Responding to Terrorism: Recovery, Resilience, Readiness (Part 2)

Mental Health

In a culture ambivalent about violence and focused on immediate gratification, Americans often have unrealistic expectations of how long healing will take and what their Government, leaders, and individuals can do to help, Brian Flynn, Ed.D., of CMHS told conference participants.

Public health models for disaster response and recovery provide opportunities to reinvent community mental health, according to Dr. Flynn. But with an enemy whose goal is to terrorize the whole country, he believes the Nation needs a new public health model that deals quickly with localized events while reaching out to the whole population and monitoring the potential spread of such threats as bioterrorism. "Anthrax isn't contagious. Fear is!" Dr. Flynn emphasized.

Dr. Brian Flynn

Despite the imperative to focus on all the victims of terror, both direct and indirect, it's just as important not to assume mental disorder where it doesn't exist, or "overpathologize," said Dr. Flynn. "While there is a huge need for healing after a terrorist attack, the greater story is resilience, hope, and health."

Dr. Meredith Alden

Meredith Alden, M.D., Ph.D., director of residency training in the Department of Psychiatry at the University of Utah and a SAMHSA National Advisory Council member, pointed out that in addition to the post-traumatic stress disorder resulting from terrorist acts, "substance abuse is very often an outcome of that also." She recommended "increasing service capacity for people with both substance abuse and mental illness."

Resilience

In the face of terrorism and possible threats of more to come, Americans have found unexpected sources of resilience, especially in their communities, their faiths, and their families.

Community

For all the stresses on emergency workers, the support of community is essential to their resilience.

Captain Susanne Caviness, Ph.D., of SAMHSA's Center for Substance Abuse Treatment, provided behavioral health trauma services at the former World Trade Center site following the September 11 attacks. "Leaving the site after one of my 12-hour shifts," she said, "I saw 30 to 40 dump trucks lined up to come in and remove the twisted metal that had been taken down. Eventually, the metal may be gone, but the scars will remain."

"No one puts out a fire by himself. People work in teams. They take care of each other," said Malachy Corrigan, director of the New York Fire Department's Counseling Unit. The fire department not only serves the community, it is its own community.

With 343 of their own lost in the World Trade Center disaster, firefighters reached out with characteristic compassion to survivors in 61 firehouses who lost colleagues, 800 children who lost fathers, and 270 women whose husbands and significant others died in the attack. Today, fire department counselors work with surviving spouses, parents, and siblings at several locations around the city.

In the close-knit family culture of firefighters, many emotional issues are worked out around the kitchen table in the firehouse, where members spend much of their time. The department is sending nearly 30 counselors to the firehouses to offer bereavement sessions and private counseling.

"There was a great public outpouring of support for firefighters after 9-11," Mr. Corrigan said. "So firehouses uncharacteristically kept their doors open. They didn't want to close people out, but they needed to be grieving. Eventually, we had to tell them to close the door and go back to the kitchen. They needed the rituals and support of the firehouse family," and the resilience it provides day in and day out.

« See Part 1: Responding to Terrorism: Recovery, Resilience, Readiness

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