The trauma of 9-11 is now many months behind us, yet we psychologists are aware that there are long-term responses to such trauma that may possibly linger. Human beings are not really built for sustained levels of stress and tension. After periods of sustained stress, the body may tend to break down physically, as well as psychologically. Physicians are seeing patients for increases in health problems, including self reported somatic complaints, exacerbation of established medical conditions, increased use of sick time, increased substance use, sleep disruption, eating problems and impaired immunological functions.
Psychologically, depression, anxiety, PTSD (Post Traumatic Stress Disorder), interpersonal relationship problems, family conflicts, financial stress, ecological worries, and excessive demands for support to others all may become more apparent. Children may start to experience increased behavioral problems, separation anxiety, aggression, and antisocial behaviors.
According to a report from The Office of Behavioral and Social Sciences Research (OBSSR) of The National Institutes of Health, research on disasters has shown that mass violence has been more disturbing to people than any other form of disaster. Of those that were involved in a disaster of mass violence, 67% were reported to be "severely impaired". This was percentage was significantly higher than the 42% of the population who reported being impaired from a natural disaster.
"According to the report, disasters that can produce long-term psychological and physical effects are those in which at least two of the following factors are present:
1. Extreme and widespread damage to property
2. Serious and ongoing financial problems for the community
3. Human carelessness or, especially, human intent caused the disaster
4. High prevalence of trauma in the form of injuries, threat to life, and loss of life."
Anyone who has been following the news or who was near the event can relate to all of these identifying factors. There will most likely be a continued demand in the future for psychological services from the public.
At this time, we have been receiving 50 --60 new referrals a month either from former patients or from insurance companies. Unfortunately, we have been unable to handle this influx of patients. People become upset when they speak to us, since they feel we are not available to them or we are not sympathetic to their present plight. We spend much of our time on the phone trying to locate therapists for these new referrals.
The reality is that the insurance companies have limited panel providers. They have kept the panel small for their own reasons. We, as providers, have no influence to make any policy changes or pressure the insurers to open up the panels or reimburse us at a fair rate. The insurers have to raise their reimbursement rates and reduce the demands for excessive information for their periodic reviews to make psychologists more
interested in working with them to provide appropriate and sensible services. Psychological services are not the expensive demand on insurers or employers as they present it to the public. We actually help save money in the long term. The stigma of being in therapy has been significantly reduced over the years and the public is seeking therapy at ever increasing numbers. The insurers have to respond to the increased demand and meet their subscribers' needs.
So, if you have had trouble finding a therapist who can treat you since 9/11, please contact your human relations department or insurer and suggest that they need to open their panels for more providers, reduce the paperwork, and raise their reimbursement rates to attract the skilled and properly credentialed therapists who have avoided signing on to the insurance company panels.