title: A mental health program for ground zero rescue and recovery workers: cases and observations.
abstract: Clinical vignettes from the World Trade Center Worker and Volunteer Mental Health Monitoring and Treatment Program at the Mount Sinai Medical Center in New York City are presented. The hospital-based program pairs mental health screenings with federally funded occupational medical screenings to identify persons with mental health problems related to their rescue and recovery roles. The program also provides on-site mental health treatment. The cases illustrate the diverse mental health needs of the rescue and recovery workers, some of whom initially sought treatment years after September 11, 2001. The cases show that in addition to symptoms of posttraumatic stress disorder, workers experienced survivor guilt, distressing memories of childhood trauma, shame associated with intense feelings, substance abuse relapse, psychosis, and problems with family relationships.
authors.affiliation: Mount Sinai Department of Social Work, New York City, USA. craiglkatz@gmail.com
authors.forename: Craig L
authors.initials: CL
authors.lastname: Katz
authors.forename: Rebecca
authors.initials: R
authors.lastname: Smith
authors.forename: Marsha
authors.initials: M
authors.lastname: Silverton
authors.forename: Anastasia
authors.initials: A
authors.lastname: Holmes
authors.forename: Carlos
authors.initials: C
authors.lastname: Bravo
authors.forename: Kristina
authors.initials: K
authors.lastname: Jones
authors.forename: Marta
authors.initials: M
authors.lastname: Kiliman
authors.forename: Norma
authors.initials: N
authors.lastname: Lopez
authors.forename: Laurie
authors.initials: L
authors.lastname: Malkoff
authors.forename: Kathryn
authors.initials: K
authors.lastname: Marrone
authors.forename: Alla
authors.initials: A
authors.lastname: Neuman
authors.forename: Tricia
authors.initials: T
authors.lastname: Stephens
authors.forename: Wendy
authors.initials: W
authors.lastname: Tavarez
authors.forename: Anne
authors.initials: A
authors.lastname: Yarowsky
authors.forename: Stephen
authors.initials: S
authors.lastname: Levin
authors.forename: Robin
authors.initials: R
authors.lastname: Herbert
mesh_terms: D000328:Adult; D003156:Community Mental Health Services / Q000706:statistics & numerical data; D015897:Comorbidity; D003419:Crisis Intervention / Q000706:statistics & numerical data; D005195:Family Relations; D005260:Female; D005500:Follow-Up Studies; D006167:Guilt; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D008016:Life Change Events; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D011939:Mental Recall; D008875:Middle Aged; D009519:New York City; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D018635:Rescue Work / Q000706:statistics & numerical data; D047851:September 11 Terrorist Attacks / Q000523:psychology* / Q000706:statistics & numerical data; D012752:Shame; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D013534:Survival / Q000523:psychology