As New York City struggled to deal with the shock and aftermath of the terrorist attacks that decimated lower Manhattan and took thousands of lives, the situation in Washington, D.C., unfolded somewhat differently.
The attack on the Pentagon, while devastating to the Washington area population, was such that loss of life and damage to buildings and roads was far less than in New York. Unlike the World Trade Center towers, the building is spread out horizontally, hunkering close to the ground, so the plane flown into it destroyed only a portion of the building. That portion had recently undergone renovations and wasn’t fully repopulated yet. Moreover, the building sits essentially by itself across the Potomac River from the many federal buildings and tourist sites in Washington, D.C., and is surrounded by acres of parking spaces.
While psychiatrists in the area quickly mobilized to provide assistance immediately after the disaster, they also began planning for residents’ long-term mental health needs. Among the stresses with which residents are grappling are worse-than-usual traffic jams because of streets blocked for security reasons; frequent bomb scares; war planning involving themselves, friends, or neighbors; the drone of military planes; and fears that more terrorist attacks—not necessarily involving airplanes—could happen at any moment.
Former APA President and former Washington Psychiatric Society (WPS) President Harold Eist, M.D., quickly responded to the immediate needs of the public to find ways of dealing with the crisis by organizing a phone bank of local psychiatrists to answer calls from worried viewers of the news at the local CBS-TV station.
"The doctors all acknowledged in their conversations with callers that many uncomfortable feelings—stress, numbness—were normal and that it’s important to seek further help, if necessary," Eist said in an interview. The effort was so successful that the station repeated the phone bank the next day.
In the meantime, the WPS’s Executive Committee, in conjunction with its members and Executive Director Walter Hill, began developing a strategy that acknowledges the need to prepare for a sustained effort in helping area residents deal with a changed reality about their safety. Hill said, "We are reaching out to the medical societies in Maryland, the District, and Virginia to let them know that we can provide help to their patients and to help the doctors themselves with what expertise we have. We decided that primary care physicians will be the point of access for many people seeking help."
WPS President-elect Catherine Stuart May, M.D., said, "School nurses are already seeing an increase in stomach aches and other physical complaints. It’s important to reach the primary care physicians because we know that somatic complaints are frequent presenting symptoms for PTSD." WPS is preparing a one-page handout for all primary care physicians that will help them recognize symptoms of PTSD and offer opportunities for help from WPS members.
The WPS is also making certain that its own members have up-to-date information about how to deal with patients who may be suffering from trauma. "We are fortunate to have members like Jerrold Post and Robert Ursano, who are national experts on the impact of terrorism and trauma," said May. "But we all will need to become experts." Training sessions about PTSD and other responses to terrorism will be offered to WPS members.
WPS also organized a series of forums where members of the public met with psychiatrists to discuss their experiences and feelings and identify sources of help. A child psychiatrist was present at each forum to help parents understand how to talk to their children about the attack. May said, "We should remember to focus on the resilience of the human spirit and avoid overpathologizing normal responses to an abnormal event. Our job is to help the community find ways of participating in its own healing."
The military is dealing with the mental health needs of survivors of the attack and the families of deceased victims, along with other personnel stationed at the Pentagon and their families. According to a spokesperson for the Society of Uniformed Services Psychiatrists, members were "hard at work" responding to the crisis. Information about specific activities, however, could not be made public until a later date.
More information on the psychiatric response in Washington, D.C., including special efforts to reach out to children and their parents, will appear in a future issue of Psychiatric News.▪