[Congressional Record Volume 147, Number 162 (Wednesday, November 28, 2001)]
[Extensions of Remarks]
[Pages E2146-E2147]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




MENTAL HEALTH AND THE WORLD TRADE CENTER CRISIS: THE IMPACT ON NEW YORK

                                 ______
                                 

                        HON. CAROLYN B. MALONEY

                              of new york

                    in the house of representatives

                      Wednesday, November 28, 2001

  Mrs. MALONEY. Mr. Speaker, on October 2, 2001, I introduced H.R. 
2992, the Mental Health Parity Enhancement Act of 2001. Clearly, we all 
have come to understand mental health is critical to the health and 
well being of our country and all Americans. I rise today to submit 
compelling, timely remarks

[[Page E2147]]

about the mental health impact of terrorism as extraneous materials to 
the Congressional Record.
  On October 3, 2001, during the American Psychiatric Association's 
Annual Mental Illness Awareness Week Congressional Luncheon Symposium, 
in which they are joined by the National Alliance for the Mentally Ill, 
one of my most dedicated and brilliant constituents, Herb Pardes, M.D., 
President and CEO of New York Presbyterian Hospital, gave an 
enlightening and heartfelt presentation about the New York hospital 
system's response to the World Trade Center crisis. He discussed the 
phenomenal emergency medical services provided to victims by the New 
York healthcare system and also the resulting impact on the mental 
health of New York City and our Nation.
  Allow me to include excerpts of Dr. Pardes' October 3 remarks into 
the Record:

       There are many perspectives on this tragic situation. 
     First, it is probably the most horrendous tragedy I, and I am 
     sure many others, have ever had the misfortune to experience. 
     The disaster for me started while I was in my office and 
     heard that a plane had crashed into the World Trade Center. I 
     could see it on television and also see the World Trade 
     Center from my office. I could watch it in both places. It 
     was unreal, unbelievable, but we had to snap into action.
       Hospitals in New York, ours included, went into emergency 
     status immediately. And that meant we stopped elective 
     clinics and elective surgery, and tried to increase our 
     capacity in anticipation of seeing a large number of patients 
     coming.
       We have a phenomenal emergency medical services team. Many 
     of them were at the World Trade Center within eight or nine 
     minutes of the crash. Tragically, they got caught when the 
     buildings fell. We lost three heroes! You cannot ask for 
     finer people and losing them is a deep tragedy for all of us.
       We prepared teams of doctors and nurses in the emergency 
     room. We decanted patients to other facilities to increase 
     capacity. We arranged for staff to be able to stay at the 
     hospital, in the event that we needed them, because we did 
     not want them to go home and not be able to get back. 
     Volunteers came from everywhere. People by the thousands 
     wanted to donate blood.
       People were calling looking for their relatives. A friend 
     of mine, Neil Levin, the head of the Port Authority of New 
     York and New Jersey was lost in this tragedy. His wife was 
     sending pictures around, so we could determine whether it 
     matched any of the unidentified people who were already in 
     our burn unit.
       We had a number of staff meetings to keep people informed 
     and to make sure we were well coordinated. The healthcare 
     people responded magnificently. Everybody was trying to help. 
     Any preexisting tensions between people were set aside and 
     instead people tried to be helpful and collaborative.
       We had good responses from many, many different hospitals, 
     from the Greater New York Hospital Association, which set up 
     a 24-hour coordinating post, from the State Commissioner of 
     Health's Office, from the City Office of Emergency 
     Management, and others. State Commissioner Antonia Novello 
     came to visit us several times and helped us with replacement 
     staffing, especially for nurse specialists.
       We received calls from the Boston teaching hospitals, from 
     the Air Force, from David Nexon in Senator Kennedy's office, 
     offering help for burn victims with skin replacements from a 
     biotech company in Massachusetts.
       Our government officials were sensational--our 
     Congressional people, our Senators--Senator Clinton, Senator 
     Schumer, the Congressional representatives, Mayor Giuliani, 
     Governor Pataki. People volunteered every conceivable way 
     they could.
       Several thousand patients apparently were seen for health 
     care in the first 48 hours. We saw close to 800. In addition, 
     there were a thousand or so people who came for help with 
     decontamination and another 4000 people who were seen for 
     behavioral health visits related to the impact of stress. Of 
     course, there were many others who went directly to their own 
     doctors' offices. These data still have to be confirmed, but 
     they give you some indication of the numbers involved.
       Our greatest disappointment was that we did not have more 
     survivors. We were ready, the teams wanted to work, and they 
     felt extraordinarily frustrated and impotent at not being 
     able to do more.
       This disaster has had quite an impact on the hospitals. We, 
     of course, spent money on additional supplies; we had 7 of 
     our ambulances and 2 vans destroyed when the buildings came 
     down. We had to pay for additional staff, for overtime.
       Also, the hospitals are very volume sensitive. When we 
     stopped all our elective and routine work and then did not 
     have all the emergency work we thought we would get, we 
     sustained a substantial financial hit. This decline lasted 
     for a number of days. Then, for the next few weeks with all 
     the transportation lines clogged, the hospitals' availability 
     for health services was made difficult. People could not get 
     to us. Around the City there was a sharp drop in healthcare 
     activity.
       Hospitals cannot cut expenses so suddenly. The New York 
     City hospitals face a big financial problem, which, I think, 
     will be in the range of $300-400 million over a period of 
     several months. This problem will continue until we attain a 
     return to normal function.
       With regard to the impact on people, which is perhaps the 
     most important, it was remarkable how many people were filled 
     with disbelief. I mentioned impotence before. They have had 
     every feeling you could imagine. Anxiety, frights, 
     depression, a feeling of being dazed, a feeling that they 
     could not get themselves going.
       This was true of our staff, it was true of patients who 
     came in, it was true of family members, it was true of 
     everybody.
       The psychiatric needs were considerable and increased over 
     time. We set up two 24-hour counseling services and staff saw 
     people on site and other places. They saw relatives; they saw 
     psychiatric patients who had become destabilized as a result 
     of the tragedy. They went to business friends who lost 
     numbers of employees and those who did not but who had 
     suffered massive stress. Our staff went to schools; they went 
     to fire departments.
       There were people who were in buildings adjacent to the 
     crash who were terribly shocked and stressed even though no 
     deaths occurred in that particular business.
       Our burn unit admitted 25 patients. Some had moderate or 
     minor burns and so they did not stay very long. But, we had a 
     number who were serious. One died before arriving at the 
     hospital. Three more have died since. We still have about 
     fourteen who are seriously burned and we are hoping to bring 
     all of them to recovery.
       Our first patient with serious burns was discharged on 
     Tuesday, October 2nd. Most remarkable, when you listen to him 
     as well as many others, is the pressure of survivor guilt. 
     His focus was: ``What couldn't I help other people, why did 
     this happen?'' He feels he has a second chance. He was very 
     appreciative to the people who had been helpful to him. He 
     was modest, and came across in a serene and endearing way.
       We have had others: a woman whose husband found her in the 
     street after her back was burned and her Achilles tendon 
     severed. She could barely walk; he helped pick her up and 
     take her to an ambulance and get her out of there just in 
     time. There were many, many stories like that.
       In summary, this is a tragedy of unspeakable proportions, 
     whose impact I think is being realized in increasing 
     increments as each day goes by.
       The one bright light, you can say, is the tremendous 
     response and sense of unity, of cooperation. We have a 
     terrific pride in our Country and our fellow citizens and our 
     health providers. Everybody pitched in.
       I feel that everyone is affected by this disaster. On the 
     other hand, the thing that disturbs us most is that there 
     were not more survivors. I am thankful that a lot of people 
     did get out. We wanted all to be survivors; we wanted to be 
     there to care for them.
       There is also a severe jolt to the New York health system. 
     The hospitals have already been too heavily stressed. We have 
     to wonder whether we have left ourselves with such little 
     elasticity in healthcare capacity that, if there were another 
     tragedy involving many people needing care, whether we could 
     handle it.
       We have to make sure our hospitals and health systems stay 
     strong. We must insure that they are not constantly 
     undermined by budget cuts, so they can be there when we need 
     them. We particularly need specialized services like burn 
     centers when we have major disasters. When they happen, the 
     services need to be in place. Such services are usually in 
     academic health centers, and they are vital.
       We also need to have mental health services both 
     financially supported and provide insurance coverage so 
     people can get services. That means broad coverage and parity 
     for mental health. Going forward, we are not sure what we are 
     in for, but it is important for this Nation to stay strong--
     for people to be powerfully together--and for us to have a 
     health system that can be there when the need arises.

     

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