Airline Crash Elicits Fast Psychiatric Response

When Judy Linger, M.D., a child and adolescent psychiatrist employed at Indian River Hospital in Vero Beach, Fla., got the call from Disaster Psychiatry Outreach (DPO) in New York City last month to volunteer at the Family Resource Center at Pier 94, she immediately said yes.

Linger told Psychiatric News that she had been waiting since September 11 for DPO to contact her to assist the relatives of those who lost their lives in the terrorist attacks. “I felt I was supposed to be there, so when they asked me to start as the clinical director the week of Monday, November 12, I quickly made arrangements to come up.

Less than than 30 minutes into her orientation Monday morning, however, she and the other volunteers at Pier 94 heard the news that American Airlines Flight 587 had crashed in a Queens neighborhood, killing everyone on board.

When the news broke about the airplane crash, DPO was asked immediately by the New York City Department of Mental Health to send psychiatrists to the Ramada Plaza Hotel, which is near John F. Kennedy Airport, to assist the relatives, according to DPO Medical Director Anthony Ng, M.D. This was the fourth time in five years that the hotel had been turned into a crisis assistance center. It served the same role after TWA, Swissair, and Egypt Air airplanes crashed in or near the Atlantic after take-off from JFK Airport.

Ng called Linger at about 10 a.m. to alert her that she and the other psychiatrists at Pier 94 might be needed at the Ramada. About 15 minutes later, Ng confirmed that she and the other volunteers should report to the Ramada.

Linger said she found three psychiatrists at Pier 94, including two who spoke Spanish, who were willing to go with her to the Ramada. Spanish was the native language of most of the passengers, who had moved from the Dominican Republic in the Caribbean to the upper Manhattan community of Washington Heights.

In addition to deploying volunteers to the Ramada, Ng and DPO President Craig Katz, M.D., advised the American Red Cross, American Airlines, and the state Office of Emergency Management about logistical matters related to mental health. “We told them that the relatives of the victims needed to grieve the loss of their loved ones in private. We recommended they use several separate rooms instead of a large ballroom for that purpose,” said Ng.

DPO also advised the Red Cross about cultural norms including how the Dominicans express grief.

“They tend to react to a tragic loss by openly wailing, screaming, and becoming agitated. This is considered a normal grief response and doesn’t require medication or hospitalization,” said Ng.

However, a small number of relatives became extremely distraught and required hospitalization, said Seeth Vivek, M.D. chair of the department of psychiatry at Jamaica Hospital Medical Center. He is also the Area 2 Assembly Representative and past president of the Queens County District Branch.

Jamaica Hospital in Jamaica, N.Y., is the nearest hospital to JFK Airport, and its two mobile emergency vans have responded to previous airline disasters, Vivek told Psychiatric News.

Ng added that another team of psychiatrists and mental health professionals came to the Ramada from Mary Immaculate Hospital in Jamaica, which is affiliated with St. Vincent Medical Centers.

Five psychiatrists were on the Jamaica Hospital team, including Vivek and Queens County District Branch President Dinshaw Bamji, M.D., said Vivek.

“I heard many heart-wrenching stories. Some relatives had just dropped off family members at the airport and were driving home when they heard on the radio that the plane had crashed, and [they] turned back. At the Ramada, some relatives were so overcome with grief they banged their heads against the wall or tried to injure themselves,” said Vivek.

“We transferred six people to our hospital’s emergency psychiatric unit for further evaluation and treatment, including a man who became suicidal after seeing off his pregnant wife and children at the airport,” said Vivek.

DPO volunteers including Linger continued to assist relatives of the deceased at the Jacob Javits Convention Center in Manhattan on Tuesday, November 13. The Red Cross moved its operations there because of its proximity to Washington Heights, said Ng.

Linger said she did not speak Spanish but through a Spanish-speaking child psychiatry resident was able to communicate to the relatives on Tuesday. Her role Monday was monitoring requests from mental health workers for medications supplied by DPO.

“I talked to a few children who had lost a parent aboard the doomed flight. But, I spent more time talking to the surviving parents who had requested assistance for their children and were understandably having difficulty dealing with their loss,” said Linger.

She said she was impressed with DPO’s collaboration with federal and local agencies. “Because these relationships are in place, they can mobilize quickly.” She would like to set up a similar organization in the southeast.

DPO needs volunteers willing to assist with future disasters. Information about volunteering, the mission of DPO, and resources on disasters are available at the Disaster Psychiatry Outreach Web site at www.disaster-psychiatry.org. ▪