| Early
mental-health intervention after exposure to mass violence reduces
psychiatric impact on survivors Early psychological intervention guided by qualified mental-health caregivers can reduce the harmful psychological and emotional effects of exposure to mass violence in survivors, according to a U.S. national conference report released in early September to precede the first anniversary of the September 11th terrorist attacks. The experts involved in formulating the report emphasized that although more research is needed, existing data, including studies of other kinds of traumatic events, as well as clinical experience, provide useful guidance to the mental-health community in responding to mass violence. "School violence, shootings in the workplace, and terrorist acts have increased Americans' exposure to mass violence during the past decade, and psychological interventions are increasingly among the first responses to it. It is vital to the health and well-being of the American people that effective interventions reach the people who need them in a timely and efficient manner," said Elspeth C. Ritchie, M.D., chairperson of the planning committee for the conference. Early intervention is defined as any form of psychological intervention delivered within the first four weeks following mass violence or disasters. Examples of early interventions include brief, focused psychotherapeutic intervention and selected cognitive behavioral approaches. The report says that some interventions -- including mass education via media outlets -- although beneficial, have potential for unintended harm. The report recommends that the leadership select professionals who have the training, expertise, accountability, and responsibility required to provide these interventions. Also, the report cites some evidence that early intervention in the form of a single one-to-one recital of events and discussion of emotions does not consistently reduce risk and may even put some survivors at heightened risk for later developing mental health problems. The report is targeted to professionals who deliver interventions to emotionally distressed persons following mass violence, to those who research these issues, and to officials who must decide what mental health help to include in responses to survivors of mass violence and terrorism. Prepared by 58 mental health researchers and clinicians from the U.S. and five other countries, the report details what is effective, what is not, and what questions require further research. The report provides guidance on screening for mass violence trauma-related mental health problems, on follow-up with trauma-exposed persons, and on the expertise, skills, and training for providers of early intervention services. The report also addresses what is known about timing for various types of early interventions. Participants agreed that it is sensible to expect persons to recover from the trauma of mass violence, although some groups may be more vulnerable, such as those with preexisting mental disorders. They also agreed that most survivors who show no clinically significant symptoms for approximately two months generally do not require follow-up and that participation of survivors in early intervention sessions should be voluntary. The report includes an outline of a sample training program for an early intervention workforce. Recognizing that persons who arrive first at a scene of mass violence may not be trained to provide early mental health interventions, participants recommended that early response personnel be trained to make appropriate referrals when additional expertise is needed. Entitled "Mental Health and Mass Violence:
Evidence-Based Early Psychological Intervention for Victims/Survivors
of Mass Violence. A Workshop to Reach Consensus on Best Practices,"
the report is available on line at |