House Bill Would Help Americans Build Psychological Resilience

Studies of the health impact of the sarin gas attack in the Tokyo subway system in 1995 and the September 11, 2001, terrorist attacks in the United States suggest that in the event of a future terrorist attack, psychiatric casualties will outnumber physical casualties by 4 to 1.

Yet taking steps to build the public’s psychological resilience has barely been on the public health system’s radar screen and has been overlooked by the Department of Homeland Security in preparing for and responding to terrorist attacks, according to psychiatrist Michael Barnett, M.D., APA’s 2002-03 Daniel X. Freedman Fellow in Rep. Patrick Kennedy’s (D-R.I.) office. Terrorism is defined in the bill as a conventional, biological, chemical, or radiological attack on the United States.

Barnett helped develop the National Resilience Development Act of 2003 (HR 2370), which Kennedy introduced last month in the House of Representatives. The bill would require federal health agencies to coordinate their efforts with the goal of increasing the public’s psychological resilience by integrating effective clinical interventions and educational programs into national terrorism preparedness, response, and recovery efforts.

To facilitate the coordination of federal efforts, the legislation calls for the creation of the Interagency Task Force on National Resilience. The secretary of the Department of Health and Human Services would head the task force, and its members would include the directors of the Centers for Disease Control and Prevention, National Institute of Mental Health, and Office of Public Health Emergency Preparedness; the administrators of the Substance Abuse and Mental Health Services and Health Resources and Services administrations; and the surgeon general of the United States.

“Most of these agencies and the surgeon general have already expressed interest in developing strategies to increase the public’s psychological resilience in the event of a terrorist attack,” Barnett told Psychiatric News.

The task force is also charged with consulting with the departments of Homeland Security, Defense, and Veterans Affairs; the American Red Cross; and national organizations of health care professionals to ensure that public communication strategies and interventions designed to build psychological resilience are integrated into national and local emergency response systems, according to the legislation.

“We recognize that there isn’t a one-size-fits-all strategy to increasing psychological resilience at the local level because of cultural and other variations among local communities,” said Barnett.

The legislation also calls for collaboration between state public health and mental health agencies in developing evidence-based interventions and educational programs to enhance psychological resilience. “The result should be better, more effective delivery of health care in the event of a disaster and more efficient collaboration with the interagency task force,” said Barnett.

To fund these provisions, the bill would require the states to set aside 1 percent of the overall emergency preparedness funds they receive from the Department of Homeland Security to use for implementing efforts to build psychological resilience locally.

Barnett was doubtful that Congress would take up the legislation before next year since there is so little time left on the congressional calendar, and Congress is occupied with other pressing issues, such as a Medicare prescription-drug benefit.

“The bill takes a proactive approach to dealing with the psychological consequences of terrorism,” he said. “We shouldn’t wait until terrorism strikes again because we will be that much further behind.”

The text of the National Resilience Development Act of 2003 can be accessed on the Web at http://thomas.loc.gov by searching on the bill number, HR 2370. ▪