For over a decade, Lieutenant Brian Orr of the Oklahoma Highway Patrol has responded to disasters throughout the state, including both the 1999 and 2013 Moore tornadoes. He remembers each of them clearly.
“It was very difficult to see things, and of course first arriving, hearing screams from people and just the total devastation,” Orr said.
After the 1999 tornado, Orr says he and many other first responders were caught off guard, as there was minimal training to prepare them for the emotional impact of what they encountered. But after the May 20 storm, things were a bit different.
“This time, we actually had a debriefing where it time for us we could kind of vent a little bit, let some of that out, discuss it amongst our peers,” he said.
“Our superiors come in and sat down with us, and they had other professionals there that, if things were bothering us, we were able to talk to them,” Orr said.
George Everly is an associate professor of psychology at the Johns Hopkins School of Public Health who studies mental health treatment of first responders. He says knowing when to intervene is crucial.
“Timing is everything. You can have a very good protocol and misapply it in terms of timing, and it's the kiss of death,” Everly said.
He says there’s often an overabundance of counselors immediately following disasters, but that may not be the best approach.
For its part, the Oklahoma Highway Patrol only had one mental health debriefing, a few days after the Moore tornado, though professionals are still available if officers need someone to talk to. While that might sound inadequate, Everly says this method actually works quite well.
“Perhaps the most important question you can ask is, ‘What can I do for ya? What do you need right now?’ And sometimes it's to be left alone. And if that's the case, you need to listen to that,” Everly said.
At the same time, while there’s a growing awareness of the mental health needs of first responders, the focus tends to be shortsighted, says social worker Kimberly Fielding, who watched the aftermath of the Joplin tornado in 2011.
“We have a lot of research for what to do immediately for first responders when we're responding that psychological first aid,” she said.
“The thing that I think mental health is asking of itself is, ‘What do we do in the long term many years down the road?’ There's just not much out there to tell us on the long term,” Fielding said.
For Lieutenant Orr, the May 20 tornado was just another part of his expected routine.
“We have a job to do and we're going to do it regardless,” he said. “Dealing with the aftermath of it, of whatever assignment we're on, those are emotions that we have to deal with on a daily basis.”
Creating standard protocols for helping first responders cope with their emotions is complicated by the fact that different units often have very different workplace cultures.
George Everly, the Johns Hopkins Professor, says that in order for treatment to be effective, counselors first need to spend some time getting to know the people they’re working with and how their unit operates.