International Journal Of Emergency Mental Health[JOURNAL]
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200 papers
Psychological interventions for terroristic trauma: prevention, crisis management, and clinical treatment strategies.
Miller L
Int J Emerg Ment Health · 2011 · PMID 21957724
Terrorist attacks combine features of a criminal assault, a mass casualty disaster and an act of war Accordingly, this article presents a model for prevention, response and recovery from the psychological impact of a ter...
Terrorist attacks combine features of a criminal assault, a mass casualty disaster and an act of war Accordingly, this article presents a model for prevention, response and recovery from the psychological impact of a terror attack. The nature of terrorism is delineated and the various psychological effects are described, including diagnostic clinical syndromes, as well as individual reactions. Interventions in the immediate aftermath of a terrorist attack include on-scene crisis intervention, short-term psychological stabilization, and longer-term psychotherapeutic approaches. Special techniques are described for individuals, families, children, and large groups of survivors and responders. Finally, the ways that mental health clinicians can serve as valuable consultants to community recovery efforts are discussed.
Reflections on ten years of clinical practice in New York City following the terrorist attacks of September 11, 2001.
Levenson RL
Int J Emerg Ment Health · 2011 · PMID 21957723
Abstract loading — click title to view on PubMed.
Working toward resilience: a retrospective report of actions taken in support of a New York school crisis team following 9/11.
Johnson K, Luna JM
Int J Emerg Ment Health · 2011 · PMID 21957722
A retrospective report details external support rendered to a Lower Manhattan school crisis team following the 9/11/01 terrorist attack on the World Trade Center This analysis occasions an opportunity for consideration o...
A retrospective report details external support rendered to a Lower Manhattan school crisis team following the 9/11/01 terrorist attack on the World Trade Center This analysis occasions an opportunity for consideration of working assumptions, the formative use of data to plan support actions, and the subsequent emergence of a collaborative approach to post-disaster team support in school settings. The nature of assessment and nature of subsequent service delivery illustrates a community resilience-based approach to school crisis management. Recommendations for such work are based upon mixed qualitative and quantitative data gathered from on-scene team members as part of the ongoing support effort.
Perievent panic attack and depression after the World Trade Center disaster: a structural equation model analysis.
Adams RE, Boscarino JA
Int J Emerg Ment Health · 2011 · PMID 21957721
Research suggests that perievent panic attacks--panic attacks in temporal proximity to traumatic events--are predictive of later mental health status, including the onset of depression. Using a community sample of New Yo...
Research suggests that perievent panic attacks--panic attacks in temporal proximity to traumatic events--are predictive of later mental health status, including the onset of depression. Using a community sample of New York City residents interviewed 1 year and 2 years after the World Trade Center Disaster, we estimated a structural equation model (SEM) using pre-disaster psychological status and post-disaster life events, together with psychosocial resources, to assess the relationship between perievent panic and later onset depression. Bivariate results revealed a significant association between perievent panic and both year-1 and year-2 depression. Results for the SEM, however showed that perievent panic was predictive of year-1 depression, but not year-2 depression, once potential confounders were controlled Year-2 stressors and year-2 psychosocial resources were the best predictors of year-2 depression onset. Pre-disaster psychological problems were directly implicated in year-1 depression, but not year-2 depression. We conclude that a conceptual model that includes pre- and post-disaster variables best explains the complex causal pathways between psychological status, stressor exposure, perievent panic attacks, and depression onset two years after the World Trade Center attacks.
Introduction to special issue commemorating the 10th anniversary of September 11, 2001.
Boscarino JA
Int J Emerg Ment Health · 2011 · PMID 21957720
Dr Boscarino was in the World Trade Center complex on September 11, 2001 when the first plane struck the Twin Towers. His World Trade Center work was supported in part by grants from the National Institute of Mental Heal...
Dr Boscarino was in the World Trade Center complex on September 11, 2001 when the first plane struck the Twin Towers. His World Trade Center work was supported in part by grants from the National Institute of Mental Health (Grants # R01 MH66403 and R21-MH-086317) and the Pennsylvania Department of Health (Contract #4100042573).
Managing problem employees: a model program and practical guide.
Miller L
Int J Emerg Ment Health · 2010 · PMID 21870386
This article presents a model program for managing problem employees that includes a description ofthe basic types of problem employees and employee problems, as well as practical recommendations for. (1) selection and s...
This article presents a model program for managing problem employees that includes a description ofthe basic types of problem employees and employee problems, as well as practical recommendations for. (1) selection and screening, (2) education and training, (3) coaching and counseling, (4) discipline, (5) psychological fitness-for-duty evaluations, (6) mental health services, (7) termination, and (8) leadership and administrative strategies. Throughout, the emphasis on balancing the need for order and productivity in the workplace with fairness and concern for employee health and well-being.
Time of psychiatric patient assaults: twenty-year analysis of the Assaulted Staff Action Program (ASAP).
Flannery RB, Flannery GJ, Walker AP
Int J Emerg Ment Health · 2010 · PMID 21870385
Apparent random acts of violence viewed in the aggregate appear to occur in fairly exacting temporal patterns. This is true of rape, street assaults, and domestic violence, among other acts of violence. Patient assaults...
Apparent random acts of violence viewed in the aggregate appear to occur in fairly exacting temporal patterns. This is true of rape, street assaults, and domestic violence, among other acts of violence. Patient assaults on staff as acts of violence should also follow a temporal pattern. This twenty-year retrospective study of assaultive psychiatric patients in one public sector examined the temporal pattern of such assaults. Inpatient assaults were more likely to occur in the summer in the middle ten days of the month, during the first shift at mealtimes. In community settings, assaults were more likely in winter during the first ten days of the month, and on the first shift at noon time. The possible reasons for these time patterns, their possible biological roots, and their implications for emergency services personnel and health care providers were discussed.
Differences in compassion fatigue, symptoms of posttraumatic stress disorder and relationship satisfaction, including sexual desire and functioning, between male and female detectives who investigate sexual offenses against children: a pilot study.
Lane EJ, Lating JM, Lowry JL … +1 more , Martino TP
Int J Emerg Ment Health · 2010 · PMID 21870384
Law enforcement detectives who work with traumatized individuals, especially children who were victims of sexual abuse or assault, are likely to experience job-related emotional distress. The purpose of this study was to...
Law enforcement detectives who work with traumatized individuals, especially children who were victims of sexual abuse or assault, are likely to experience job-related emotional distress. The purpose of this study was to examine the relations among compassion fatigue, probable PTSD symptoms, and personal relationship satisfaction, including communication and sexual satisfaction, in a sample of 47 male and female detectives. Responses to the administered questionnaires indicated a relation between compassion fatigue symptoms and probable PTSD symptoms. There also were compelling gender differences. For example, for male detectives, open communication with their spouse or significant other was negatively correlated with burnout, indicating the more open the communication, the lower the reported burnout. However for female detectives there was a negative correlation between open communication with spouse or significant other and compassion satisfaction, suggesting that more open communication was related to lower levels of satisfaction with their ability to be a professional caregiver Furthermore, although stepwise regression analysis indicated that years of service as a detective is independently associated with sexual desire, female detectives evidenced less sexual desire and more difficulty with sexual functioning than did male detectives. Implications of these preliminary findings are discussed and limitations addressed.
The parent-rated social skills of a sample of New York City preschool children 8-10 months after September 11, 2001.
Yasik AE, Saigh PA, Mitchell P … +1 more , Abright AR
Int J Emerg Ment Health · 2010 · PMID 21870383
This study compared the Social Skills Rating System-Preschool Parent Version ratings of two groups of New York City preschool children 8-10 months after September 11, 2001. One group of children was within 1 mile (1.61 k...
This study compared the Social Skills Rating System-Preschool Parent Version ratings of two groups of New York City preschool children 8-10 months after September 11, 2001. One group of children was within 1 mile (1.61 km) of the World Trade Center (WTC) during the attack and exposed to one or more traumatic events. The second group was 2.04 to 14 miles (3.28-22.54 km) away from the WTC and not exposed to traumatic events. The social skills ratings of the comparison groups did not significantly differ These outcomes were consistent after statistically adjusting for the potentially confounding influence of parental PTSD, anxiety, and depression symptoms.
The use of psychosocial assessment following the Haiti earthquake in the development of the three-year emotional psycho-medical mental health and psychosocial support (EP-MMHPS) plan.
Jordan K
Int J Emerg Ment Health · 2010 · PMID 21870382
This article provides information about the 2010 Haiti earthquake. An assessment model used by a crisis counselor responding to the earthquake is presented, focusing on the importance of gathering pre-deployment assessme...
This article provides information about the 2010 Haiti earthquake. An assessment model used by a crisis counselor responding to the earthquake is presented, focusing on the importance of gathering pre-deployment assessment and in-country assessment. Examples of the information gathered through the in-country assessment model from children, adolescents, and adults are presented. A brief overview of Haiti's three-year Emergency Psycho-Medical Mental Health and Psychosocial Support (EP-MMHPS) is provided. Finally, how the psychosocial manual developed after assessing 200 Haitian survivors through in-country assessment, and information gathered through pre-deployment assessment became part of the EP-MMHPS is offered.
Helping military children cope with parental deployment: role of attachment theory and recommendations for mental health clinicians and counselors.
Miller L, Miller HB, Bjorklund D
Int J Emerg Ment Health · 2010 · PMID 21870381
Military deployment of a parent carries with it a number of stresses for children, all centering around uncertainty, instability and unpredictability. This article conceptualizes military deployment and relocation stress...
Military deployment of a parent carries with it a number of stresses for children, all centering around uncertainty, instability and unpredictability. This article conceptualizes military deployment and relocation stress in the context of attachment theory, and describes the types of adverse outcomes that can occur as the result of impaired attachment. It then presents a set of practical recommendations for mental health clinicians and counselors for helping children and families cope productively and negotiate the developmental hurdles associated with maintaining healthy attachment and family stability in the face of military deployment.
The scope of emergency mental health services.
Miller L
Int J Emerg Ment Health · 2010 · PMID 21870380
Abstract loading — click title to view on PubMed.
America's sons and daughters.
Valdez HL
Int J Emerg Ment Health · 2010 · PMID 21473372
Abstract loading — click title to view on PubMed.
War then and now: from surviving to thriving.
Honig AL
Int J Emerg Ment Health · 2010 · PMID 21473371
Call it Shell Shock, Battle Fatigue or PTSD. Throughout history, war has produced, to one degree or another an acute and chronic behavioral health condition amongst returning personnel. The lack and fluidity of a clearly...
Call it Shell Shock, Battle Fatigue or PTSD. Throughout history, war has produced, to one degree or another an acute and chronic behavioral health condition amongst returning personnel. The lack and fluidity of a clearly identifiable zone of combat has placed more soldiers at risk. Changes in the nature of war have led to higher rates of both physical and mental injury, as well as improved treatment interventions. The fact that soldiers are surviving what in the past would have been deadly physical injuries has presented a greater need to address the emotional casualties that remain. Improved programs proactively emphasizing resiliency and stress inoculation as well as formal reintegration strategies, assessment, individualized treatment planning and follow-up, have resulted in improved outcomes. Future developments in the field of military psychology should only further improve the current situation.
Psychological hardiness and meaning making as protection against sequelae in veterans of the wars in Iraq and Afghanistan.
MacDermott D
Int J Emerg Ment Health · 2010 · PMID 21473370
Veterans of the wars in Iraq and Afghanistan are at an increased risk of suicide and other serious psychological sequelae following deployment. Mental health professionals must seek to detect and understand the presence...
Veterans of the wars in Iraq and Afghanistan are at an increased risk of suicide and other serious psychological sequelae following deployment. Mental health professionals must seek to detect and understand the presence of risk and resilience factors in this vulnerable population so that early intervention and treatment can prevent long-term suffering and suicide. This article explores both psychological hardiness and finding meaning in trauma as factors that can reduce the risk of pathology. Particularly when deployment-related stressors are high, these protective processes may be crucial in fostering hope and resilience. A traumatized individual may interact with the meaning-making process in one of three ways: searching for and finding meaning in the trauma, searching for and never finding meaning in the trauma, and never searching for meaning. These three styles may have a direct effect on a veteran's sense of hope or hopelessness, which likely will strongly influence suicidal tendencies and mental health.
Mental health considerations for military humanitarian aid personnel.
Holloway J, Everly GS
Int J Emerg Ment Health · 2010 · PMID 21473369
Mental health services for veterans of humanitarian assistance (HA) missions is a critical and growing need within the United States military. The mental health impacts of such missions are both similar to and different...
Mental health services for veterans of humanitarian assistance (HA) missions is a critical and growing need within the United States military. The mental health impacts of such missions are both similar to and different from those experienced on combat missions, and may have an equally significant impact on the health and wellness of our troops. As the US military increasingly deploys humanitarian teams on both peacetime and contingency missions, this need can be expected to grow and must be addressed with more research and more attention to prevention, screening, and treatment. In this paper we will present a brief summary of the possible mental health effects of military HA missions, and propose remedies to address the adverse conditions that may arise in the pre-deployment, deployment, and redeployment settings.
Psychotherapy with military personnel: lessons learned, challenges ahead.
Miller L
Int J Emerg Ment Health · 2010 · PMID 21473368
Increasingly, civilian mental health clinicians will be enlisted to evaluate and treat active duty and post-deployment military service members of the OIF/OEF theaters, as well as veterans of previous wars. This article...
Increasingly, civilian mental health clinicians will be enlisted to evaluate and treat active duty and post-deployment military service members of the OIF/OEF theaters, as well as veterans of previous wars. This article provides a summary of some of the effective psychological treatment modalities for military service members that can be adapted to outpatient psychotherapeutic practice, including structured psychological interventions and specialized techniques of individual psychotherapy, with special applications for dealing with combat stress, depression, suicidality, conflicts over killing, brain injury effects, family issues, post-deployment readjustment, and long-term problems. By adapting and integrating psychotherapeutic lessons learned from treating related populations of law enforcement and emergency services personnel, clinicians who treat military service members and vets can become more flexible, well-rounded, and effective clinicians for a wide variety of high-need service members.
Large group intervention for military reintegration: peer support & Yellow Ribbon enhancements.
Castellano C, Everly GS
Int J Emerg Ment Health · 2010 · PMID 21473367
University Behavioral HealthCare, University of Medicine and Dentistry of New Jersey in partnership with the New Jersey Department of Military & Veterans Affairs established a program entitled the "New Jersey Veterans He...
University Behavioral HealthCare, University of Medicine and Dentistry of New Jersey in partnership with the New Jersey Department of Military & Veterans Affairs established a program entitled the "New Jersey Veterans Helpline," modeled after the "Cop 2 Cop Helpline," in 2005 to assist veterans and their families within the state. The events of September 11, 2001, demanded an unprecedented response to address the behavioral health care needs of first responders in New Jersey and highlighted the similarities amongst the military population in their response. Although the New Jersey Veterans Helpline program was initiated as a peer based helpline, the need for support in pre- and post-deployment quickly emerged. This paper describes the application of the Cop 2 Cop interventions with the Port Authority Police Department (PAPD) entitled "Acute Stress Management Reentry Program." This program was adapted and combined with Yellow Ribbon Guideline enhancements to create a "60 Day Resiliency & Reintegration Program" led by the New Jersey Veterans program to over 2,400 soldiers returning from war.
Mental health experiences and needs among primary care providers treating OEF/OIF veterans: preliminary findings from the Geisinger Veterans Initiative.
Boscarino JA, Larson S, Ladd I … +2 more , Hill E, Paolucci SJ
Int J Emerg Ment Health · 2010 · PMID 21473366
This study describes the results of the Reaching Rural Veterans Initiative (RRVI) funded by the Commonwealth of Pennsylvania and the Federal Government. The purpose of this project was to address the needs of veterans an...
This study describes the results of the Reaching Rural Veterans Initiative (RRVI) funded by the Commonwealth of Pennsylvania and the Federal Government. The purpose of this project was to address the needs of veterans and their family members in rural communities who were seen by non-VA primary care providers. As part of this project, an assessment of healthcare providers' knowledge and awareness of mental health-related issues and experiences with veterans' healthcare services was conducted. Following this assessment, an education program was developed and implemented at primary care sites within the Geisinger Health System and also made available to other area providers. The survey indicated that Geisinger's primary care providers are currently involved with providing mental health care to area service members and their families. It was estimated that these providers saw about 1,200 Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) patients and 3,600 of their family members in clinics over a 6 month period. A significant number of these persons had mental health problems. About two-thirds (65.4%) of providers reported having a mental health professional onsite and nearly 23% reported that over one-third of their patients have mental health problems. Significant mental health gaps discovered indicated that providers lacked knowledge of PTSD and other combat-related stress disorders, as well as knowledge of VA resources. In addition only 20% of the providers rated their mental health treatment skills as high and only about 8% reported that they had adequate knowledge of current mental health treatment strategies. Based on this needs assessment and the results of the provider intervention, further service improvements are planned.
Critical incident stress management (CISM) in support of special agents and other first responders responding to the Fort Hood shooting: summary and recommendations.
Strand R, Felices K, Williams K
Int J Emerg Ment Health · 2010 · PMID 21473365
On November 5, 2009, an individual entered the Fort Hood Soldier Readiness Processing (SRP) site and opened fire with a handgun. The result of the shooting was a total of 13 people killed and 31 wounded. A two-person cri...
On November 5, 2009, an individual entered the Fort Hood Soldier Readiness Processing (SRP) site and opened fire with a handgun. The result of the shooting was a total of 13 people killed and 31 wounded. A two-person critical incident peer support (CIPS) team from the United States Army Military Police School (USAMPS) provided critical incident stress management (CISM) in the forms of critical incident stress debriefings (CISD) and one-on-one crisis intervention for investigators and their spouses. This article provides a summary and discussion of the results of the interventions that were conducted. Key results for successful CISM were accessibility of CIPS team, the credibility of trained peers and the development of supportive relationships, the reduction of stigma by requiring attendance at interventions, and the commitment of the CIPS team to the principles of CISM (e.g., homogenous groups, utilizing a multicomponent approach, and facilitating the normalization of emotional reactions to the crisis). Recommendations include mandating critical incident peer support cells for Criminal Investigation Division (CID) units, Director of Emergency Services (DES) on military installations, and Military Police units; providing a pool of trained peers in the above-mentioned organizations; providing permanent funding for USAMPS' CIPS Course; and recognition of CIPS/CISMas an essential element of Comprehensive Soldier Fitness and Army Human Capital in promoting Soldier Family, and Civilian well-being and resiliency. This article would benefit leaders, chaplains, mental health professionals, and emergency services personnel in investigative, operational, and U.S. Army Garrison units.
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