Monday, September 12, 2011

Help-Seeking Behaviors and Mental Health Response Efforts in Large Scale Disasters: Central Texas Wildfires and a Reflection on September 11th by Tammy Holleman, LMSW

The upcoming 10-year anniversary of the September 11th terrorist attacks and the recent wildfires in Central Texas highlight not only the generosity and sensitivity of humankind, but also the importance of coordinated mental health interventions following large-scale disasters and the continued need to de-stigmatize those seeking help for mental illness. Large scale disasters, although traumatic and often debilitating, can also have the positive effect of increased public altruism and community cohesiveness. Warring neighbors become best friends. Divided religions unite to bring messages of peace and faith to all victims. I have read many an article quoting survivors of 9/11 stating how religion, race and socioeconomic status all became invisible that day. People are more willing to accept help, help others, and discuss their emotions. I have witnessed this first hand as friends and family, living elsewhere, have called, emailed, and sent text messages asking about the Central Texas wildfires and how my family and I are coping.

Immediately following a disaster, mental health interventions become normalized as PTSD and stress are common words found in media headlines. Public displays of emotion are commonplace as often stoic politicians shed tears on national television. News reports display websites of and directions to mental health facilities. Unfortunately, the positive effects are often short lived as relief efforts stretch on for months, there are delays in government funding, and many don’t get the help they need. People become disillusioned and adopt the attitude that if they don’t help themselves nothing will get done. Soon altruism goes out the window as fear of aid running out causes the “me first” attitude to develop.

Research conducted on services provided by Disaster Psychiatry Outreach (DPO) during and following the 9/11 World Trade Center attacks in New York City stressed the importance of psychiatrists (and other mental health responders) having a pre-planned, organized system of responding, including clinical record keeping, training for volunteers, and practical, ethical provision of services. I recently received a forwarded email from a colleague asking that social workers volunteer to help speak to the victims of the wildfires in Bastrop. The email stated that no formal schedule or structure had been developed. I will be heading there to help, after informal training on critical incident debriefing, but it leads me to question, is unorganized, rapid assistance better than a planned, coordinated effort that is delayed?

Additionally, how do we as a society continue the post-disaster altruism all year long? How do we as mental health professionals organize our response to disasters so that victims will continue help-seeking behaviors and not feel stigmatized?

2 comments:

  1. On your first question: I noticed the same thing in the legal community's response to the wildfires. A request for volunteers to provide legal advice to wildfire victims was quickly sent, but I did not see any reference materials or training opportunities and the reality is that most lawyers would likely have no idea how to answer the majority of the questions the victims would ask. The volunteer attorneys could field the questions, research the topics and then respond, but that would be massively inefficient. Though I realize it is difficult to predict when, where and exactly how disasters will happen, I believe that some pre-planning could certainly occur--especially with respect to natural disasters such as wildires (and floods, tornados, etc.)--including, in the case of legal advice, the preparation of anticipated questions and guidelines for answering them, as I believe has been done following past hurricanes. Rapid deployment of a planned, coordinated effort seems to me to be the ideal approach.

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  2. Maybe the Austin American-Statesman read your blog; this article touches on some of your points:

    http://www.statesman.com/news/local/fire-victims-face-tough-emotions-1865798.html?viewAsSinglePage=true

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