Hundreds of commuters who traveled daily from suburbs in New Jersey and Connecticut to offices in the World Trade Center in Manhattan are now presumed to be dead.
Joseph Napoli, M.D., chair of the Disaster Preparedness Committee of the New Jersey Psychiatric Association (NJPA), told Psychiatric Newst that New Jersey police officials estimate that 560 families in New Jersey had relatives who were employed at the World Trade Center and did not survive the attacks. In addition, New York police officials told Psychiatric News that 23 police officers and 300 firefighters perished in rescue attempts including some who lived in New Jersey or had colleagues there.
"I am seeing a range of reactions from intense grief to traumatic stress reactions," said Napoli, who has been doing individual grief counseling and group debriefings for the New Jersey Port Authority and a television station.
He explained that the debriefings help people regain their psychological equilibrium through talking about their experiences and reactions. In the debriefings, he gives practical advice on ways people can take care of themselves to help prevent being traumatized further.
Because numerous NJPA members have agreed to provide free consultations to people affected by the attacks, Napoli also gives out the main NJPA telephone number for referrals.
Employees of the New Jersey Port Authority lost 39 of their colleagues who were working on several floors in the north tower when the building collapsed. "In addition to grieving, the employees were afraid that other locations such as bridges were vulnerable to future attacks," said Napoli.
Indeed, earlier this month the New Jersey Port Authority received a bomb threat for the George Washington Bridge, which crosses into Manhattan. While the threat turned out to be baseless, Napoli said the Port Authority asked him to return to do more crisis debriefings for each of three shifts of employees.
A television station also called Napoli last month to conduct a debriefing for employees stressed from repeated viewings of the World Trade Center attacks. "This included the news show producers, video editors, and graphic artists. Some were putting in long hours and experiencing normal stress reactions, which typically resolve, but it’s possible that others may develop posttraumatic stress disorder," said Napoli.
NJPA member Cheryl Kennedy, M.D., who is trained in crisis incident stress debriefings, worked with the Jersey City Police Department the week of the disaster. The police department provided a continuous flow of emergency workers and supplies to ground zero, which is just across the river, Kennedy told Psychiatric News.
Her role was providing emotional and practical support to the droves of rescue workers who came to the dock in Jersey City to volunteer their services. Many of them were young and inexperienced emergency medical technicians, police, firefighters, and construction workers from New Jersey, Pennsylvania, and Ohio, said Kennedy.
"I tried to emphasize to the ones I talked to the importance of taking care of themselves by stopping to eat, drink water, and rest," said Kennedy. "But the nature of trained rescue workers is not to stop until the job is done. The fact that there were so few survivors drove many of them to continue to work in spite of their own exhaustion."
She and other volunteers checked the workers before they left the dock to ensure that they had adequate protective equipment. When they returned, often after 12-hour shifts of sifting through rubble with their hands, the volunteers checked them for injuries, said Kennedy. "While we helped them wash out their eyes, we engaged them in casual conversation, which essentially was a debriefing," said Kennedy.
She appreciated that the workers accepted her as one of the medical personnel, whom they viewed as necessary partners in their rescue efforts. "I have learned from previous experiences with disaster victims to adapt to the situation at hand and not have preconceived ideas of practicing psychiatry. It was a very rewarding experience," said Kennedy.
Other NJPA members responded to the attacks by holding disaster training sessions, talking about expected responses to the disaster on television programs, and sharing relevant mental health information on the Internet.
The Connecticut Psychiatric Society was asked by the state Department of Children and Families and the Department of Mental Health and Addiction Services to compile a list of members willing to offer free counseling sessions to people affected by the disaster.
Executive Director Jacqueline Coleman told Psychiatric News that more than 70 members throughout the state had volunteered their services and were willing to go to Fairfield County, where most of the victims’ families lived.
Members of the Massachusetts Psychiatric Society (MPS) also played an important role in helping their communities cope with the loss of an estimated 150 passengers and crew members aboard the United Airlines and American Airlines planes that crashed into the World Trade Center.
Todd Holzman, M.D., cochair of the MPS Disaster Readiness Committee, told Psychiatric News that within hours of the attacks, the American Red Cross set up a Family Assistance Center near Logan Airport in Boston. Holzman was there also in his role as head of the disaster services of the American Red Cross Massachusetts Bay Chapter.
"We made ourselves available to families and friends of passengers aboard the airplanes, airline workers, local and federal government officials, and emergency services workers. Our goal was to provide compassionate care and support, and listen to people if they wanted to talk," said Holzman. "We also helped the families sort through a host of procedures, briefings, and interviews."
When the official word came that their loved ones were aboard the doomed planes, Holzman said, "there was palpable shock, grief, and overwhelming horror that the crash had been deliberate."
"Because the mental health professionals were also exposed to the unfolding tragedy along with the families and witnessed their grief and horror, we debriefed each other at the end of the day,"he said.
Holzman recommended that psychiatrists become certified by the American Red Cross to respond to local, regional, and national disasters. The MPS is planning and cosponsoring a training session with the American Red Cross and a series of workshops to hone people’s skills in dealing with psychiatric issues related to disasters, he said.
The training will assist the estimated 100 people, many of them MPS members, who volunteered to help people and groups affected by the tragedy wherever they are needed, he said.
In addition to Holzman, about 100 MPS members volunteered to come to the Family Assistance Center, which operated for eight days after the attacks. MPS members also provided consultations to the media, schools, government agencies, their own institutions, the clergy, and patients, said Holzman.
The Web address for the NJPA is www.psychnj.org, which includes information on how NJPA members can volunteer their services. To contact the Connecticut Psychiatric Society, call Jacqueline Coleman at (860) 243-3977. To contact the Massachusetts Psychiatric Society, call Dorothy Mooney at (781)237-8100. ▪