xxAACP Newsletter, Volume 15, Number 4, Fall 2001
REGIONAL REPORT
AREA II: New York City
The September 11, 2001 terrorist destruction of the World Trade Center has caused unparalleled psychological trauma and grief to New York City and its surrounding communities. A mental health response has been forming from the start and, as of this writing on September 30th, there is an evolving system of care.
In the opening days of the crisis there was an improvised mental health intervention. It consisted of an outpouring of volunteers, including AACP members, augmenting local emergency room personnel services and staff from several New York City public agencies. Three organizations were designated by the City of New York as clearinghouses for volunteers: the American Red Cross, the Mental Health Association, and another, local, volunteer nonprofit organization, Disaster Psychiatry Outreach (DPO). Through DPO, much needed volunteer psychiatrists have been deployed.
At Ground Zero, in hospital emergency rooms, on telephone help lines, and in newly-formed centers for families, psychiatrists and other mental health workers have bobbed and weaved through the shock and trauma. They have confronted massive separation and loss, and while also facing their own feelings, they have connected with rescue workers, victims, and their families during this massive catastrophe.
The relief efforts have continued through the past three weeks, yet there is expectation that the brunt of the mental health impact is yet to come. The statistic that between ten and fifteen percent of bereavement evolves into depression acquires perspective when contemplating the nearly six thousand dead. For example, can we estimate that each lost person was closely connected to an average of four other lives?
To prepare for the work of the coming months (and years), a constellation of agencies and institutions are moving forward, addressing what will inevitably be a massive public health initiative focusing on mood disorders, post-traumatic stress, and family crises. This necessitates coordinating ongoing care, collecting and analyzing epidemiological data, and offering public and professional education. The challenges are particularly daunting, considering the different levels of traumatic exposure and personal loss, as well as the fact that the episode itself continues to unfold as recovery efforts continue and families and friends of victims acquire the realization of loss. The situation’s fluidity lends equal challenge to the training of professionals, as clinicians try to aim at "a moving target" while helping to manage the crisis. In this way, training must be ongoing and phasic, with didactic installments focusing on the evolution of personal responses, as well as on how the aftermath is affecting full scale community psychology.
On September 18th, New York State’s Office of Mental Health was awarded a $22.7 million Federal grant for the City and seven surrounding counties for crisis counseling, education, and referral services. This sixty-day grant will be followed by a second and larger Federal application for an additional nine months’ services, research, and education. As for response, that this disaster happened in New York represents both strength and challenge. The resources, both human and material, are great, though in New York City, especially, there are traditions of city bureaucracy and of competition among providers that are equally strong. However, a feeling of solidarity has risen from this terrible experience, with connectedness, cooperation, and altruism as keynotes. The New York City Department of Mental Health, under Commissioner (and AACP member) Neal Cohen, MD, has expressed a strong mission to carry forth this feeling, taking leadership in forming a comprehensive program of care to be shared by the City’s municipal and nonprofit service organizations. We will follow its progress for the AACP membership.
Area II Representative, AACP
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