Behavioral Health
3:30 am
Wed June 12, 2013

When Violence Strikes, What About Mental Health?

The last couple years have seen high profile mass shootings and terrorist attacks — Aurora, Newtown, Boston.

Here in Pittsburgh we’ve seen the same. Last year a gunman opened fire at Western Psychiatric Institute and Clinic, killing one person and injuring seven. And in 2009, a man walked into an aerobics class at an L.A. Fitness and started shooting, killing three women and injuring nine.

There are also regular incidents of community and street violence. Last month a gunman injured two women and killed a 15-month-old in the East Hills.

When those incidents occur, police and paramedics respond immediately, and so does a group from the Center for Victims.

"We get there and assist with the victims in terms of supporting them with the police, we help them in that traumatic state in terms of helping them feel safe and secure," said Mary Jo Harwood, who runs the Dialogue and Resolution Center at the Center for Victims.

The Center for Victims uses a model that helps people understand what typical trauma reactions are and what might trigger panic attacks so they can be prepared for the first couple days, weeks and months in recovery.

"That’s the feedback we get with folks if we had not helped them identify those things they would have thought they were going completely crazy, they would have felt like their life was completely shattered," she said. 

Harwood said the emotional response for people who are experiencing a mass event is, at its core, not that different from someone who has experienced an individual act of violence — it just takes on a different feel when many people are experiencing it all at once.

"They can go into isolation in an attempt to protect themselves from it ever happening again," she said. "So when people as a group have all experienced the same thing and you bring them together, they validate each other and they learn from each other in terms of the coping skills that can be helpful in recovering from that traumatic experience."

But in some ways it is different. Jeffrey Magill, project coordinator for behavioral health emergency management at Western Psych, said in the immediate aftermath there is a lot of stabilization that takes place, and while he knows how to do the long-term care, the vulnerability people experience after a shooting or terrorist attack is unlike anything else.

"People are creatures of habit and familiarity, and the more we can begin to put familiarity in an unfamiliar situation and put those pieces back together ... it helps our stabilization and recovery process," he said. 

Magill and a couple dozen others were at a three-day training at the Center for Victims last week where they were taught the ins and outs of responding to a mass-casualty event. 

They covered everything from how to put together the right response team, a child development specialist if children are involved, making sure the team reflects the community, keeping cultural and religious sensitivities in mind and also reminded responders to remember to eat and take care of themselves.

Attendees were from various organizations. Some like Lizzie Anderson, who works at The Carnegie Museum for Natural History, were there on their own accord.

"I think with the world that we live in, the unfortunate fact is that these things keep on happening more and more," she said. "I would like to be prepared for something that might happen in my community, whether its in my specific community or the specific community of Pittsburgh or of this country."

Anderson has worked in domestic violence shelters but has never responded to a mass attack. But some of the attendees like Rhonda Urqhart, from the Center for Victims, has responded to many incidents over the last 17 years. The work can be emotionally difficult, but she said the responders help each other out.

"I always say we are like sponges and we like to wring ourselves out on each other," Urqhart said. "There is pain and sorrow and we also laugh a lot. We use each other very much and we do a very good job of that."

Harwood said they work primarily with victims of violence because the emotional response is different than victims of natural disasters.

"When its at the hand of another human being its so much more difficult for people to get their heads around why would somebody intentionally inflict this pain and horror on me or my family or my loved ones," she said.

She said for victims of violence, the recovery rate is longer because of what is called secondary victimization — dealing with medical issues and watching the aftermath play out in the court or media doesn’t allow people to heal as easily.