man playing guitar with granddaughter

After San Bernardino: psychological trauma and recovery

December 08, 2015 | Patricia Harriman
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A couple embraces following a shooting that killed 14 people at a social services facility last week in San Bernardino. Photo: David Bauman/The Press-Enterprise/AP

When disasters, such as the San Bernardino mass shooting occur, survivors are not only at risk for physical injuries, but can also experience lasting emotional and psychological consequences.

Healthcare providers face the challenge of identifying individuals with psychological injuries and providing timely treatment that may prevent post-traumatic stress disorder, depression and anxiety.

UCI Health trauma/disaster psychology expert Merritt D. Schreiber, PhD, says this challenge is most effectively met when an agency like the American Red Cross, hospitals, clinics, first responders or local public health department conduct a needs assessment to identify those who are most at risk for developing psychological issues after the immediate event.

Determining level of risk

Schreiber has developed a system called PsySTART used by the Red Cross and agencies across the country to triage the mental health of disaster survivors.

PsySTART involves learning from survivors about their experiences during the disaster in order to determine their level of risk from exposure to traumatic events. Greater levels of exposure to trauma usually correspond to a higher risk for developing mental health issues and need for timely care.

“Being upset after a disaster does not mean you are at risk, it’s more about what you experienced. We want to know these things: what happened to them, what happened to their loved ones, and what did they see,” Schreiber said. This process replaces assumptions about what survivors may be feeling with a clear understanding of what each individual actually experienced, he said.

“If we can reach high-risk adults and children within the first two to three weeks following the disaster, we can direct them to the appropriate services and level of care they need in order to help them avoid the onset of PTSD, depression and anxiety,” Schreiber said.

Resilience is vital to recovery

Though the Inland Regional Center in San Bernardino was ground zero for the mass shooting, the shooting’s effect spread far beyond that location. People not involved in the original attack may have been affected by the subsequent police pursuit, shoot-out and nearby search activities.

San Bernardino survivors were exposed to trauma levels ranging from being shot to losing family members and friends to being fearful for their lives and the safety of their loved ones. There is also concern about the responders and their families.

“In addition to immediately assessing the population’s mental health and emotional stability, it is also important for local leaders and public health officials to establish follow-up care initiatives that help build resilience,” Schreiber said.

“Resilience is vital to recovery. As a community, members know that if another disaster strikes, they will have access to the help and support they need.”

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