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INTRODUCTION
The bombing of the Alfred P.
Murrah Federal Building in Oklahoma City on
April 19, 1995, killed 168 people including
19 small children. Hundreds more were injured
in the building and in the surrounding neighborhood.
The bombing was both a terrorist act and a major
crime. Media coverage produced powerful images
of trauma, loss, and suffering. For days, nothing
except bomb-related programming aired on the
major broadcasting stations in the area.
ORGANIZATION
Establishing Institutional
Roles
The aftermath of a disaster
is commonly characterized by chaos and confusion.
The Oklahoma City bombing was no different.
The community response was dramatic involving
over 12,000 individuals. Many wanted to contribute
and many felt a need to be involved in the process.
Coordination was essential, especially with
a response of this magnitude. Local, state,
and national professional organizations, public
agencies, volunteer groups, and individuals
emerged as leaders in the response.
One of the first important
individual or institutional tasks in responding
to disasters of such magnitude is to determine
an appropriate role which should be based on
an examination of the individual's or the institution's
relative strengths. Failure to identify an appropriate
role may result in duplication of services,
exhausted personnel, and depleted resources.
In the Oklahoma City bombing,
the Governor aided in the assignment of roles
among state agencies by designating the state
Department of Mental Health and Substance Abuse
Services (DMHSAS) as the agency responsible
for coordinating publicly-funded mental health
services. The bomb-site Compassion Center, established
to provide crisis care, was eventually relocated
and renamed Project Heartland. Project Heartland
remains in operation today, well over one year
later. Staff at Project Heartland provide crisis
intervention, brief treatment, group work, referral,
and outreach. The University of Oklahoma Health
Sciences Center (OUHSC) was charged with responsibility
for overseeing research activities. The two
organizations continue to work closely together,
and with the Oklahoma Department of Health,
another major public agency responsible for
many aspects of the disaster response.
Funding
The Federal Emergency Management
Agency (FEMA) provided an immediate services
grant to the DMHSAS, which was available within
weeks of the bombing. That was followed by a
nine-month regular services grant beginning
November 1995. The DMHSAS utilized many community
providers and institutions by awarding subcontracts
for service to special populations such as children,
the aged, and minority groups. An extension
grant provided new monies and allowed monies
already received to be expended over a longer
period of time. The extension is crucial in
the Oklahoma City disaster because of anticipated
problems associated with the criminal trial.
Referral Mechanism
There is often little time
to develop and organize services following a
disaster. When many individuals are seen for
brief periods by providers with different levels
of training and experience, pathology may go
unrecognized. This is especially important in
disasters like the Oklahoma City bombing because:
the need was so great, most volunteer providers
had little or no experience with disasters of
this magnitude, and the federally-funded program
relied heavily on non-doctoral clinicians and
did not provide for comprehensive evaluation
and intensive treatment. When individuals experience
more serious psychological responses, they may
require referral, making it essential that a
mechanism be established early. The professional
response in Oklahoma City was impressive; many
professionals volunteered their time to treat
bomb-related problems for free or at reduced
rates.
Long Term Care
Long term care must be considered
immediately because federal monies do not cover
those services. In Oklahoma City, funding requests
to address long term need began within weeks
after the disaster. There remains concern, however,
that the funds secured will be inadequate to
meet that need.
CONSULTATION AND TRAINING
Few mental health professionals
have had experiences that would prepare them
for disasters of the magnitude of the Oklahoma
City bombing. Recognizing this, FEMA provided
funding for consultation and for training of
professionals. Consultation by a number of individuals
and organizations has been useful in anticipating
and identifying concerns related to community
needs and in organizing the immediate, short
term, and longer term efforts. In the immediate
aftermath of the bombing, minimal attention
was paid to individual training and experience,
but within weeks, a mechanism for the screening
of professionals was established.
RESEARCH
When the impact of disaster
is as great as in the Oklahoma City bombing,
it is important to assess individuals at risk
for problems due to their emotional and/or physical
proximity to the disaster or to preexisting
conditions. Screening should identify symptomatic
individuals who have not come to professional
attention. Screening should also provide information
useful for planning service delivery, developing
funding requests, and research.
Disaster research is fraught
with concern. Victims may be exploited, even
traumatized or retraumatized, in the research
process and results may not accurately reflect
events that occurred, particularly if people
are subjected to repeated and leading questioning.
Most, if not all, mental health research related
to the bombing has been motivated by clinical
or service delivery needs, with care taken in
the design and timing of our studies. The collection
of data following the bombing was particularly
important because there had not been a disaster
of this magnitude in our country in recent memory.
CONCLUSION
Disaster is rarely anticipated.
It burdens individuals and institutions, forces
people and agencies into new roles and relationships,
alters priorities, and exerts an emotional impact
on rescuers and responders as well as victims
and survivors. An abundance of support poured
into Oklahoma City on April 19, 1995, and the
days that followed. That support came from within
the community, state, and nation. Both the bombing
and the response changed the complexion of our
community, proud of the compassion that emerged
to support the newly vulnerable.
©1996 by
The American Academy of Experts in Traumatic
Stress, Inc.
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