The effects of impact of event and five categories of worker stress were studied with 140 police, fire, medical, and mental health personnel who were involved in emergency service work following a shooting in an elementary school. A questionnaire distributed 6 months after the incident was utilized. Public safety personnel reported a recollection of significantly fewer intrusive thoughts than medical and mental health professionals immediately following the incident. Groups did not differ in intrusive or avoidance scores on the Impact of Event Scale 6 months after the event and all groups showed a significant decrease in both scores over time. Stepwise linear regression showed that a self-reported qualitatively heavy work load predicted intrusiveness and avoidance of thoughts both immediately after and at the 6-month anniversary of the incident. Additionally, time pressure and quantitatively heavy work load also predicted avoidance score at the time of the incident. Results are discussed in terms of control models of anxiety and as foci for debriefing with affected personnel.
Two community care system programs, one based in a hospital and the other in the community, each providing structured bus service to insure that patients who are chronically mentally ill attend their day treatment programs, are described. One program was planned from its inception to include busing as a therapeutic tool to help patients in their attendance in a social skills workshop. The second initiated busing to increase daily attendance for noncompliant patients attending a day treatment center. Costs for the busing programs were offset by fee for services. Clinical benefits to patients are discussed. The importance of aggressive but nonintrusive community support programs is highlighted.
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