Terrorism and Man-Made Disasters: Coping With This Week’s Trauma

Full Publication

Some individuals are more vulnerable to serious stress reactions and lasting difficulty, including those with a history of:

  • Other traumatic experiences (such as severe accidents, abuse, assault, combat, etc.)
  • Chronic medical or mental illness
  • Chronic poverty, homelessness, unemployment, or discrimination
  • Recent or earlier major life stressors or emotional strain (such as divorce or job loss)

People affected by disasters should try to:

  • Focus on what’s most important to themselves and their families TODAY
  • Try to learn and understand what they and their loved ones are experiencing, to help remember what’s important
  • Understand personally what these experiences mean as a part of their lives, so that they will feel able to go on with their lives and even grow personally
  • Take care of themselves physically, including exercising regularly, eating well, and getting enough sleep, to reduce stress and prevent physical illness
  • Work together with others in their communities to improve conditions, reach out to persons who are marginalized or isolated, and otherwise promote recovery

How would I decide if I need professional help? If after the end of a disaster, these normal experiences do not slowly improve or if they worsen with time, it is helpful to find professional support:

  • Intrusive re-experiencing (terrifying memories, nightmares, or flashbacks)
  • Unsafe attempts to avoid disturbing memories (such as through substance abuse or alcohol)
  • Complete emotional numbing (unable to feel emotion, as if empty)
  • Extended hyperarousal (panic attacks, rage, extreme irritability, intense agitation, exaggerated startle response)
  • Severe anxiety (paralyzing worry, extreme helplessness)
  • Severe depression (loss of energy, interest, self-worth, or motivation)
  • Loss of meaning and hope
  • Sustained anger or rage
  • Dissociation (feeling unreal or outside oneself, as in a dream; having “blank” periods of time one cannot remember)

–International Society for Traumatic Stress Studies (ISTSS)


On The Anniversary of a Brother’s Suicide

Sad woman outdoorsMy brother would be 39 years old if he had not jumped off a bridge two years ago, on 4/20/2011. When I was informed of his death, I went into a dissociative state and thought that I had jumped off the bridge and killed myself. I thought “we” were dead. My friends got me through the next few hours, until I realized what was going on.

My brother suffered from severe depression and survived 37 difficult years. “The rate of suicide in mental health patients is 10 times what it is in the general population, and the main cause of premature death in mental health patients,” Louis Appleby, MD, told reporters attending a news briefing.

Dr. Appleby added that clinicians and other healthcare workers are sometimes “pessimistic” about the mentally ill and view suicide as “an inevitable consequence” of severe mental illness. (See Full Article)

Although mental healthcare workers frequently suffer burnout due to their emotionally taxing jobs, all of the evidence suggests that suicide is PREVENTABLE, not inevitable.

A suicide fact sheet from the National Institute of Mental Health (See Full Article), states that: “For example, because research has shown that mental and substance-abuse disorders are major risk factors for suicide, many programs also focus on treating these disorders as well as addressing suicide risk directly.

Studies showed that a type of psychotherapy called cognitive therapy reduced the rate of repeated suicide attempts by 50 percent during a year of follow-up. A previous suicide attempt is among the strongest predictors of subsequent suicide, and cognitive therapy helps suicide attempters consider alternative actions when thoughts of self-harm arise.

Specific kinds of psychotherapy may be helpful for specific groups of people. For example, a treatment called dialectical behavior therapy reduced suicide attempts by half, compared with other kinds of therapy, in people with borderline personality disorder (a serious disorder of emotion regulation).

The medication clozapine is approved by the Food and Drug Administration for suicide prevention in people with schizophrenia. Other promising medications and psychosocial treatments for suicidal people are being tested.

Since research shows that older adults and women who die by suicide are likely to have seen a primary care provider in the year before death, improving primary-care providers’ ability to recognize and treat risk factors may help prevent suicide among these groups. Improving outreach to men at risk is a major challenge in need of investigation.”

Suicide is one of the main reasons that “People with serious mental illnesses, including schizophrenia, die an average of 25 years younger than the general population.” – National Association of State Mental Health Planning Directors, 2006


Imaging Biomarker Predicts Response to Rapid Antidepressant

A telltale boost of activity at the back of the brain while processing emotional information predicted whether depressed patients would respond to an experimental rapid-acting antidepressant, a National Institutes of Health study has found.

“We have discovered a potential neuroimaging biomarker that may eventually help to personalize treatment selection by revealing brain-based differences between patients,” explained Maura Furey, Ph.D., of NIH’s National Institute of Mental Health (NIMH).

Scopolamine, better known as a treatment for motion sickness, has been under study  since Furey and colleagues discovered its fast-acting antidepressant properties in 2006. Unlike ketamine, scopolamine works through the brain’s acetylcholine chemical messenger system. The NIMH team’s research has demonstrated that by blocking receptors for acetylcholine on neurons, scopolamine can lift depression in many patients within a few days; conventional antidepressants typically take weeks to work. But not all patients respond, spurring interest in a predictive biomarker.


Full Article

On Language and Limits; Missions and Mental Health

In this article, a long-time provider of technical assistance for the National Institute of Corrections discusses how jail leaders can promote a mission-focused discussion of the jail’s role in community mental health. Severson contrasts the specialized roles of jails and the community mental health system and provides a rationale for avoiding “mission creep.”

The jail’s core mission is to provide safe and secure custody of persons who are legally confined. By articulating and advocating for that mission, and its boundaries, jail administrators can contribute greatly to the development of true mental health solutions for their communities.

Severson also suggests several practical actions jail leaders can take now to optimize the delivery of mental health care in their facilities.

By Margaret Severson, J.D. and M.S.W., Professor, School of Social Welfare, the University of Kansas, Lawrence, Kansas

Click Here for Full Article

HUD and HHS Partner to Provide Permanent Housing and Services to Low-Income People With Disabilities

To prevent thousands of people with disabilities from experiencing homelessness or unnecessary institutionalization, the U.S. Department of Housing and Urban Development (HUD) and the U.S. Department of Health and Human Services (HHS) today announced nearly $98 million in funding for 13 state housing agencies for rental assistance to extremely low-income persons with disabilities, many of whom are transitioning out of institutional settings or are at high risk of homelessness.

HUD’s support of these state agencies is made possible through the Section 811 Project Rental Assistance Demonstration Program (PRA Demo) which enables persons with disabilities who earn less than 30 percent of median income to live in integrated mainstream settings.  The state housing agencies are working closely with their state Medicaid and Health and Human Service counterparts to identify, refer, and conduct outreach to persons with disabilities who require long-term services and supports to live independently.

–U.S. Department of Health and Human Services

Full Article

Prevention Efforts Focused on Youth Reduce Prescription Abuse into Adulthood

NIH-funded research shows effectiveness of community-based, substance abuse prevention interventions begun during middle school years. Middle school students from small towns and rural communities who received any of three community-based prevention programs were less likely to abuse prescription medications in late adolescence and young adulthood. The research was funded by the National Institute on Drug Abuse (NIDA), NIAAA, and NIMH.

–National Institues of Health (NIH)

Full Article

Research Points to Early Warning Signs for Schizophrenia

Changes in brain function may foreshadow schizophrenia as early as puberty, nearly a decade before most patients begin showing obvious symptoms, new research from the University of North Carolina shows.

Researchers in Chapel Hill looked at brain scans of 42 children, some as young as 9, who had close relatives with schizophrenia. They saw that many of the children already had areas of the brain that were “hyper-activated” in response to emotional stimulation and tasks that required decision-making, said Aysenil Belger, associate professor of psychiatry at the UNC School of Medicine and lead author of the study.

“These children are trying extra hard to do something that other children are able to do without so much effort,” Belger said.

Belger said her team’s findings could help establish an earlier diagnosis of the brain disease and ultimately point to techniques for offsetting or minimizing disease progression.

By Renee Elder, News Observer

Full Article

NIH Study Finds Missed Opportunities for Underage Alcohol Screening

Physicians often fail to ask high school-aged patients about alcohol use and to advise young people to reduce or stop drinking, according to a study led by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). In a random survey of more than 2,500 10th grade students with an average age of 16 years, researchers from NIAAA and the Eunice Kennedy Shriver National Institute of Child Health and Human Development found that 34 percent reported drinking alcohol in the past month. Twenty-six percent said they had binged, defined as five or more drinks per occasion for males, and four or more for females. While more than 80 percent of 10th graders said they had seen a doctor in the past year, just 54 percent of them were asked about drinking, and 40 percent were advised about alcohol harms. In addition, among students who had been seen by a doctor in the past year and who reported drinking in the past month, only 23 percent said they were advised to reduce or stop drinking.

–National Institutes of Health (NIH)

Full Article

Smoking Among U.S. Adults with Mental Illness 70 Percent Higher Than for Adults With No Mental Illness

Studies show need for enhanced prevention and quitting efforts for people with mental illness

The report finds that 36 percent of adults with a mental illness are cigarette smokers, compared with only 21 percent of adults who do not have a mental illness. According to the report, nearly 1 in 5 adults in the United States – about 45.7 million Americans—have some type of mental illness. Among adults with mental illness, smoking prevalence is especially high among younger adults, American Indians and Alaska Natives, those living below the poverty line, and those with lower levels of education. Differences also exist across states, with prevalence ranging from 18.2 percent in Utah to 48.7 percent in West Virginia.

–Centers for Disease Control (CDC)

Full Article

Sebelius: Bring Mental Illness out of the Shadows

Fifty years ago Tuesday, President John Kennedy shattered the national silence when he delivered a message to Congress in which he called for a bold new community-based approach to mental illness that emphasized prevention, treatment, education and recovery.

In the half century since, we’ve made tremendous progress as a country when it comes to attitudes about mental health. But recent events have reminded us that we still have a long way to go to bring mental health fully out of the shadows.

The vast majority of Americans with a mental health condition are not violent. In fact, just 3% to 5% of violent crimes are committed by individuals who suffer from a serious mental illness.

But we know that some instances of mental illness can develop into crisis situations if left untreated, and those crises can lead to violence. More often than not, those with mental health conditions direct these violent acts at themselves. Tragically, there are more than 38,000 suicides in America each year, more than twice the number of homicides.

by Kathleen Sebelius, USA Today

Full Article