Reactions and Needs of Tristate-Area Pediatricians After the Events of September 11th: Implications for Children's Mental Health Services

Abstract

Pediatric practitioners in the tristate area reported that children/families sought care for an array of mental health-related concerns. Generalists in the areas affected and those who identified gaps in knowledge or skills in responding to the psychological effects of community disasters should be targeted for additional education.

Social, Psychological, and Psychiatric Interventions Following Terrorist Attacks: Recommendations for Practice and Research

“…Likely reactions may include severe anxiety, panic behavior and panic attacks, retaliatory attacks on local minority groups, actions that are themselves dangerous (eg, use of unapproved gas masks or medications), and actions that have major economic impact (eg, decreased air travel). Bioterrorist attacks of greater magnitude, those that affect several thousand to a hundred thousand individuals, are less likely (although they can occur through such means as the water system or communicable disease), but would produce much more severe psychological reactions (Boscarino et al, 2003;Hobfoll, 1991;Laraque et al, 2004). Accordingly, government, and public and private agencies, must prepare for small to medium magnitude attacks, whereas government and major pubic agencies must also have a plan for more major attacks (Bravata et al, 2004;Khan et al, 2000).…”

“…(1) Dispatch of police and emergency for coordination and management of activities in the site of the incident and installation of law and order if necessary. (2) Activation of community-based support and intervention systems that should be prepared long before the terrorist attack (Laraque et al, 2004). (3) Initiation of public announcements that suggest specific actions and provide nonspecific information as to the extent and type of attack (Boscarino et al, 2003).…”

“…The greater the extent and number of sites and the less effective is the handling of the public immediate reactions, the more severe will the psychological reactions likely be later on (Jones and Fong, 1994;. The primary interventions involve providing suggestions for what people and organizations can do on their own and collectively, as well as identifying individuals with severe reactions for referral to appropriate professionals (Laraque et al, 2004).…”

“…Most individuals who are not immediately and directly victimized will have minor to moderate psychological reactions (Boscarino et al, 2003, which can be handled by family physicians and mental health professionals through a combination of reassurance, relaxation and cognitive behavioral techniques, and medication (Laraque et al, 2004;McFarlane, 1994). Schools, businesses, and the public at large should be made aware of the signs of more severe reactions (PTSD, clinical depression, suicidality) and instructed how to make referrals.…”

“…During this time frame, it is critical that government officials work with the American Psychological and American Psychiatric Associations and their panels of experts, as well as other professional groups, such as the American Academy of Pediatrics and similar groups (Covello et al, 2001;DiGiovanni, 1999;Khan et al, 2000;Laraque et al, 2004). While the mechanisms for this kind of collaboration has been lacking in the past, this is changing (Bravata et al, 2004).…”