Mental Fallout from the Boston Bombings

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David L. Ryan / The Boston Globe via Getty Images

Two explosions went off near the finish line of the 117th Boston Marathon April 15.

The bombings in Boston has stirred many reactions throughout the country – and in me.

I am shaken by the pictures, which look too much like the bombings in Iraq, Afghanistan and Israel.

Except those at the center of the blasts are American citizens on U.S. soil, in the heart of one of the nation’s most historic cities.

9/11 comes back to me.

The radio is full of horrific descriptions of the wounded, severed limbs and blood everywhere. We are advised, wisely, not to leap to conclusions.

As the chief clinical officer for the Department of Mental Health in Washington, D.C. – and, with that title, the responsibility for Disaster Mental Health — we are always preparing for this kind of thing.

So what does disaster mental health have to offer Boston?

First of all, it is the long view. Tending to the wounded and helping them start down a path of recovery will be underway relatively soon. After that, based on past such events, it will be about the dead, their families, and the mental-health impact on them and the city where it occurred.

Disaster mental health requires an assessment of mental health needs not only yesterday, today and tomorrow, but for years to come.

Psychological first aid is the first step. Tend to the immediate needs of injured people. Reunite families. Get back to a normal routine as soon as possible.

Yet these tragedies reverberate for years. For the severely wounded, multiple surgeries are likely. For the city, anniversaries often prove difficult.

The fact that this one is lashed to the nation’s oldest marathon – since 1897 – will cloud future Patriot Days, and the runners and spectators to come.

As time goes on, we will learn more about the attacks, the casualties, and the motives, such as they were.

And we also know that — however quickly the perpetrator and motive for this heinous act may be pinpointed — its psychological effects will last a long time.