Published online by Cambridge University Press: 05 August 2012
In the hours after the 2001 attack on the World Trade Center, New York City hospitals prepared to receive the wounded. Outside St. Vincent's Hospital in Greenwich Village, gurneys dressed in clean white linens were neatly arrayed along Seventh Avenue. Doctors stood at the ready, awaiting a deluge of injured survivors. But the hospital beds remained empty. Due to the impact of the airplanes, the heat of the flames that engulfed Trade Center offices, the thickness of the smoke inside them, the debris that rained down from the towers, and the sheer force of their collapse, most injuries were fatal, so that persons with physical wounds never materialized in great numbers. In lieu of bodily injuries, many of those who escaped from the immediate vicinity of the World Trade Center attack – like scores of others less directly exposed to it – suffered wounds that were psychological. As the loss of life, the property damage, and the terrorist threat were measured, and as the shock and fear settled in, attention quickly turned to the public's mental health.
Concerns about widespread psychological injuries escalated, especially once the attack was officially declared a federal disaster. Disasters are events of such magnitude and severity that they exceed the capacities of local governments and organizations to cope with them and to provide for the recovery of all whom they affect. Events that fall into this category are known to cause extensive psychological harm (Norris et al. 2002; Vlahov 2002).