Either having escaped themselves or been carried to safety by others, many of the victims who survived the World Trade Center disaster experienced shock and pain as they hurriedly exited a site where bodies, metal and rubble formed a temporary graveyard in New York City on the morning of Sept. 11.
There, until the area could be cleaned up, the spot would remind the world of a tragedy that will never be forgotten, and the aftermath left firefighters and police officers clutching the hope of discovering lives as they worked their way through the death and debris which had been left behind by the toppled Twin Towers.
Then, in hospitals, in the armory serving as a family center, in front of their televisions, on their telephones, in the arms of sobbing relatives and friends, families clung to faith while grieving loss and trying to understand the horror of what had just taken place.
In Monmouth County, the disaster was much more catastrophic than the Traumatic Loss Coalition of the county’s mental health department had ever prepared for. And, at one of the county’s largest private counseling services, the telephones have not stopped ringing with calls for help in coping with the effects of the tragedy.
In response to the devastation, the county mental health department, headed by Administrator Charles D. Brown, is conducting a needs assessment, working with county and state departments and agencies to determine the scope of loss in Monmouth County, the concentration of areas mostly affected by the disaster and the needs of those families who are experiencing grief and loss, according to county mental health officials.
Brown said there is a roster of 65 individuals trained in mental health counseling who specialize in responding to mental health needs when disasters occur.
Dr. Mary Ann Cernak has been the county’s coordinator of the Traumatic Loss Coalition since the county received a $25,000 grant in January to fill the position to effectively and comprehensively assist school personnel among designated districts to manage significant losses and traumatic events that impact the school community.
Within the past two weeks, Cernak has spent time putting together information about human response to terrorism for the county superintendent of schools office and faxing that information to area schools. In addition, the team provides instruction through counseling for the administration, guidance departments and teachers to help them better serve the student population in times of grief and tragedy.
Cernak’s experience in leading mental health outreach teams comes from having worked through disasters such as the aftereffects of Hurricane Floyd in 1999 and the Edison pipeline explosion which occurred in 1994. In working with the Piscataway offices of the University of Medicine and Dentistry of New Jersey (UMDNJ), she was at the site of the Edison explosion as disaster site coordinator, serving as a consultant.
To help manage the results of Hurricane Floyd in Somerset County, Cernak worked with the state through the Federal Emergency Management Agency to intervene and assist children and families who were struggling to cope amidst the conditions of excessive flooding throughout that area. Cernak was trained late last year into the spring of this year in an international trauma studies certification program through New York University, New York.
Cernak said the coalition and the grant funding her part-time position was intended to aid in incidents involving numbers of people on a much smaller scale.
"When they set up the program they didn’t expect anything like this was going to come down the pike," Cernak said.
However, she said she believes her training — in formal education as well as in previous life experiences — has helped in her work in response to disasters, such as the one that occurred Sept. 11.
"This is far beyond the scope of anything that has happened in our country before," Cernak said.
Cernak spoke of the biological, psychological and physical effects resulting from the disaster, saying the immediate response has been one she referred to as "the heroic phase," a period of between a few weeks to a few months during which the wounded will be tended to, survivors will be discovered, and the cleanup of the destruction will take place.
"Then, the cold hard reality starts to set in," she continued. "People will go back to their lives. (Some) people must adjust to life without (certain loved ones) in their lives. That’s the hard part of the whole process."
Following the initial shock and denial of the situation, the phase of disillusionment may occur; a period of between two and six months during which the injured and families of the dead and injured will struggle when "they’re realizing it’s never going to be the same," Cernak explained.
She pointed to the healing of those people involved in the Oklahoma City bombing as a situation in which people have already lived through what the New York-New Jersey area is experiencing today.
"Oklahoma City taught us that for people who have lived in that area, it was such a shock … a massive terrible situation. It still haunts them," Cernak said.
Many people, Cernak said, are coping with the lack of closure which exists when their loved ones cannot be found.
"It makes it much harder to go through the normal grieving process when you don’t have the opportunity to say goodbye. In addition to the grieving process, you have that kind of inability to have an ending," Cernak said. "It looks like there’s a tremendous amount of people in that situation."
Parents can best help their children by being understanding and patiently answering questions the youngsters may have, Cernak said. She also noted the significance for parents to keep routines for their children, set aside time for play, and reassure the youngsters that "the world, most of the time, is a safe place." She said she herself comprehends the difficulty parents may have in helping their children to understand the senselessness of the situation which has just occurred.
"It’s very hard, too, for adults to understand that people can be that cruel to one another," she said.
At CPC Behavioral Healthcare, one of the area’s largest counseling services with centers in Monmouth and Ocean counties, the telephones have been steadily ringing with calls from those looking for comfort and coping strategies as a result of the disaster.
Vera Sansone, vice president of mental health and substance abuse services at CPC Behavioral Healthcare, described "a fairly large response" of those seeking counseling assistance since the disaster on Sept. 11. On Sept. 12, three or four individuals received counseling during emergency visits and approximately 10 telephone calls were taken, Sansone said.
The following day, Sept. 13, the number of incoming calls for emergency assistance doubled, as did the number of people visiting the centers for emergency assistance, she said.
Kerry Herbert, director of development for CPC, reported on Sept. 21 that the volume of calls for individual counseling as a result of the tragedy had increased by 20 to 25 percent over normal levels.
In response, CPC is offering free counseling assistance for those who can identify they have been affected by the tragedy. Those individuals may call (732) 842-2000, Ext. 4221. CPC maintains offices in Freehold, Middletown and Manahawkin. CPC also offers tips for coping with the disaster on its Web site at www.cpcbehavioral.org. According to Pam Ronan, spokeswoman for the state Division of Mental Health Services, New Jersey instituted a crisis number, 1-866-NJCRISIS, which can be called to obtain basic information and report missing individuals. This telephone number is in operation seven days a week from 7 a.m. to 9 p.m.