Disaster Response in the Mental Health Community

By Rowland Hill, CSW, Senior Consultant, NYC Dept. of Mental Health
(February/March 2002)

I was getting ready to leave for work on 9/11 when I saw the NY-1 report about the first plane crash at the Trade Towers. Even today there is a feeling of unreality about that news report. As much as we have been through these past five months it remains difficult to grasp the enormity of both the tragedies (including also the anthrax and American Airlines incidents) and the intensity of the attempt to put together an effective response.

From those first moments I, along with my coworkers at the Department of Mental Health's Crisis Intervention Unit became engaged in efforts to assess the needs of those affected by the terrorist attack and to pull together the resources necessary to address those needs.

Thankfully there was an immense outpouring of volunteer support by social workers and other mental health professionals from throughout the region and beyond.

In collaboration with the Office of Emergency Management (whose offices were destroyed that day), the State Office of Mental Health, Red Cross, NYPD's Community Affairs personnel and a wide range of other agencies situated at the Family Assistance Centers, located initially at the Lexington Avenue Armory and later moved to Pier 94, we managed to provide a holistic response to those both directly and indirectly affected. It should be mentioned that this is probably the first major catastrophe where organized massage and pet therapy were included early on to engage those who were not inclined to interact around their losses at a verbal level.

It perhaps goes without saying but this was very emotionally demanding and taxing work, even for those who are used to counseling trauma clients. Volunteers, coordinated through LifeNet, often committed to 8- or 12-hour shifts with little mitigation from constant grief, pain, anger and anguish, other than the support of peers and the supervisory staff. This staff made certain that volunteers took regular breaks and were spelled when the work became too much for them. It was particularly difficult in part because no one was unaffected, the whole city having been subjected to the aftermath of the attack, and also for the reason that no event of this magnitude had ever taken place on U.S. soil. Even experienced disaster responders were challenged by the breadth and severity of the response.

What was particularly satisfying in the first months of the response was the way in which many of the normal political, interdisciplinary and turf battles that occur in coordinating massive projects like this were put aside, the focus exclusively being on the care and support of those whose community had been torn apart. Some 2500 people were processed during one day at the armory; as many as 80 city mental health volunteers a day were engaged at the Family Center. It is truly a testament to all New Yorkers that a can-do attitude prevailed and that the many displacements, distractions and ego gratifications that often take away from the real needs in these situations did not crop up or were quickly put aside.

Many dedicated social workers and other professionals took on unfamiliar and trying tasks, creatively using their skills in unheralded ways and, at times, assuming leadership roles in chaotic and stressful conditions. It is nothing less than amazing that seemingly whenever our senior staff was feeling overwhelmed or at a loss as to what to do next, someone stepped out from the background and provided support or solutions that kept things moving along smoothly. As our office has moved out of the limelight and tried to move back into our more routine roles, others in the Department are moving ahead with the next phase; Project Liberty, funded by FEMA, is working vigorously to provide ongoing crisis counseling, outreach and education about post-trauma effects to those suffering aftereffects in the communities where they live.

A word of thanks should be said to all of those who volunteered in a variety of capacities after the disaster. Care should be taken both individually and organizationally to protect against vicarious traumatization, also known as compassion fatigue. Those who have been subjected to extending their capacities to attend to the needs of others must in turn make certain to attend to their own needs as well. These include addressing the need for spiritual renewal, limiting further exposure both with clients and through the media, setting clear limits (which also means knowing what our limits are), maintaining professional support and seeking to extend our skills through further education, as well as working to establish balance in our lives between work, recreation, family and friends. Without self-renewal and institutional acknowledgment of the needs of workers, we end up as a profession feeling numbed, cynical, lacking in hope, with reduced self-esteem and disconnected from our own wants and needs as well as those of others. We owe it to ourselves to take pride in our efforts and to take care that these events change us in a positive direction rather than leaving us feeling diminished. There is a long way to go in healing this community; I have confidence that we can succeed and thrive again.