Ruth Barron, M.D., a psychiatrist and national consultant to the American Red Cross disaster mental health services program, got her first exposure to disaster work when she led a team of mental health professionals to help the victims of Hurricane Hugo on the Caribbean island of St. Croix in 1989. She is a clinical instructor at Harvard Medical School in Boston and practices in a multispecialty group also in Boston.

The Red Cross disaster-relief philosophy is to support and work with local health and mental health personnel who can manage victims’ long-term treatment. " Because Hugo caused widespread devastation, mental health professionals and community leaders were among the victims. To make the most of our limited resources, we focused our efforts on helping them recover so they could then help others. We ran a support group for the island’s ministers because we discovered they hold the reins to the local communities," said Barron.

When she suggested to the American Red Cross (ARC) they adopt these and other strategies, they invited her to serve on a national mental health task force charged with developing the agency’s first disaster mental health services program, said Barron.

Now in its seventh year, the program recruits and trains psychiatrists and mental health professionals, including social workers, nurses, and psychologists, to assist disaster victims and relief workers. More than 7,000 psychiatrists and mental health professionals from across the country have taken the two-day training course at the national headquarters of the American Red Cross in Falls Church, Va., or their local Red Cross Chapter, according to a spokesperson for the American Red Cross.

They can assist with a range of jobs including working one on one with victims and relief workers, counseling and support, and educating students and faculty about possible posttraumatic stress reactions.

Barron commented, " We look at victims and relief workers in a holistic way and pitch in to meet their needs, whether it is providing a blanket or making a sandwich. We also help them cope with the present adversity by providing support and reminding them of their strengths.

" With relief workers, the challenge is to become one of them while still maintaining some professional distance so you can help them. Everyone’s adrenaline is pumping because they are working around the clock and trying to do a good job. When a lot of people have died or the landscape is ruined, it can be traumatizing."

Workers occasionally cannot handle the grizzly disaster scenes and become unstable. They may have preexisting problems such as substance abuse, said Barron. " Some people become volunteers to escape their personal problems. Because workers must operate in chaotic, stressful conditions, we want people who are mentally sharp and stable."

In her role as a mental health consultant to the American Red Cross, Barron becomes involved in personnel issues including evaluating workers for psychiatric and/or substance abuse problems that could jeopardize the mission of the Red Cross. Based on her assessment and other factors such as the person’s previous work history with the Red Cross, she advises the human resource department on whether the person should continue in his or her present position.

Barron also participates in the American Red Cross’s Aviation Incident Response (AIR) Team, which requires specialized training and experience. The National Transportation Safety Board named the American Red Cross as the lead agency to care for the emotional needs of victims, families, and rescue workers in 1997. When Congress passed the 1996 Aviation Disaster Family Assistance Act, it made the NTSB rather than the airlines responsible for coordinating disaster-response operations, including the care of families, said Barron.

Information about the American Red Cross’s disaster mental health services program and training and the aviation disaster training is available by calling the ARC headquarters at (703) 206-6000 or the local Red Cross chapter. Information about Red Cross volunteer opportunities can be obtained by calling (800) HELP NOW. General information about the ARC response to disasters is also available on the Web site <www.redcross.org/index.html>.