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This week marks the 20th anniversary of the deadliest terrorist attacks on US soil. On 11th September 2001, terrorists hijacked a series of planes and flew them into the Twin Towers in New York and into the Pentagon. A further plane crashed in Pennsylvania after passengers attempted to wrest back control from the hijackers.
Almost 3,000 people were killed. The first responders on the scene in New York – mostly police and firefighters – suffered greatly as the Twin Towers collapsed, killing more than 400 of their members.
Each anniversary since that day has brought extensive media coverage, with news broadcasts replaying images of the moments of impact, the collapse of the Twin Towers and the smoking ruins of the crash sites. Major anniversaries, such as this 20th anniversary, see even greater media saturation.
Tim Peck, Senior Specialist Police and Emergency Services, Phoenix Australia, has a policing background stretching back for more than 20 years. He says that while there is still progress to be made, the two decades since 9/11 have seen significant improvements in the recognition and treatment of trauma for first responders.
This includes the recognition that anniversaries can bring thoughts and feelings surrounding a traumatic incident flooding back.
“Anniversaries take you back to the day – your senses come alive to where you were on the day it happened. You think you have moved past it and then it’s like you are there again,” says Tim.
“It’s important for clinicians to be mindful that, for their clients, anniversaries might bring back thoughts and feelings from a specific incident – even if it was years ago. They can help prepare a client to understand that an anniversary might be a stressful time and challenging feelings and difficult thoughts may come up, so it’s important to do the little things we need to do look after their mental health every day, particularly if we know it will be challenging.
“When it comes to the strategy the member employs, they are often in the best position to know what works for them when this anniversary hurdle comes along. It doesn’t have to mean people are going to fall into a mental health spiral. Understanding that it is normal to have feelings that remind you of the day, that is part of the trauma process, and that’s OK as long as they are aware of the need to be really proactive with their health during these periods.”
Since 9/11, the effects of traumatic events on first responders have been more widely acknowledged.
“At the time of an event like 9/11, first responders who attend the scene are in professional mode. They are embedded in their role and that is a protective factor which may push the trauma to the background for a period of time” says Tim.
“But first responders are human and the impacts of trauma present in many forms. Lethargy, lack of sleep, not wanting to talk, continually ruminating about what you saw and heard is normal in the days and weeks following a traumatic incident. Being able to identify a normal response to trauma as opposed to a condition that develops from traumatic exposure is a key to identifying when further assistance is required.
“The longer-term effects happen when people don’t get time to process what happened and move on to the next event. This can lead to escaping with alcohol or drugs, increased anxiety and a sense that everyone else is fine so there must be something wrong with you.”
Connecting first responders to services and clinicians with an understanding of the nature of their work and who provide evidence-based treatment as soon as possible is key. TPAV and Phoenix Australia has launched BlueHub to provide specialised mental health services to members of Victoria Police.
“Awareness around mental health injuries is far more advanced than 20 years ago. Then there was a ‘suck it up and keep going’ attitude. Now there is more acceptance that mental health can have an impact but there is still some stigma around coming forward and seeking help for mental health injury,” says Tim.
“Early access to evidence-based treatments provides better outcomes so we want to identify members and have them attend treatment earlier.”
A suite of resources is now available to support first responders and their mental health including chaplaincy, peer support, inhouse psychology, Employee Assistance Programs and access to clinicians with experience in dealing with emergency services workers.
Clinicians who are part of the BlueHub network complete a cultural competency course to gain a deeper understanding of what policing work is like and how what they witness can impact the mental health of police officers.
“You don’t have to have worked in emergency services to be a good clinician, but having an understanding of the background and some of the issues for members helps the therapeutic process. It ensures the clinician and client are on the same page,” says Tim.