Overview: Mental Health Services Provided in the Aftermath of an Aviation Disaster

By William Rizzo PsyD

About twenty years ago, the field of mental health began to pay closer attention to the psychological effects of aviation disasters. There arose a consensus within mental health professional groups such as psychologists, social workers, and counselors who provided therapy services (as well as those who conducted research) that there was a substantial need to provide timely and effective support for air disaster survivors and their families, as well as other persons affected by these tragedies.

This article/series of articles will describe some of the attempts made to provide psychological services as they have been documented in the professional literature. While there have been few studies which have sought to measure the effectiveness of these interventions, it may be helpful to bear in mind the developing nature of both theory and practice as they apply to posttraumatic stress and bereavement; two common, even ubiquitous, human reactions after the terrible reality that surrounds the crash of an aircraft.

The crash of United Flight 232 in Iowa on July 19, 1989 saw the initial provision of mental health services through the psychiatric units of the Sioux City hospitals to which survivors were being taken. At nearby Briar Cliff College, a Survivors and Family Services Center was established to try to meet the needs of surviving passengers and family members. This center was staffed in part by faculty and graduate students of the clinical psychology department of the University of South Dakota, who had offered their help to the Sioux City chapter of the American Red Cross. This was soon augmented by professionals representing every psychiatric facility within 60 miles of the airport totaling approximately 300 personnel. Efforts were made to provide for effective coordination of these professionals’ involvement, to ensure that their qualifications and credentials were appropriate to the situation, and to ensure that counseling was available to those wanting it. Counselors and therapists were on hand for one of the most difficult tasks of the response to this disaster, the delivery of formal death notices. Therapists were also placed on shuttle vans traveling between the college and the airport, some of them accompanying families on visits to view the personal effects of loved ones. Counseling services were also made available to airline personnel and rescue workers such as volunteers from the 185th Air National Guard Unit who recovered what they could from the wreckage.

In another example, the Allegheny County Department of Mental Health in Pennsylvania activated its response plan when US Air Flight 427 was lost in 1994. This agency had trained mental health teams sent to Pittsburgh airport, the flight’s destination, to meet families and friends who had been waiting for the flight’s arrival and were instead greeted with news of the disaster. These teams were also sent to local hotels designated to house families traveling to the crash site. As in the Sioux City crash, they were there to support families throughout their stay and even assist them with tasks unrelated to mental health, such as obtaining dental records from physicians. The site itself, where rescue workers performed the extremely difficult duties of recovering passengers and the aircraft, was staffed by Red Cross Disaster Mental Health Services volunteers whose obligation was to support the workers’ emotional states as compassionately as possible. Also, support groups that were run by experienced mental health professionals allowed a large number of families to access some form of treatment.

Mental health professionals also attempt to help child victims of air disasters. One example of this can be taken from the aftermath of Pan Am Flight 759, which crashed in a residential area. A young boy who had witnessed the airplane hit his neighbor’s home and cause extensive damage to his own house soon developed symptoms of post-traumatic stress. Through the process of “play” therapy, he was given a secure environment in which to express his fears through play activities with the therapist. Gradually, over a period of several months, he was able to process his emotional reactions to the crash and eventually returned to a childhood which resembled his life prior to the crash.

In another example, the Nassau County Department of Mental Health saw its own disaster mental health plan activated when Avianca Flight 52 crashed on Long Island after running out of fuel. There were more than twenty child survivors who participated in an art therapy/group program run by local mental health counselors who had experience working with children in therapy. Using projective drawing and storytelling techniques, the counselors helped these children begin to deal with the raw emotions they had experienced as a result of their involvement in the crash. Additionally, this program assisted the counselors in identifying those children needing more intensive services so that appropriate referrals could be made.

All this being said, it would be wrong to assume that the field of mental health has succeeded in providing needed care to those affected by an air disaster. In fact, there have been unfortunate cases in which the help that was offered did more harm than good. However, it does seem clear that there have been several researchers and scores of practitioners who have committed themselves and large portions of their professional careers to doing what they can to help survivors and family members cope with extreme tragedies such as the ones discussed above. The possibility that this burden could be made more tolerable by even a small amount is worth all the dedication that has been given so far and will be given in the future.