Helping at TWA #800
by Dottie Brier, CSW, ACSW, American Red Cross Disaster Mental Health Volunteer
Soon after TWA Flight #800, en route from New York City to Paris, crashed off Long Island on July 17, 1996 killing all 230 people aboard, families assembled, rescuers mobilized to recover bodies and social workers, among other mental health professionals, played a significant role by helping distraught families and helpers cope with the tragedy.
Many volunteered through American Red Cross Disaster Mental Health Services, a national program that lessens the personal traumatic effects of disasters. Certified/licensed social workers and other credentialed mental health professionals take specialized Red Cross courses and volunteer crisis services to people affected by disaster: those directly harmed, their families and friends, as well as Red Cross and other organizations' staff and volunteers. At TWA Flight #800, they were at the hotel with families and at the recovery site with rescuers and other responders.
The program assumes that people affected by disasters, regardless of their usual emotional/mental status, are having normal reactions to abnormal situations, with assessment, however, to ensure that those occasional clients who might be dangerous to themselves or others are referred to appropriate facilities. A range of crisis intervention services are used, encompassing ventilation, universalizing, reassurance as to the normalcy of feelings, encouragement to use natural support systems, problem-solving, guidance, education, advocacy, collaboration and referral. The goal is to meet basic needs and restore clients to predisaster levels of functioning.
At TWA #800, Mental Health was a major component of the Red Cross operation. Families and friends came from around the world, were in an unnatural setting, away from usual supports. Foreign nationals confronted unknown customs and sometimes an alien language. The cause of the crash is still unknown and bodies took a long time to be recovered and identified. Families' stays at the hotel and in turn the Red Cross operation, took over three weeks, much longer than usual for a plan crash.
Many survivors required, wanted and received on-going counseling and crisis care at the hotel. These included many families whose relationships were complicated by the event; people with unresolveed past traumas; or, more commonly, vulnerable frightened people who had meaningful connections with their workers. Referrals, when indicated, were to agencies in clients' home communities, arranged through national and international Red Cross networks.
Major issues for families included the strain of waiting to learn if and when the bodies of their loved ones would be recovered. Families needed bodies found for psychological and sometimes religious reasons to fully accept the death and begin the mourning process. One mother stated that until her son's body was found, she would always think he was alive, even though intellectually she knew differently. Complying with requests from the Medical Examiner's office was often difficult. Many mourners felt frustrated by perceived communication lacks with authorities. Responses ranged from annoyance to rage. These pressures exacerbated usual feeling from the sudden, unexpected loss of loved ones.
From the moment of the crash, offerings of help were impressive, a typical and poignant early disaster response. Social workers were no exception and comprised about 50% of the 473 mental health workers at the operation. Red Cross coordinated their own professionals and those sent by local, state, and private mental health agencies and professional associations.
Some workers new to Red Cross returned frequently, often on their own time, and over 60 have since applied to take the training to become active Red Cross volunteers. But disaster mental health work is not for everyone and at TWA #800, volunteers could test their suitability for this work. For example, did they want to initiate contacts with clients rather than having clients request help? Social workers and others accustomed to a reach-out approach were comfortable doing this. Others were challenged and gratified when suggested methods worked. Some found it too scary, intrusive or distasteful. Certain volunteers were frustrated by periods of inactivity as they were unaware of how meaningful their presence could be even if they said or did nothing. Disaster work requires good physical stamina, creativity, quick decision-making based on intuition as well as information, tolerance for limited comforts and, mostly, flexibility. Work shifts of 8 to 12 hours were often extended.
What did volunteer say that first night? A brief introduction, an inquiry about the passenger, a smile, a hello or an offer of refreshments was offten enough to start conversations. Non-verbal behavior, sticking with painful material no matter what it triggers off in the helper, and sensitivity to intrusiveness makes a professional more than just another empathic ear. Volunteer listened, accepted and, when indicated, encourage expression of feelings and thoughts.
In addition to on-going work with specific families, mental health staff stayed in areas where families assembled, looking for upset people and offering interventions. They accompanied families to memorial services and a children's excursion and staffed a playroom, providing respite for children and opportunity for therapeutic interventions.
The families were not, however, the only ones hurting. Hundreds of service providers from governmental and other agencies including Red Cross, TWA staff, installation and maintenance workers, hotel personnel and responders at the recovery site were also affected. A senior law enforcement official, for example, spoke of his anguish, pain and hidden tears upon hearing a subordinate describe a child's loose hand clutching a teddy bear. Rescuers also feared that they might be unable to retrieve all the bodies. For mental health volunteers too, the sadness of the situations to which they were constantly exposed resulted in varying degrees and types of stress reactions, coupled with strong positive feelings of gratification from helping.
Red Cross is experienced in counseling staff and volunteers on assignments, defusing tense situations as they arise, and debriefing personnel on departure, individually or in groups, debriefing being a process that enables service providers to review their emotional reactions with a professional to gain awareness, obtain perspective, prepare for a return home and selectively be referred for on-going help. These are routine functions at big disasters.
Mental health workers were both providers and recipients of these services. The most helpful activity was discussing their feelings, with debriefers, on-site colleagues, supervisors, family members or friends. In addition to benefits of ventilating, one can receive reassurance about the universality of the reactions and affirm one's self-worth by choosing to speak to people who will acknowledge and appreciate one's accomplishments. Recognition is important. TWA #800 helpers were fortunate to have the media and even political figures like President and Mrs. Clinton praise us. Sleeping enough, eating properly and using personal stress management techniques are imperative. Humor can be a good stress-reliever.
In addition to what individuals can do to help themselves, organizations have responsibilities to help staff diminish or at least better handle stress. Red Cross has some supports which can serve as prototypes for other settings. Some start well before a disaster, such as recruitment standards that ensure adequately trained personnel, an obvious prerequisite for performance that warrants a good sense of accomplishment. Mandatory Red Cross classes further the competence, with course videos preparing staff for the sounds and sights, feelings and stresses to be experienced. On-site orientations, such as at TWA #800, alerted workers to prevailing family issues and operational tensions.
Red Cross also has excellent policies that set bounderies on worker-client relationships. Opportunities exist for task diversity and personnel guidelines for private hotel rooms, reasonable work hours and days off are helpful even if not always feasible. Technical supervisors and debriefers are accessible at all major Red Cross disasters and stress reactions are not stigmatized. Skilled and experienced workers recognize, accept and ask for help with their reactions.
I perceive my contribution at TWA #800 as a highlight of my professional life, drawing on my previous social work experiences as a practitioner, collaborator, administrator, and educator. Although there was much sadness, the families and the helpers were in great need and I felt good that I could aid through my direct services and by contributing to the development of a successful mental health team. I was stimulated working with people from other agencies and I loved being able to educate the public on grief reactions and mental health functions through the media.
Certified social workers who are interested in Red Cross Disaster Mental Health Training should call (212) 875-2322.