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By Phyllis Hanlon
Shortly before midnight on Feb. 20, the fourth deadliest fire in
U.S. history ripped through a Warwick, R.I. nightclub, claiming
99 lives and injuring 190 people. Within hours of the tragedy, this
tiny state implemented an effective, well-organized disaster plan
that brought a variety of mental health services together to minister
to those affected by the blaze.
A. Kathryn Power, director of Rhode Island's Department of Mental
Health, Retardation & Hospitals (DMHRH), says, "Rhode Island was
one of the first states to have a disaster preponderance plan in
place." It was that sophisticated state of readiness that enabled
a host of mental health care agencies and individuals to spring
into action by staffing hotlines and organizing operations.
In addition to using home state clinicians, Power reached out to
neighboring Massachusetts and Connecticut. Marty Krugman, Ph.D.,
chairman of the Salem State College psychology department and co-chairperson
of the Disaster Response Network (DRN) in Massachusetts, was summoned
at 2 a.m. "With the magnitude of the problem, they needed out-of-state
assistance," he says. "I received a call for help in identifying
psychologists who could respond immediately and in the following
days."
Krugman spent the next day at the Crowne Plaza as part of the "compassionate
presence." He says, "The role of the psychologist was to help families
cope with the crisis and obtain information they needed." He says
that the first day was the most difficult for relatives and friends.
"So many families didn't know if their loved one was alive or dead.
The identification process was unavoidably slow because of the devastation
of fire," he says. "There was a lot of denial, a lot of hope until
the actual notifications when people had to address their grief
directly."
This type of situation calls for a level of care that differs from
the typical counseling session. "The kind of services you offer
at such an event is more psychological first aid versus therapy,"
says James Campbell, Ph.D., counseling center director at the University
of Rhode Island. He emphasizes the need for more specialized education
to effectively deal with this type of complicated situation. "We're
talking about the kind of training necessary to get people ready
to provide those kinds of services as well as to understand the
quite complex logistical things that come into play when these operations
occur. Each one is unique, depending on what has happened."
Tragedies such as this one imprint a lasting mark on victims, their
families, friends and the community-at-large. "Nothing can take
away their pain in this kind of moment but they know that people
care, that people were working really hard to get them the information
that they wanted and needed," Campbell says.
The site visit presented one of the most moving moments for Campbell.
Thoughtfully planned, the trip seemed to draw individuals together.
"Coming back from that site visit, the climate in the place changed
so much. It was more animated. There was still clearly plenty of
sadness, but more a sense of community and more energy. This (visit)
seemed to be a meaningful experience for those who participated,"
he says. Campbell estimates that psychologists, clergy and other
mental health professionals numbered nearly one per family during
the emotional journey to the charred remains of The Station nightclub.
In addition to coordinating services for volunteers, staff and
first responders, Campbell also participated in the debriefing process.
"At the end of every shift, the Red Cross wants everyone to go through
a short debriefing to help them move what they've felt and experienced
into more of a narrative frame mind," he says. "The intensity of
the pain and the scale of the disaster is just so profound. The
horror of fire is so horrific that it deeply affects even experienced
clinicians. No one is immune to that."
The Family Assistance Center out of Kent County Hospital is currently
providing consequential management. "Counselors and clinicians skillful
in helping deal with intense grief and fear and anxiety are seeing
a host of people," Power says.
Within the next six months, Paul Block, Ph.D., secretary of the
Mental Health Association of Rhode Island and co-director of Psychological
Centers, expects to open a community-based outreach facility to
assist those experiencing residual symptoms. He reports that, as
time passes, emotional problems will surface in the schools and
workplaces. "Everyone has some degree of vulnerability," he says.
Those personally affected by the tragedy, as well as those who have
suffered trauma in the past, most likely will require counseling
in the wake of the disaster.
"I am very proud of the state of Rhode Island, specifically the
staff of the behavioral healthcare division," Power says. "They
did masterful work with a deep level of compassion, despite the
terrible tragedy. It will never return to what we were before, but
we're trying."
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