An EMS professional understands that the job comes with a high level of danger. Domestic violence, combative patients, the aftermath of an accident or a violent crime are confronted daily. The knowledge that every single day on the job will bring trauma and violence takes a toll on personal health, and death can come in the line of duty. In fact, between 1995 and September 10, 2001, there were three line-of-duty deaths of New York City EMS personnel.
Since the terrorist attack of September 11, 2001 another level of danger has been added which has had a dramatic effect on many who were involved with the tragedy. First, eight EMS personnel died during the collapse of the World Trade Center -- five more deaths than during the preceding five years combined. Following the disaster, EMS personnel were heavily involved in the search effort, spending day after day sifting through debris and body parts, hoping to find their friends but instead often finding only bodies, guilt, and disillusionment.
The job they did at Ground Zero was Herculean, and it inspired people throughout the world. Their sacrifice was so great - so visibly painful - that the rest of us were able only look to them with awe. We built mountains of flowers on the sidewalks, lit thousands of candles, and hugged them while we told them of our gratitude. They were our heroes.
In the face of such a monumental tragedy, many of these workers bravely swallowed their grief and ignored any signs of stress while they continued to perform their daily work routine. After all, a hero can’t allow feelings of anger. A hero doesn’t cry. A hero bravely tries to stay on his pedestal while the sadness just deepens and the pain grows worse. When someone asks how he’s doing, the hero knows it’s his job to say, “Me? I’m fine.”
“Hero” is a heavy title. Regardless of what he says, he knows he’s not “fine.” But protecting one’s public image is critical to job success, so there’s fear of searching for help. Limited counseling is available to emergency service and uniformed personnel, but these well-meant efforts are often viewed with suspicion by the very people they’re designed to help. If he attempts to discuss feelings related to his job, our hero worries, isn’t he just opening himself up to questions about his job performance, inviting potential impact on his career over the long term?
So, fear makes counseling unthinkable to those who may need it most. The cost of this reticence to ask for help is extremely high. In the first year after September 11, 2001, eight suicides were recorded among emergency and uniformed personnel – an increase of 1002% over the typical year. In the last several months of 2002, the rate continued to escalate, with a staggering suicide or attempted suicide being reported every six to eight weeks (before September 11, suicides or attempts at suicide were recorded every six or eight months).
The scope of the problem is just beginning to be calculated. In January of 2003, a study by the Mt. Sinai Medical Screening Program was released. The study, which analyzed the physiological and psychological impact of working at the WTC site, found that nearly 40 percent of those Ground Zero workers examined had ear/nose/throat problems or other physical symptoms. Fifty-seven percent had pulmonary problems, and 52 percent had symptoms of mental health problems. Roughly 20 percent showed signs of post-traumatic stress disorder.
Nearly 30,000 people worked at Ground Zero. The need to make mental health care available to these heroes is becoming increasingly necessary and, in many cases, vital to their survival. However, in order to be effective, it must be offered in an environment that is safe and non-judgmental.
It is against this backdrop that the idea for a respite center for uniformed personnel was first conceived by two emergency medical professionals, CRMS Chief Rosendo Velez and George W. Contreras, Director-Health Research Training Program and Coordinator, Emergency Preparedness for the NYC Department of Health and Mental Hygiene’s Bureau of Public Health Training. These dedicated men who lost scores of friends in the attack were at the site until all clean-up efforts were complete. It has become increasingly important to Velez and Contreras that they create a safe environment for healing for all those who had been involved in the tragedy – a place called the Emergency Services Respite Center.