November 2025 – May 2026 · Field account
CASSM did not set out to work on adolescent mental health. The direction emerged from a debrief after three disaster deployments, was confirmed by an observation about what news coverage was and was not addressing, and was made actionable by a piece of information encountered in a conversation with a school guidance counsellor. This account describes how a disaster response configuration was redirected toward schools, how the schools were selected, and what that selection could not have been expected to catch.
What the debrief surfaced
Following the Black River, Petersfield High School and Seaford Town deployments, CASSM conducted a debrief with participating practitioners alongside internal reflective analysis. Psychological distress had not presented as a discrete clinical category during the deployments and was not something the configuration had been built to address. It surfaced instead in what patients said while being treated for something else, remarks about lost possessions, and about not knowing what would come next.
This is an observation about circumstance rather than a clinical finding. No assessment instrument was administered and no diagnostic conclusion was drawn. What the debrief established was that a need had been present which the deployment had no means of recognising or responding to.
News coverage in the period following the hurricane appeared to reflect a similar pattern, with attention directed at affected adults and comparatively little at children. Schools followed from that observation as the obvious setting: a defined population of children, already assembled, with an existing duty of care and, as one practitioner noted, an audience that is present whether or not it has chosen to be.
A coincidence that made the direction actionable
CASSM approached a high school through an alumnus connection. In conversation with the guidance counsellor it emerged that May is observed in Jamaica both as Child Month and as Mental Health Awareness Month, and that the national theme for the period addressed children's mental health directly. The school already had institutional reason to host what CASSM was proposing. Neither the observation from the debrief nor the calendar alone would have been sufficient. The direction became actionable because both were true at once, and because someone happened to ask.
What changed in the configuration
The disaster configuration was built around acute presentation and volume, registration, triage, doctor's consultation, examination, dressing, emergency, pharmacy. Services were narrow and capacity was weighted toward throughput within a constrained operating window.
The school configuration inverts that. Rather than a large number of patients receiving a narrow service, it delivers a deeper intervention to a defined cohort, a single-day deployment structured around registration, nurse intake, mental health, and general practitioner review, with a colour-coded triage system routing students to routine care, referral, or immediate escalation. Mental health professionals were added to the team, providing coping and stress management support directly. Dental and vision were offered where partner availability allowed, which was not at every site.
That variability is a structural feature rather than a shortcoming. The configuration has a core that CASSM can staff independently and a set of services contingent on partner participation, which means a deployment proceeds at reduced scope rather than being cancelled when a partner cannot attend. The cost is that what a student receives depends in part on which day their school was scheduled.
One further difference worth stating was the basis on which schools found the offer valuable. Practitioners visit Jamaican schools with some regularity, but typically to perform a single task. CASSM's proposition was several services delivered in one day or in some instances over a weekend by a coordinated team, with the results connected. A student flagged at nurse intake could be seen by mental health and by a general practitioner in the same visit, with referral where indicated. Further dental and vision were rolled in depending on partner availability.
Selecting the schools
The decision of which rural schools to approach was made against two data sources. The first was population data for the parishes most affected by the hurricane, drawn from the Statistical Institute of Jamaica. The second was a GIS overlay plotting school locations against the storm track, produced in QGIS (QGIS Development Team, 2025). Spatial analysis of this kind was new to CASSM at this point, and the procedures used were learned from the software documentation rather than drawn from existing capability.
School locations were drawn from OpenStreetMap (OpenStreetMap contributors, 2026), which returned 312 institutions nationally. That is a partial rather than complete record, since OpenStreetMap is contributor-maintained and coverage varies by area. The overlay therefore shows where mapped schools sit relative to the track, not where all schools sit.
A 20 km buffer was applied either side of the storm track to define the area within which schools were treated as potentially exposed. That distance was an operational cutoff rather than a hazard threshold. Exposure assessment in the cyclone literature typically works at much greater distances from the track, since damaging winds extend well beyond 20 km, and CASSM's narrower corridor reflected the need to produce a workable candidate list rather than a defensible estimate of the affected area. Exposure is not impact in any case: distance from the track, together with rainfall, flooding and damage data, is what would establish severity, and CASSM held none of those layers in November 2025 when the schools were selected. Hazard material was subsequently obtained from the Meteorological Service of Jamaica following a request made in January 2026, and its integration is described in the closing section.
St. James and Westmoreland carried substantial affected populations and sat within the corridor of greatest exposure, as did St. Elizabeth. The buffer defined the candidate area rather than the final list: it identified the parishes and the corridor within which schools were treated as potentially exposed, returning a substantial number of candidates, and the two-urban, two-rural, all-boys criteria set out below narrowed the field to Cornwall College near Montego Bay and Munro College in St. Elizabeth. Neither school was selected because it fell at a particular distance from the track, and neither was the only school meeting the criteria; both were reachable, which is what settled it.
Selecting the schools and reaching them were separate problems. With the criteria applied, CASSM canvassed its networks for anyone connected to schools in the candidate dataset. That led to the Cornwall College Old Boys Association and to Mr. Earl Findlater and Mr. Neville Bell, and, through Raymond and Julia Moodie, to Munro College, Mr. Moodie's alma mater, where Mr. Moodie introduced CASSM to Mr. Bromfield, Head of the Mathematics Department and Vice Principal. This is purposive rather than probability sampling, and cases are chosen because they possess characteristics relevant to the question at hand, with no claim to statistical representativeness (Gill, 2020).
The design, and the reasoning behind it
Four schools was the working number. It was chosen for affordability under fiscal constraint rather than because four was optimal, a sufficient rather than an ideal figure, arrived at by asking what could be delivered adequately rather than what would be best.
Two urban and two rural was deliberate. If a means could be established of using field data ethically, a configuration of that shape would permit comparison of interaction and outcome across contrasting settings. That remains conditional as the consent and data-use questions are unresolved and are addressed separately.
All-boys schools were selected on the author's own reasoning rather than on established evidence. The observation is that girls appear to receive earlier health attention, and the proposition is that early-stage intervention with boys may bear on downstream chronic disease prevalence. Neither is offered as a finding. Both are stated as the basis on which a selection was made, and both would require proper investigation before being relied upon further.
Where the design broke, and why it was allowed to
During planning for the Cornwall College deployment, an incident involving students of Cornwall College and Mount Alvernia High School was reported. Mount Alvernia is an all-girls school in close proximity. Mr. Bell suggested its inclusion, and CASSM agreed. Hampton High School was subsequently included on the precedent that decision established, together with its proximity to Munro and its position within the same affected corridor. No comparable incident prompted the Hampton decision.
Both decisions departed from the stated selection criteria, and both were made on the basis of who CASSM knew rather than on the analysis. The consequence is that the two-urban, two-rural, all-boys configuration no longer exists, and with it the comparative structure that had been part of the rationale. That cost is real and worth naming. The judgement was that responding to a specific circumstance at a specific school outweighed preserving a design that was, in any case, conditional on data-use questions that remain open.
Need that surfaces after planning closes
Schools in Black River were subsequently found to require assistance. CASSM learned of this in conversation with Mr. Donovan Smith of Don's Motor World, who had provided the operational base for the original deployment, and some months after school selection had been completed.
This is not a failure of the selection criteria. The information was not available when the criteria were applied, and no weighting would have surfaced it. What it illustrates is a different constraint. Need continues to emerge after planning closes, and by the time it does, resources are committed. Deployments to Munro, Hampton and others were already in flight. CASSM is attempting to include the Black River schools, and the obstacle is cost rather than willingness. For an organisation operating at this scale, the practical question is not only how to select well at the outset but how much capacity to hold uncommitted against need that has not yet been reported.
The method that followed
Selection on population size and track proximity has a recognised limitation: demographic data describes where people are, not what happened to them. That limitation prompted the construction of a weighted multi-criteria model for prioritising subsequent deployments. It scores candidate communities against unmet population need at 40 percent, service coverage gaps at 25 percent, household vulnerability based on crowding at 20 percent, and population size at 15 percent, producing a relative priority score and a ranked shortlist. The weighting is intended to prevent three failure modes, namely serving only the largest towns, returning repeatedly to areas already covered, and overlooking vulnerable but smaller populations.
The model still captures exposure rather than impact. Closing that gap requires data CASSM cannot generate. In a concept note submitted in January 2026 to the Meteorological Service of Jamaica and the Office of Disaster Preparedness and Emergency Management, MobiCare Humanitarian Medical Relief, the medical arm operating under the CASSM Foundation charter, set out the analytical framework and requested access to event-specific rainfall accumulation, flood extent, and storm surge impact datasets. The Meteorological Service responded and provided material. Integrating it into the prioritisation model is work in progress, and the interpretation is being verified before conclusions are drawn from it.
The wider point for organisations working under similar constraints is that neither the redirection nor the selection method arrived by design. The first came from a debrief, a media observation, and a conversation. The second came from data, which was overridden twice for defensible reasons, and was later shown to be limited by information that no method could have supplied at the time. What can be transferred is not the model but the practice of examining decisions after the fact closely enough to find out where they held and where they did not.
Acknowledgements
Mr. Earl Findlater and Mr. Neville Bell of the Cornwall College Old Boys Association provided the connections through which the Cornwall College deployment was arranged, and Mr. Bell proposed the inclusion of Mount Alvernia High School. Mr. Raymond Moodie and Mrs. Julia Moodie connected CASSM to Munro College, Mr. Moodie's alma mater, and introduced CASSM to Mr. Bromfield, Head of the Mathematics Department and Vice Principal of Munro College, who received the approach and facilitated the deployment. Mr. Donovan Smith of Don's Motor World provided the operational base for the Black River deployment and brought the situation at the Black River schools to CASSM's attention. The Meteorological Service of Jamaica responded to CASSM's request for hazard data.
References
Gill, S. L. (2020). Qualitative sampling methods. Journal of Human Lactation, 36(4), 579–581. https://doi.org/10.1177/0890334420949218
Meteorological Service of Jamaica. (2026). Hurricane Melissa track and hazard data [Data set]. Provided on request.
OpenStreetMap contributors. (2026). Jamaica school locations [Data set]. OpenStreetMap Foundation. Licensed under the Open Database License. https://www.openstreetmap.org/copyright
QGIS Development Team. (2025). QGIS Geographic Information System (Version 3.44.7 Solothurn) [Computer software]. QGIS Association. https://qgis.org
Statistical Institute of Jamaica. (2025). Population statistics by parish. https://statinja.gov.jm