Englewood Cliffs, NJ

Sunday, November 08, 2009

ENGLEWOOD CLIFFS, NJ: The fatal shootings at Ft. Hood, TX by a psychiatrist who was charged to counsel soldiers going to or returning from a war zone has not only shocked the nation, it has opened up questions of failure to report. The talk shows have been rife with talking heads and apologists for "why" or "it's not a fault of the system."  Who's right here?

The question of helping the helpers has been dealt with in both the medical literature and the mental health community for more than the past 30 years as the AIDS onslaught hit healers. It was discovered that the helpers needed help and, if this was not recognized before it became an apparent problem, the results could be tragic. How many of these helpers or first responders ended up committing suicide? The numbers are not readily available, but we know that even those who did not hurt themselves via suicide, may have hurt themselves in other ways, particularly alcohol or drug addiction. The feeling now is that this should never have been unrecognized. How can we expect these people to be above human emotion? How can we expect them to handle things that we know are incredibly difficult for the "man on the street" as it were?  They are just as human and frail as anyone among us.

The shooting on the Army base in Texas may not have been as unforeseeable as it would appear, if we can believe bits and pieces of information coming out. Putting the pieces together, however, may have been a problem because the behaviors were not in one place, before one set of supervisors. There were apparently problems in prior medical placements where evaluations were problematic.

Can medical personnel, such as psychiatrists, suffer from PTSD themselves? Post Traumatic Stress Disorder knows no boundaries and anyone who is touched by trauma, whether by actual combat situations, hearing of them, or video, can experience the disorder. We know that now and it is, in my opinion, to be expected in medical personnel helping these soldiers. How this is done is quite simple; supervision. It is in supervision situations where the helpers themselves are helped to cope with this unbelievable burden. The supervisors look for signs of burnout, e.g., feelings of helplessness, changes in mood, irritability and, perhaps, an unwillingness to continue in their jobs. Burnout is a serious, pervasive and treatable condition that requires prompt attention.

The public, unfortunately, may have been led to believe that psychiatrists are somehow immune from burnout or PTSD. Certainly anyone who must deal day in and day out with the tragedy of war, with the emotional and physical wounds of war is in a prime position to be a victim themselves. They are not immune and if they or anyone supervising them think they are, this is a major problem that requires immediate redress. Certainly, the armed forces have recognized the enormity of the PTSD problem in service personnel, but there may have been a failure to recognize it in their medical personnel.

Not only psychiatrists are at risk here. Anyone who deals with or counsels trauma victims is at risk and, for that reason, many health professionals take "mental health days" to help them decompress and get some distance from the trauma. How many mental health days do the armed forces personnel take or get? I have had army personnel relate to me that they are reluctant to indicate their mental health problems because of a fear that it will damage their career. Is this a pervasive believe in the military, especially among medical personnel? It needs to be examined, too.

Rather than look for scapegoats, the course of action now must be to review procedures, retrain supervisors and put a more adequate system of checks in place before any more soldiers or physicians are placed in harm's way.

http://www.drfarrell.net

Patricia A. Farrell, Ph.D.

Licensed Psychologist

Patricia A. Farrell, Ph.D., LLC

Englewood Cliffs, NJ

201-944-3509