Preparing for the Psychological Consequences of Terrorism: A Public Health Strategy

185 Pages·2003·3.22 MB·English

by  Committee on Responding to the Psychological Consequences of Terrorism, Adrienne Stith Butler, Allison M. Panzer, Lewis R. Goldfrank

PREPARING FOR THE
PSYCHOLOGICAL
CONSEQUENCES OF
A PUBLIC HEALTH STRATEGY
Committee on Responding to the Psychological Consequences of Terrorism
Board on Neuroscience and Behavioral Health
Adrienne Stith Butler, Allison M. Panzer, Lewis R. Goldfrank, Editors
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, N.W. Washington, DC 20001
NOTICE: The project that is the subject of this report was approved by the Governing Board
of the National Research Council, whose members are drawn from the councils of the Na-
tional Academy of Sciences, the National Academy of Engineering, and the Institute of Medi-
cine. The members of the committee responsible for the report were chosen for their special
competences and with regard for appropriate balance.
Support for this project was provided by the Institute of Medicine, and the National Institute
of Mental Health and Substance Abuse and Mental Health Services Administration, U.S.
Department of Health and Human Services. The views presented in this report are those of
the Institute of Medicine Committee on Responding to the Psychological Consequences of
Terrorism and are not necessarily those of the funding agencies.
Library of Congress Cataloging-in-Publication Data
Preparing for the psychological consequences of terrorism : a public
health strategy / Committee on Responding to the Psychological
Consequences of Terrorism Board on Neuroscience and Behavioral Health ;
Adrienne Stith Butler, Allison M. Panzer, Lewis R. Goldfrank, editors.
p. ; cm.
Includes bibliographical references.
ISBN 0-309-08953-0 (pbk.) ISBN 0-309-51919-5 (PDF)
1. Mental health services—United States—Planning. 2. Crisis
intervention (Mental health services)—United States—Planning. 3.
Terrorism—Government policy—United States. 4. Terrorism—United
States—Psychological aspects. 5. Terrorism—Health aspects—United
States. 6. Victims of terrorism—Rehabilitation—United States.
[DNLM: 1. Stress Disorders, Traumatic—prevention & control—United
States. 2. Terrorism—psychology—United States. 3. Disaster
Planning—United States. 4. Mental Health Services—United States.
WM 172 P927 2003] I. Butler, Adrienne Stith. II. Panzer, Allison M. III.
Goldfrank, Lewis R., 1941- IV. Institute of Medicine (U.S.). Committee
on Responding to the Psychological Consequences of Terrorism Board on
Neuroscience and Behavioral Health.
RA790.6.P735 2003
362.2’0973—dc21
2003013770
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COMMITTEE ON RESPONDING TO THE PSYCHOLOGICAL
CONSEQUENCES OF TERRORISM
Lewis R. Goldfrank (Chair), Director, Emergency Medicine, Bellevue
Hospital Center, Medical Director, NYC Poison Center, New York
University Medical Center
Gerard A. Jacobs, Director, Disaster Mental Health Institute, University
of South Dakota
Carol North, Professor of Psychiatry, Washington University School of
Medicine
Patricia Quinlisk, Medical Director and State Epidemiologist, Iowa
Department of Public Health
Robert J. Ursano, Director, Center for the Study of Traumatic Stress
Professor and Chairman, Department of Psychiatry, Uniformed
Services University of the Health Sciences
Nancy Wallace, President, New Health Directions, Inc.
Marleen Wong (Liaison to the Board on Neuroscience and Behavioral
Health), Director, School Crisis and Disaster Recovery, National
Center for Child Traumatic Stress, Director, Crisis Counseling and
Intervention Services, Los Angeles Unified School District
CONSULTANTS
Thomas H. Bornemann, Director, Mental Health Programs, The Carter
Center
Daniel A. Pollock, Medical Epidemiologist, Centers for Disease Control
and Prevention
IOM PROJECT STAFF
Adrienne Stith Butler, Study Director
Allison M. Panzer, Research Assistant
IOM BOARD STAFF
Andrew M. Pope, Acting Director, Board on Neuroscience and
Behavioral Health
Catherine A. Paige, Administrative Assistant
Rosa Pommier, Financial Associate
COPY EDITOR
Florence Poillon
v
Reviewers
This report has been reviewed in draft form by individuals chosen for
their diverse perspectives and technical expertise, in accordance with pro-
cedures approved by the NRC’s Report Review Committee. The purpose
of this independent review is to provide candid and critical comments
that will assist the institution in making its published report as sound as
possible and to ensure that the report meets institutional standards for
objectivity, evidence, and responsiveness to the study charge. The review
comments and draft manuscript remain confidential to protect the integ-
rity of the deliberative process. We wish to thank the following individu-
als for their review of this report:
Edward Bernstein, Department of Emergency Medicine, Boston
University, Boston, MA
Colleen Conway-Welch, School of Nursing, Vanderbilt University,
Nashville, TN
Brian W. Flynn, Rear Admiral/Assistant Surgeon General, U.S. Public
Health Service (retired)
Dennis Perotta, Bureau of Epidemiology, Texas Department of Health,
Austin, TX
Robert S. Pynoos, National Center for Child Traumatic Stress,
University of California, Los Angeles
Henry W. Riecken, University of Pennsylvania School of Medicine
(emeritus), Washington, DC
Monica Schoch-Spana, Center for Civilian and Biodefense Studies,
Johns Hopkins School of Public Health, Baltimore, MD
vii
viii REVIEWERS
Merritt Dean Schreiber, National Center for Child Traumatic Stress,
University of California, Los Angeles
Arieh Y. Shalev, Department of Psychiatry, Hadassah University
Hospital, Jerusalem
Neil J. Smelser, Department of Sociology (emeritus), University of
California, Berkeley
Bradley Stein, RAND Health; Department of Child Psychiatry,
University of Southern California, Los Angeles
Although the reviewers listed above have provided many construc-
tive comments and suggestions, they were not asked to endorse the con-
clusions or recommendations nor did they see the final draft of the report
before its release. The review of this report was overseen by Lester N.
Wright, Deputy Commissioner and Chief Medical Officer, New York De-
partment of Correctional Services, and Charles Tilly, Joseph L.
Buttenwieser Professor of Social Science, Columbia University, New York,
NY. Appointed by the National Research Council and Institute of Medi-
cine, they were responsible for making certain that an independent ex-
amination of this report was carried out in accordance with institutional
procedures and that all review comments were carefully considered. Re-
sponsibility for the final content of this report rests entirely with the
authoring committee and the institution.
Acknowledgments
Several individuals and organizations made important contributions
to the study committee’s process and to this report. The committee wishes
to thank these individuals, but recognizes that attempts to identify all and
acknowledge their contributions would require more space than is avail-
able in this brief section.
To begin, the committee would like to thank the external sponsors of
this report. In addition to funding provided by the Institute of Medicine,
funds for the committee’s work were provided by the National Institute
of Mental Health and the Substance Abuse and Mental Heath Services
Administration, U.S. Department of Health and Human Services. The
committee thanks Farris Tuma and Robert DeMartino, who served as the
Task Order Officers on this grant.
The committee would next like to thank consultants Thomas H.
Bornemann, Director of Mental Health Programs, The Carter Center, At-
lanta, GA, and Daniel A. Pollock, Medical Epidemiologist, Centers for Dis-
ease Control and Prevention, Atlanta, GA. These individuals provided
invaluable contributions to the committee’s deliberations. They are not
responsible for the final content of the report.
The committee found the perspectives of many individuals to be
valuable in providing input regarding the psychological responses to ter-
rorism, recognizing vulnerable populations, and identifying gaps in vari-
ous systems of response. Several individuals and organizations provided
important information at an open workshop of the committee. The com-
mittee greatly appreciates opening and sponsor comments provided by
VADM Richard Carmona, Surgeon General, US Public Health Service;
ix