Emergency health care providers are often the first to respond to the needs of children after a disaster. Although there has been an increase in research related to the impact of disasters, including terrorist events, on children's mental health, physicians continue to cite a need for additional information and training on the topic. This article provides an overview of recent literature on disasters and mental health, covering children's stress reactions, mental health problems that may arise, and risk factors that affect these reactions. Practical guidance for pediatric emergency health care providers is emphasized, including psychological first aid, recommendations for screening questions to facilitate mental health triage, and an overview of effective mental health interventions. It concludes with a discussion of the impact of providing care in the aftermath of a disaster on the health care professional. © 2009 Elsevier Inc. All rights reserved.