1) Past—the past is used as a guide to the future. Past research is used in the article such as from the Vietnam War.
2) Present—PTSD and MMD are explored in detail in areas that have been effected by it.
3) Future-- post-disaster plans and planning to better administer Psychological First Aid (PFA).
With its large amount of citations and a wide variety of sources, we can extrapolate that this research article was made with a good deal of time and care. There are even citations to other works by Galea, but it appears that the only original research done for the article was interviewing responders and patients.
“From the first moments to the last, however, their efforts were plagued by failures of communication, command and control.” This main point is supported in several ways. The police helicopters said that the collapse of the towers was “imminent” a full 20 minutes before the south tower fell and an hour and 29 minutes before the north tower. Most firefighters in the north tower did not even know that the south tower had fallen. Most fighter fighters did not recall ever hearing the dispatch to evacuate the north tower despite multiple broadcasts. The chain of command and orderly response also failed. First responders ignored and disobeyed orders to wait to respond until called upon. Some self-dispatched taking taxis, driving themselves, and hoping on other departments’ rigs. “Discipline Broke Down In Eagerness to Help”. The police commissioner, Bernard B. Kerik, did not even know that there were any serious communication issues between the agencies. Assistant Chief Joseph Callan ordered an evacuation of the north tower at 9:32 am, almost a full hour before it fell, but few ever received this command. These failures resulted in the needless loss of life and a response that could have been far better.
The main focus of the article is mental health issues resulting in the aftermath of a major disaster. Mental health is rarely discussed in these types of environments but persists long after the dust has settled and the houses rebuilt. This article seeks to explore the current state of mental health care in disaster environments.
It has been cited 39 times as of 10/23 according to google scholar, the majority of these being disaster/mental health related articles.
The New York Times conducted over 100 Interviews over 6 months with police officers, firefighters, government workers, and witnesses.
“Those interviews were supplemented by reviews of 1,000 pages of oral histories collected by the Fire Department, 20 hours of police and fire radio transmissions and 4,000 pages of city records, and by creating a database that tracked 2,500 eyewitness reports of sightings of fire companies, individual firefighters and other rescue personnel that morning.”
Dr. Emily Goldmann graduated from the University of Michigan with her PhD in Epidemiology and Columbia University with a Bachelor’s in economics and Chinese. Dr. Goldmann is currently a clinical assistant Professor of Global Public Health at New York University. “I am currently on the faculty of NYU's College of Global Public Health, in the Division of Social Epidemiology. My current research focuses on the intersection between physical and mental health in older adults, specifically trajectories of depressive symptoms following stroke. I also have a strong interest in the characterization, prevention, and treatment of mental illness in low-resource settings globally. I currently teach a master's level course in global mental health and an introductory course in epidemiology to undergraduate students.” (LinkedIn profile)
Dr. Sandro Galea graduated from University of Toronto with his MD, Harvard with a MPH, and Columbia with a DPH. Dr. Galea works as a physician and epidemiologist at Boston University School of Public Health. “In his scholarship, Dr Galea is centrally interested in the social production of health of urban populations, with a focus on the causes of brain disorders, particularly common mood-anxiety disorders and substance abuse. He has long had a particular interest in the consequences of mass trauma and conflict worldwide, including as a result of the September 11 attacks, Hurricane Katrina, conflicts in sub-Saharan Africa, and the American wars in Iraq and Afghanistan. ” (Boston University Biography)
Psychological first aid (PFA) administration is the main focus of the emergency response solution.
PFA has eight main action items to administration:
Contact and engagement, safety and comfort, stabilization, information gathering: current needs and concerns, practical assistance, connection with social supports, information on coping, and linkage with collaborative services. (nctsn.org)
1) “From the first moments to the last, however, their efforts were plagued by failures of communication, command and control.”
2) ''It's a disgrace,'' he said. ''The police are talking to each other. It's a no-brainer: Get us what they're using. We send people to the moon, and you mean to tell me a firefighter can't talk to a guy two floors above him?''
3) “Throughout the crisis, the two largest emergency departments, Police and Fire, barely spoke to coordinate strategy or to share intelligence about building conditions.”
I researched more into why the fire department’s Radios were having difficulties and issues, especially on the higher floors. First, the agency primarily used VHF (very high frequency) radios which are better for long distance when there is line-of-sight form point-to-point with minimal obstructions. UHF operates on a higher frequency and thus transmits with shorter wave-lengths which is better for object penetration. There are many challenges with radio communications in a city like NYC, starting with the sheer fact that to transmit directly from the ground to the top requires going through over a hundred stories of steel and concrete.
The repeaters worked to an extent. We know that they were operational and working, at least partly, as they recorded the relayed transmissions. The police used a separate but almost identical repeater as the fire department with mostly success. The NYFD experienced more issues. I found reports that claimed from fire fighters in the towers that while the transmissions were getting through, they were not understood due to the loud working environment and congested radio traffic.
The Incident Command System was largely ineffective. The only agency that was properly trained in ICS was the fire department which made inter-agency command and control through ICS moot. It was because of the events on 9/11/2001 that resulted in the development of the Nation Incident Management System, by the Department of Homeland Security, which encompasses ICS and more. Federal funding for emergencies now requires that NIMS be used as well as all first responders that respond to hazardous materials incidents be trained in the ICS.