊所能够更快地过渡到提供远程保健服务。由于新的远程保健立法，精神病学。

Data availability

数据可用性

No datasets were generated or analysed during the current study.

在当前的研究中，没有生成或分析数据集。

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Reprints and permissionsAbout this articleCite this articleOrengo-Aguayo, R., Stewart, R.W., Rodríguez-Sanfiorenzo, T.d.M. et al. Implementation of trauma and disaster mental health awareness training in Puerto Rico.

转载和许可本文引用本文Orengo Aguayo，R.，Stewart，R.W.，Rodríguez Sanfiorenzo，T.d.M.等人在波多黎各实施创伤和灾难心理健康意识培训。

npj Mental Health Res 3, 65 (2024). https://doi.org/10.1038/s44184-024-00110-wDownload citationReceived: 29 February 2024Accepted: 13 December 2024Published: 21 December 2024DOI: https://doi.org/10.1038/s44184-024-00110-wShare this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

npj心理健康研究3,65（2024）。https://doi.org/10.1038/s44184-024-00110-wDownload引文接收日期：2024年2月29日接受日期：2024年12月13日发布日期：2024年12月21日OI：https://doi.org/10.1038/s44184-024-00110-wShare本文与您共享以下链接的任何人都可以阅读此内容：获取可共享链接对不起，本文目前没有可共享的链接。复制到剪贴板。

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