When trauma lingers after a disaster, crisis counselors come to the aid of local survivors.
A bombing in Boston, a massacre in Vegas, a hurricane in Louisiana, and 9/11.
Within the 24/7 news cycle, a tragedy makes headlines and seems to "one-up" its predecessors—each shooting or weather disaster claiming more lives than the last. The death toll runs across the ticker for 12 hours before the next evening’s story features, eventually fading away from public memory.
Then there are those who don’t forget.
Dr. April Naturale has traveled the country over the past 30 years, embedding herself in the communities of some of the worst tragedies in American history. She calls on her clinical experience in extreme traumatic situations to assist the countless survivors who don’t show up in the mortality statistics. Nonetheless, they suffer from the unquantifiable mental distress that follows—horror that disturbs us with the how? but rarely provides the why?
That’s one of the questions facing survivors of the Las Vegas Rte. 91 Harvest Festival massacre, which took 58 lives and wounded 489 last fall.
“What we see after natural disasters is that people accept that these things happen and most will move forward in good time,” Naturale says. “But the difficulty with a human-caused violent event is that it prolongs the recovery process. It is much harder to understand and accept.”
Naturale brings experience in both arenas to Las Vegas, where she’s helping communities in Nevada and California cope with the deadliest mass shooting in modern history. As she determines the survivors’ psychological needs, she calls upon precedence from her work in the field in almost every state and several countries where she has assisted with operations management and training, public communications, crisis counseling, and troubleshooting.
Unlike the firefighters, EMTs, and utility crews on the front lines of these disasters, Dr. Naturale is not what most people would consider a first responder. Her work is more closely associated with the externalities of trauma that has a lasting effect on communities post-tragedy.
At ICF, she's part of a larger disaster response team, which helps states and localities implement full-scale recovery plans, preparedness initiatives, and resilience solutions. Most of the specialists work under the pressure of efficient turnaround management: how quickly can you assemble call centers? How many families are included in your underwriting? What technical assistance do grant applicants need?
In the aftermath of 9/11, Dr. Naturale directed Project Liberty, the FEMA-funded mental health response to the World Trade Center disaster—the largest crisis counseling assistance and training program awarded in the program's history. The program provided public educational and crisis counseling services to tens of thousands of New Yorkers in its initial months of operation and eventually reached 1.2 million. During this time, she and her team of 4,800 crisis workers saw people whose reactions varied on the spectrum of severity from acute traumatic stress to full on posttraumatic stress disorder.
“We worked with family members who were in shock,” Naturale said. “Their ability to even being the grieving process was prolonged as they held out hope that they would find a hospital somewhere with their family member still alive.”
Then came Hurricanes Katrina, Rita, Wilma, and later on, Ike. Naturale has been to each scene affected by the natural devastation of storm season: entire coastlines in Alabama and Mississippi wiped out, with only slabs remaining where houses once stood.
Texas took in thousands as evacuees with open arms and thirty three other states helped settle survivors willing to start anew across the country. ICF’s teams of crisis counselors helped in many different ways from handing out sandwiches while letting people talk about what happened to organizing children’s activities in the FEMA camps.
Naturale’s team spent the Thanksgiving holiday aboard a cruise ship docked along the coast of Mississippi (which housed over a thousand displaced evacuee families) and provided resource assistance as survivors considered their next steps towards resuming normal life.
Between the man-made tragedies and the natural occurrences, context and environment affects the public’s response—but one variable has remained constant: trauma is trauma, no matter the nature of the event. The astonishing commonality across disasters in this country is not the size nor scope of devastation. As Naturale has seen, the art of disaster recovery comes in human resilience.
“Every disaster is different and the same,” Naturale says. “Human reactions to trauma are the same across the globe -- with only cultural variations in their expression. The unique challenge lies in getting back to normal.”
For now, she’s ready to get on a plane to the next town that needs more normal.