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Individual and Community Mental Health Interventions title Individual and Community Responses to Trauma and Disaster expands the focus on terrorism.
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Even if people experience occasional anxiety or stress having "perfectly normal reactions," she explains.

Another reaction frequently projected on survivors of the attacks is the notion of survivor guilt. Although it is no longer recognized as a formal condition—now living, diagnostically, as a part of PTSD—it is especially common among those "who used to fight together or endure adversity together, such as firefighters, police officers or soldiers," Neria says. In general, the prevalence of PTSD tends to decline steadily in the months and years after a traumatic event, especially if people can get back to relatively normal routines. Research conducted in New York showed that the rates of PTSD among the general population eased from about 5 percent a year after the attacks to 3.

Even many of the first responders and long-term cleanup workers seem to have largely recovered psychologically. But one group of workers has curiously not followed this trend: retired firefighters. In some studies, they seemed to have an increased prevalence of PTSD as time went on. Dass-Brailsford suggests that in addition to having to cope with the trauma of the event, having gone on disability or into early retirement "means that you're not working, you're not occupying your time, and you have more time to sit and think about what happened to you, so your reactions become stronger.

First responders of any type also rely on having delayed emotional reactions to best perform their stressful jobs. And in the general population as well, "in the immediate aftermath of a traumatic event, a lot of people are numb," Dass-Brailsford explains.

Community Mental Health in disaster situations. A review of community-based models of approach

Research has also found that basic differences in socioeconomic status can make big differences in how likely someone is to have sustained PTSD. And not everyone who suffered from PTSD or other symptoms the event had any direct contact with the attacks—or even lived in the affected areas.

The more graphic television coverage of the attacks a person had watched in the intervening time, the more likely they were to report the major symptoms.


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At the time of the September 11 attacks, the accepted protocol for handling large-scale traumatic events was to perform so-called critical incident stress debriefing, like that Dass-Brailsford led in New York, to discuss events and assess how people are reacting psychologically. In the past decade, however, research has shown that sort of intervention, no matter how well intentioned, is probably not the most helpful response to get victims feeling better more quickly. As Watson notes, these sessions might well "be too brief to allow for adequate emotional processing, may increase arousal and anxiety levels or may inadvertently decrease the likelihood that individuals will pursue more intense interventions.


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  5. Since the late s, the trauma-response field has been moving toward what is known as psychological "first aid. Psychological first aid's focus is on practical needs so that, the theory goes, other immediate stressors, such as finding a safe place or a way to reach relatives, do not exacerbate trauma from the event itself. In the days after the earthquake in Haiti, for example, many public health officials worried that rather than infectious diseases, mental health was going to be a more pressing issue for the country. Sandro Galea, chair of the Department of Epidemiology of Columbia's Mailman School of Public Health, noted at the time that, "psychological first aid is giving people what they need to rebuild their lives.

    Terrorism, Disaster and Children

    It will mean restoring people to their jobs, restoring people to their schools, restoring families. Current guidelines, published in , suggest a five-pronged approach to promote mental and emotional well-being after a disaster or during ongoing violence: "promoting a sense of safety, promoting calming, promoting a sense of self-efficacy and community efficacy, promoting connectedness and instilling hope," Watson and her colleagues summarized in their recent paper.

    The study of psychological reactions to terrorism is ongoing. But in the past decade researchers have made small steps in understanding how it is similar to other traumatic events, such as experiencing natural disasters, and how it differs. To treat victims of terrorism, mental health practitioners have been turning to cognitive behavioral therapy, which has gained favor in recent years to treat many common mental ailments, including depression and PTSD. In this sort of therapy, patients work through traumatic events in a safe, supportive setting. This allows them to "reprocess the experience to support the natural extinction of the fear, extinction of the painful memories," Neria says.

    Taking lessons from the extensive work done with veterans and other survivors with PTSD, researchers have found that "the content of the treatment could be different" when treating terrorist attack survivors "but the strategies and interventions are pretty similar," Neria says. But cognitive behavioral therapy might not be a cure-all. People experience trauma reactions differently, Watson notes, so the field should not limit itself to cognitive-behavioral approaches entirely.

    As Neria points out, as well, "the mental health toll of disasters and terrorism is not limited to post-traumatic stress disorder.

    Adriano Diop

    But diagnosing these conditions and getting the right help to the right people has become much more efficient in the past decade. Researchers have learned to work through schools, workplaces and other institutions to more efficiently screen larger populations of people and address their specific needs.

    The Helpline has language access and 24 hour capability. During a declared disaster, the Director of the Disaster and Terrorism Branch is responsible for activating the state's mental health disaster response plan in coordination with the Emergency Social Services Coordinator and the New Jersey Office of Emergency Management.

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    Each New Jersey County also maintains a county-specific, all-hazards mental health disaster plan. During times of disaster, the county's plan can also be activated by the County Mental Health Administrator in coordination with the County Office of Emergency Management and in collaboration with the state partners.

    The Division of Mental Health and Addiction Services has more than contracted community mental health provider agencies. Federal grant programs provide disaster training for these mental health providers as well as private practitioners.

    Bioterrorism-Disaster Preparedness Resources

    The Disaster and Terrorism Branch is home to a multi-disciplinary Training and Technical Assistance Group TTAG which has the capacity to provide on-demand training for mental health professionals in the wake of disaster to further increase the state's capacity to address the psychosocial needs of the community. The services available through the Disaster and Terrorism Branch include:. The Branch works in close collaboration with public health, law enforcement, emergency management, and other professionals at the local, state and federal levels to coordinate mitigation, planning, response and recovery efforts.

    Helping Victims of Mass Violence and Terrorism: Partnerships and Planning, Response, Recovery

    The Branch also actively promotes the participation of mental health professionals in drills, exercises, and ongoing professional development activities. Shereef Elnahal, M. Commissioner P. Box Trenton, NJ Healthy NJ Chronic Disease Prevention Plan New Jersey is home to over 2, licensed hospitals, nursing homes, and medical care facilities. The New Jersey Department of Health works to ensure that citizens receive appropriate levels of care in every regulated facility. Consumer Complaints.