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From November 2001 NASW NEWS Social Workers Heed Call After Attacks
There were many acts of personal sacrifice in the tragedy's wake. By John V. O'Neill, MSW, NEWS Staff Thousands of social workers set aside their routine work and their own needs to respond to the public's dire need for social services and mental health assistance in the terrible days after the Sept. 11 terrorist attacks. Their actions were taken in organizations and institutions like NASW chapters that mobilized to match volunteers with those who needed help, then turned to long-range planning for the years of assistance people will need in the wake of such a massive tragedy. There were personal acts, like those of the social worker Red Cross disaster mental health volunteers who served food and water to the rescue workers at "ground zero" in New York City, while offering encouragement. Or those who sat on the grass with exhausted fire fighters outside the burning Pentagon to extend their thanks and support. There were the traumatized social workers at agencies, some near the World Trade Center, who, though dislocated by the catastrophe, continued to provide services to children and the mentally ill and to plan assistance for the estimated 15,000 children who lost parents. The tragedy brought forth a legion of social workers who wanted to volunteer, said Madelyn Miller, who chairs the NASW New York City Chapter's Disaster Trauma Working Group. "People felt a dramatic, immediate need to help," she said. "Every social worker I've spoken to has been committed to helping on some level, almost as if compelled," said Miller. "It's instinctive almost to want to find a way to respond using our own perspective and skills and conceptualizations." Among the thousands of responses, a few examples follow. Ilia Rivera-Sanchez, a member of a Red Cross disaster mental health team in Alexandria, Va., was on the scene at the Pentagon by 6 p.m. Sept. 11, providing water, food, iced towels and encouragement to fire fighters as they came down from ladders and to military personnel and other rescue workers. Once the fire was extinguished, she worked with military chaplains to help rescue workers as they sought to shore up the building so they could search for victims. One night she was assigned to the morgue, to work with those bringing bodies out of the building. Rivera-Sanchez, a native of Puerto Rico, also did group work with Hispanic workers who had been removing asbestos from a nearby hotel and witnessed the airplane crash, and she translated for military personnel when needed. "We also talked to each other, to debrief and help ourselves," she said.
"We give them basic education to help them understand their symptoms and tell them how they can help their children. Children are affected on many levels." LaDue, whose regular job is as co-director of the National Mass Fatalities Institute in Cedar Rapids, said her function is to work with overwhelmed community agencies until they can regain their equilibrium and help them maintain and continue with delivery systems when the Red Cross is gone. "That is why my social work training in systems is so valuable," she said. At NASW's national office in Washington, D.C., Senior Staff Associate Rita Webb was working with the national headquarters of the American Red Cross to process a request for disaster-trained volunteers to staff a nationwide information and assistance hotline. More than 1,000 social workers were contacted through the association's chapters. NASW's government affairs staff was working with Senate contacts to ensure that all levels of social work were included among disciplines to deliver disaster mental health services resulting from special appropriations after the Sept. 11 attacks. At the 265-year-old Bellevue Hospital, the public hospital closest to New York City's ground zero, more than 4,000 volunteers showed up to help just after the attacks, most of them doctors and nurses, said Pat Blau, head of the 150-person social work department. But it soon became apparent that the need for mental health assistance was going to outweigh needs for physical emergency care. As people rushed from hospital to hospital hoping to find family members alive in the aftermath of the attack, most came to Bellevue. Social workers met them at the front of the building to offer support and comfort, said Blau. A wall for a new ambulatory unit at the hospital had been erected, and people turned it into a shrine, posting pictures of loved ones, prayers and poems and lighting candles. In the hectic, around-the-clock efforts in the first weeks after Sept. 11, hospital social workers and psychiatrists established walk-in support centers, one for staff and one for families of victims, and sent teams to city facilities where lists were being compiled of missing persons. Teams were available to help community agencies that called for assistance. Four retired social work volunteers, along with staff social workers, helped the hospital handle the emotional telephone calls from people searching for family members. Clothing was provided to anybody who needed it, including staff who slept there for several days. "Many people are numb and not ready to deal with what happened," said Blau two weeks after the tragedy. "We need to do more reflecting on the future, the long-term picture."
After Sept. 11, Miller, in conjunction with the New York City Chapter, quickly set four dates in October for additional training at New York University, which she called "basic training" for disaster mental health work. "The trainings will address the significant impact of this disaster on each of us, compounded by the nature of our direct work during this time, and will provide an opportunity for support and sharing," stated program materials. Miller and others spoke of the gravity and scope of the Sept. 11 events. "This trauma has no parameters," she said. "It intrudes on our sense of security and predictability, introducing a sense of uncertainty to all our lives. After the shock and disbelief, people are moving into fear and a very deep sadness for what this means: the city as a safe place is no longer." "We all saw it. We all smelled it. So many heard it. People saw the World Trade Center from their windows in Brooklyn. I don't know a person who isn't having trouble sleeping, with concentration and with memory," said Miller. "At such a time of profound helplessness, when all is out of control to such a degree, the desire and recognition of the need to help is critical to our own healing, or processing of this disaster," she said. Miller, a private practitioner who specializes in trauma, said because it was human-made rather than a natural disaster, the impact will be deeper. "We need to recognize the negative impact on us of living through this trauma, compounded by the nature of the work we do in our offices, hospitals and agencies, whether with our usual clients, or our usual clients and our additional disaster work," said Miller. "We need to create support among ourselves and strengthen our connections and bonds, to balance the work we are doing and know when to step back and take care of ourselves — to sustain our relationships among all our networks of support as a way of taking care of ourselves."
At NASW's New York City Chapter offices at 50 Broadway exactly two weeks after the terrorist acts, Executive Director Robert Schachter reflected on what had been done and the huge challenges ahead, occasionally glancing through the office window, which was gray with soot and filth from the collapse of the World Trade Center just six blocks away. For the first week after Sept. 11, most of the area around the office was like a war zone, with military and police personnel everywhere, and off limits to most people. The air inside the NASW office was too poor to allow entry anyway. Some staff and volunteer members worked from a makeshift office at nearby New York University to return telephone calls left on voice-mail offering to volunteer. By the end of the second week, most of the staff was back in the regular office, although the air still had a foul, acrid odor. The chapter has been busy trying to set priorities, said Schachter. Topping the list were trying to provide members with the information they would need immediately and over time, connecting volunteers with those who needed social work help and trying to decide where to use volunteers in the future. Already the chapter had set up important meetings: four training sessions in disaster mental health for October, and a meeting of the social work community scheduled for Oct. 9 at Hunter College, to better prepare social workers for the work ahead. Among topics for the community meeting were clinical and social service disaster-trauma responses needed across practice settings, the impacts on different communities that need social work services, and how a climate of tolerance can be encouraged. More than 300 volunteers were called more than once in efforts to connect them with those in need. The dilemma lies in where social workers are most needed, said Schachter. Financial organizations in the World Trade Center, where hundreds of lives were lost, have great needs, and many of their managed care plans make little provision for mental health services. But they are somewhat more affluent than social work's typical clients in agencies — the chronically and persistently mentally ill, low-income groups, the working poor and the 35,000 to 40,000 New Yorkers who will reach the end of eligibility for public assistance at the end of the year — who also have tremendous needs. "The number of people to volunteer has really dwindled down, so we have to assess the sustaining power of people who want to volunteer, because there are still great needs out there," said Schachter. "What's the role for NASW moving forward in light of what the resources are and the need is?" Soon the staff will have to begin paying more attention to ongoing commitments, said Schachter. How many staff resources can be devoted to the disaster will depend on funding. "If we could get funding, we might be able to have somebody to coordinate training to agencies and to social workers over a longer period of time to adjust to needs." "It is a fluid situation," said Schachter. "We are figuring it out day to day." In Garden City, N.Y., which lost many of its citizens in the financial offices in the World Trade Center, Estelle Rauch coordinated free walk-in clinics on three days in October where licensed mental health professionals with special expertise in trauma and groups would be available.
"We are mindful to have much more content about crisis intervention, trauma and grief counseling in our curriculum and to have it early in the school year," she said. Back to NASW NEWS Contents
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