Many of our patients and staff have been deeply affected by this week’s tragic events. The first thing to remember is that we have a common bond with our patients, because we are all affected in one way or another. These few recommendations for dealing with the emotional and physical aftermath of 4/15 in our clinical practice may be helpful to you.
1. In the few days ahead, ask your patients if they have been traumatized by the events. Let them talk and tell you in what way and how they have been coping with the situation. This will give you an opportunity to see if this tragedy is seriously affecting them, bringing back old memories and losses such as 9/11; making their medical problems worse; and/or exacerbating an existing mental health problem (e.g. anxiety, PTSD, depression).
2. Check to see if your patients are having sleep disturbances, especially nightmares. You may want to provide reassurance – see item 4.
3. In all disasters, make sure people feel safe, secure, and know where all their family members are located and if they are OK.
4. Reassure the patients that it is completely normal to have some symptoms of PTSD, such as nightmares, poor sleep, ruminating on the events, worries about their safety, and depressive symptoms such as sadness, despair, and discouragement about the world situation. For the great majority, these symptoms will resolve relatively soon.
5. Recommend to patients the 3 major social instruments of coping: altruism (i.e. helping others), work (or school studies); and spirituality. Do not be afraid or worry you’ll offend the patients by speaking to them openly about their spiritual beliefs and practices.
6. Make sure their kids and teens are OK. Encourage them to check in with their children. It is helpful to turn off the TV news, which is revisiting all the gruesome details of the tragedy over and over again. Stimulating high emotional arousal in young children from TV images of violence is never a good situation. Young children may think the events are recurring, leading to a lot of fear and anxiety.
7. Empathic and sensitive listening is your best therapy. Only a small percentage of patients will need medication or a mental health referral.
8. Most importantly, show solidarity with your patients. This is a situation when the health care practitioner and the patient have shared a tragic and disturbing event. You can express your solidarity with the patient; the patient will really appreciate it.
9. Practice your own self-care since you’ll be experiencing a lot of distress and will need a way of dealing with this yourself.
10. Peer supervision is highly recommended. At periodic meetings with your fellow healthcare professionals (which are not group therapy), discuss those cases related to the tragedy that are bothering you. In this way you can receive and give support to your colleagues. Peer supervision is one of the best things you can do to enhance staff morale and group self-care.
For more information on supporting our patients during this recovery phase, the following website may be helpful.
Psychological First Aid: Field Operations Guide. Agency for Healthcare Research and Quality http://www.innovations.ahrq.gov/content.aspx?id=117
The Harvard Program in Refugee Trauma (HPRT) and its international faculty sends its condolences to the families and community of Sandy Hook Elementary School and Newtown, CT. This tragedy affected all of us who have worked with survivors of extreme violence over the past 3 decades. We remain committed to serving our society at the time of crisis and are concerned for the mental health of affected families and first-responders six months down the road when natural attention has faded. At this time, HPRT can be called upon if necessary, to lend support.
Parents and other family members will struggle with what to tell their children/siblings regarding the horrific shooting event in Newtown, CT. The shooting was a horrible event.
Being together with other people at a time like this is an important source of support. Relying upon ones religious faith and participating in the life of that faith community by worshipping and praying together and reflecting upon the sacred writings of that tradition can bring immediate and over time long lasting relief of some of the emotional pain caused by trauma.
Frederick J Streets, former Chaplain of Yale University, is a member of the faculty at Yale Divinity School, a clinical social worker and Acting Pastor of the Dixwel Avenune Congregational Church, New Haven, CT.
Greetings. It has been a joy to work with all of you over the past 6 years. We now have an incredible group of 320 alumni working in 80 countries.
Our vision at HPRT from day one has been to help create, with your assistance, a global Community of Practice that can be a Community of Influence.
Well it is my honor to inform you today that we have arrived.
A new alumni blog/newsletter is ready to go.
A new global society is on its way.
You will be hearing from our alumnus Paul McEnroe who is Editor-in-Chief and a distinguished journalist. Our faculty member Dr. Paula Madrid from Columbia will be Deputy Editor. The new alumni blog/newsletter has been designed to be interactive, informative, scientifically and culturally useful. All alumni will have an equal opportunity to contribute information as well as lead discussion groups.
Paul and Paula will follow up this e-mail in the next few days with all the information on signing up and participating in this new adventure.
Best to all.
The Harvard-Japanese Team that was assembled during the 1995 Kobe earthquake (see on this website Tokyo Guidelines) has been invited by the Japanese Government to contribute to the mental health relief of the survivors of the recent earthquake, tsunami and radiation exposure.
October 14, 2010
On October 14th, 2010 Professor Richard F. Mollica was presented with the Kun-Po Soo Award by the American Psychiatric Association which recognizes an individual who has made significant contributions to understanding the impact of Asian cultural heritage in areas related to psychiatry. During the award ceremony Dr. Mollica presented a video lecture called Songs of Three Worlds: The Contributions of Asian Culture and Society to Global Mental Health. This lecture honored the thousands of Asian patients his group at Harvard has cared for over the past 30 years and their contribution to new scientific knowledge and the cultural understanding of traumatic life experiences.
September 24-25 2010
On April 6, 2009 a massive earthquake devastated and destroyed the beautiful medieval town of L’Aquila and its local environment in the Abruzzo region of Central Italy. Over 300 people died, thousands were injured and more than 60,000 residents left homeless. The Basilica of Saint Bernadino of Siena was destroyed. The whole dome of the 18th century church of Anime Sante in Piazza Duomo fell down. Unfortunately, almost all of the surgeries of the more than 100 general practitioners (GPs) serving area were also destroyed.
HPRT through the generous support of the U.S. Embassy, Rome, Caritas, and the National Italian American Foundation (NIAF), launched a major effort through its Harvard-Italian team to (1.) review the existing scientific literature on disasters and mental health in modern Italy; (2.) develop an Italian version toolkit for the detection and treatment of patients severely affected by the disaster in primary health care; (3.) establish a supervision linkage between the local medical school and Italian General Practitioners (GPs); (4.) train the GPs in areas (1.) to (3.).
The toolkits and training of the local L’Aquila GPs by the Harvard –Italian Team and the L’Aquila Medical School Department of Psychiatry occurred on September 24th and 25th, 2010
This work called the “Abruzzo Model” for trauma and recover is the first attempt at training GPs in Italy post-disaster using a science and culture-based toolkit. This effort has been recognized by members of the Italian Parliament as a major contribution to disaster relief policy in Italy and stands ready to be applied in new crisis.
In December 2004 HPRT with the support of: The World Bank, U.S. Fulbright New Century Scholar Program, The Karolinska Institutet, the Italian Ministry of Health and Foreign Affairs, Instituto Superiore di Sanita (Rome), and Caritas Roma, assembled for the first time the Ministers of Health from the world’s conflict/post-conflict countries. This historic meeting lead to the GMH Certificate Training Program, Book of Best Practices and the World’s first Global Mental Health Action Plan.