Mental Health Facilities “Overwhelmed” By Sept. 11 Aftermath
By Sarah Sparks
WASHINGTON – In the weeks following the Sept. 11 terrorist attacks, America turned out overwhelmingly to help the wounded, with millions of dollars in donations for aid and medical supplies and lines out the doors at blood banks around the country. But now lawmakers and health experts are debating how caregivers best can treat the mental scars that could last months or years after physical wounds have healed.
“Mental illnesses suffered in the wake of tragedies like the assault on the World Trade Center and the Pentagon are a silent scourge,” said Sen. Edward Kennedy, D-Mass., during a hearing yesterday on the psychological trauma of the attacks.
“Like the war on terrorism itself, the struggle against the psychological trauma inflicted by terror cannot be won without substantial resources and a substantial national commitment,” Kennedy said at the hearing of the Senate Committee on Health, Education, Labor and Pensions which he chairs.
The Pew Research Center’s post-attack survey of 1,200 Americans found that 71 percent said they have felt depressed since the attacks; nearly half have had difficulty concentrating; a third had trouble sleeping.
Unfortunately, the people most at risk may be those who have given the most: the rescue workers and physicians.
Spencer Eth, vice chairman of psychiatry at St. Vincent Catholic Medical Center, the trauma hospital closest to ground zero in New York, said the staff has been strained to breaking with more than 7,000 victims needing care. “I can attest that my many hospital colleagues are more anguished now than at any previous time in their careers,” Eth said.
Kerry Kelly, director of medical services for the New York City Fire Department, was at the World Trade Center, helping firemen, when the towers collapsed. “It was like a battlefield, with bodies and debris raining from the sky,” Kelly said.
In New York, 60 fire companies have lost one or more members; of the 343 members missing or confirmed dead, 75 have close relatives still in active duty. “We have retired officers digging for their sons, two brothers uniting in grief to search for a third sibling,” Kelly said. This additional shock makes many rescue workers doubly at risk for trauma-related disorders.
Kennedy agreed, citing statistics from police and rescue organizations on hand at the crash site of Pan Am Flight 103 in Lockerbie, Scotland in 1988. A quarter of the Lockerbie rescue workers who handled the bodies of victims took early retirement within 18 months, Kennedy said; since the crash, 78 rescuers have committed suicide.
The mental health professionals testifying urged Congress to quickly reinforce the country’s strained support network. “Just as emergency rooms were quickly overrun with the wounded and dying in the first hours after this disaster, existing mental health infrastructures may be overwhelmed in the coming months,” said Carol North, psychiatrist and disaster studies expert the Washington University School of medicine in St. Louis, Mo.
Kennedy vowed the committee would work to bring more aid to mental health programs. “One hundred families in my own state of Massachusetts were personally affected,” Kennedy said. “Our goal is to do all we can to help those affected by the attacks … and to be fully prepared for any future disasters.”
Kennedy and Sen. John Kerry, D-Mass., are two of 61 Senate co-sponsors for the Mental Health Equitable Treatment Act, set to go to the Senate floor Monday. The bill, proposed by Sens. Paul Wellstone, D-Minn., and Pete Domenici, R-N.M., would require group health plans that offer mental health coverage to treat those benefits the same as medical and surgical benefits – preventing insurance companies from imposing treatment limits only on mental health care, for example.
“The role of private insurance is especially critical,” Kennedy said. “There must be no skimping or rationing of needed care for victims of this assault on America.”
North advised Congress to take a two-pronged approach. First, for those who suffered mild trauma – from watching the attacks on television, for example – community leaders should offer crisis counseling and public forums for people to share their grief, anger and fear. For those highly traumatized – such as survivors, rescue workers and families of victims – doctors must quickly identify patients developing depression, post-traumatic stress syndrome or other disorders and set up a long-term treatment plan.
“People so traumatized by the disaster that they are emotionally numbed and can cope only by avoiding all reminders of it are at particularly high risk,” North said.
