Ad­dress­ing men­tal health is vi­tal long af­ter tragedy strikes

Modern Healthcare - - NEWS - By Maria Castel­lucci

When 24 vic­tims of the 2013 Bos­ton Marathon bomb­ing flooded the trauma cen­ter of Beth Is­rael Dea­coness Med­i­cal Cen­ter, the im­me­di­ate fo­cus was on sav­ing lives.

But af­ter pa­tients sta­bi­lized in the days and weeks ahead, clin­i­cians were acutely aware of an in­jury that couldn’t be eas­ily seen: emo­tional trauma.

Beth Is­rael’s li­censed so­cial work­ers were be­side pa­tients and their ter­ri­fied fam­ily mem­bers for their en­tire hos­pi­tal stay to of­fer any sup­port they needed.

“We had pa­tients here for up to five weeks. We made sure that ev­ery pa­tient that was here had someone they would see as a fa­mil­iar face and was avail­able to them,” said Bar­bara Sarnoff Lee, se­nior di­rec­tor of so­cial work and pa­tient and fam­ily en­gage­ment at Beth Is­rael.

Car­ing for the men­tal health of vic­tims and their fam­i­lies af­ter trau­matic events like the Bos­ton bomb­ing and last week’s mass shoot­ing in Las Ve­gas is an es­sen­tial part of dis­as­ter re­sponse, ac­cord­ing to be­hav­ioral health ex­perts. Af­ter such events, men­tal health pro­fes­sion­als from the com­mu­nity—and even across the coun­try—mo­bi­lize to help vic­tims deal with the trauma.

“Ev­ery state, ev­ery county, ev­ery town has a dis­as­ter plan, and they have rules on the phys­i­cal side and the emo­tional side,” said Linda Rosen­berg, CEO of the Na­tional Coun­cil for Be­hav­ioral Health. “Usu­ally, men­tal health pro­fes­sion­als will be part of the first-re­spon­der groups. They will do coun­sel­ing, they will be there as a re­source.”

Las Ve­gas de­clared a state of emer­gency af­ter the mass shoot­ing last week and coun­sel­ing was part of the re­sponse. The city used the Las Ve­gas Con­ven­tion Cen­ter to pro­vide 24/7 grief coun­sel­ing and be­reave­ment ser­vices to fam­ily mem­bers of vic­tims and the com­mu­nity.

Lo­cal men­tal health providers in the com­mu­nity stepped up to help as well. Skye Coun­sel­ing, an out­pa­tient men­tal health fa­cil­ity in Las Ve­gas, pro­vided free coun­sel­ing to any­one af­fected by the mass shoot­ing.

“The main thing for us is to let peo­ple tell their sto­ries in a safe place where they don’t feel judged and feel com­fort­able,” said Jennifer Howe, a Skye coun­selor.

Its also typ­i­cal for the fed­eral gov­ern­ment to get in­volved. The Fed­eral Emer­gency Man­age­ment Agency fa­cil­i­tates and pro­vides grief coun­sel­ing af­ter dis­as­ters that in­volve fed­eral gov­ern­ment in­ter­ven­tion. For in­stance, FEMA was de­ployed to Ok­la­homa City af­ter the 1995 bomb­ing that killed 168 peo­ple. FEMA of­fered grief coun­sel­ing to the vic­tims and their fam­i­lies “for years” af­ter the at­tack, Rosen­berg said.

The Sub­stance Abuse and Men­tal Health Ser­vices Ad­min­is­tra­tion also pro­vides coun­sel­ing af­ter dis­as­ters. It opened a hot­line that’s pro­vid­ing im­me­di­ate coun­sel­ing to any­one af­ter the Las Ve­gas shoot­ing.

The agency also had boots on the ground in Texas, Florida and Puerto Rico af­ter hur­ri­canes Har­vey, Irma and Maria. It even trained com­mu­nity vol­un­teers to go door-to-door in af­fected ar­eas and check on fam­i­lies to see how they are cop­ing. Those ef­forts can last years if nec­es­sary.

“One of the goals is to cre­ate an at­mos­phere of re­siliency so com­mu­ni­ties and in­di­vid­u­als are able to cope more ef­fec­tively in the long term,” said Maryann Robin­son, chief of the emer­gency men­tal health and trau­matic stress ser­vices branch at SAMHSA.

But vic­tims and the com­mu­nity aren’t the only ones vul­ner­a­ble to trauma, said Laura Usher, se­nior man­ager for crim­i­nal jus­tice and ad­vo­cacy at the Na­tional Al­liance on Men­tal Ill­ness. Dis­as­ter can lead to burnout and distress for men­tal health pro­fes­sion­als. There is a short­age of providers, so they can be stretched thin in mo­ments of tragedy. The U.S. Health Re­sources & Ser­vices Ad­min­is­tra­tion pro­jected that the na­tion needs to add 10,000 providers to each of seven sep­a­rate men­tal health­care pro­fes­sions by 2025 to meet growth in de­mand.

“Men­tal health pro­fes­sion­als who go out of their way to as­sist peo­ple and work ex­tra hours are more likely to burn out and ex­pe­ri­ence trauma them­selves,” Usher said. “You want ev­ery­one to be healthy, and I think that be­comes more dif­fi­cult and more strained when there are fewer men­tal health pro­fes­sion­als.”

AP PHOTO Friends of Las Ve­gas shoot­ing vic­tim Denise Bur­di­tus of Martins­burg, W.Va., at­tend a vigil in her honor.

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