While the need to address disparities in care is well known, few strategies for reducing disparities have been studied systematically.
Spring is warming the streets of Newtown, Conn., as neighbors continue to come together to mend lives forever altered by the tragic events that took place on December 14 at Sandy Hook Elementary School.
In February, Jill Barron, MD, MHS, a former Robert Wood Johnson Foundation (RWJF) Clinical Scholar (2007-2009) quietly began working behind the scenes with Donna Culbert, MPH, director of health for Newtown, as a mental health adviser. On March 18, Barron’s role became official.
A child, adolescent, and adult psychiatrist with expertise in trauma, Barron completed her RWJF Clinical Scholar term at Yale University. Her first assignment is to conduct a mental health needs assessment for the town. Her work is being supported by a $50,000 grant from Praxair, Inc., a Danbury, Conn.-based company.
“Newtown is a very close-knit community with a strong faith base. These qualities form an important platform of strength and are often the foundation for recovery and resilience,” Barron said. “It is important to keep in mind that not everyone will need professional mental health care. Many may choose to talk to clergy, primary care physicians, friends or family. My job is to ensure that those who seek help can get that assistance in an effective and coordinated fashion.”
Creating a Safety Net
A post-9/11 consultant to the New York City Fire Department and other first responder communities, Barron will use her skill working with large groups to map the mental health services landscape of Newtown. “When you seek to understand the needs of a community, you think about concentric circles—identifying the different points of impact,” Barron said.
“We will be working with different groups within the community, including first responders and people who were at risk before the event occurred, to get a sense of the services they have received and the other services they may need,” Barron explained. “We will then gauge the capacity of local mental health and primary care providers, as well as the broader community.”
“Sharing basic information with these groups can often help reduce tension and provide an alternate lens through which one might look at behavior or emotions. This can be incredibly helpful to individuals and providers,” she said.
Barron advised that people can benefit greatly from knowing what to expect after a trauma and understanding perfectly normal reactions such as sleep disruptions, anxiety, regression to prior developmental stages among children and even adults. “Knowing when to seek more specialized care is equally important,” she added.
The process is ongoing, Barron explained, “because reactions to tragedy may appear many months, even years, after an event. I see people in the New York City Fire Department, for example, who are still dealing with reactions to 9/11.”
Caring for Communities in Crisis
Drawing on her RWJF Clinical Scholar program experience investigating unmet health care needs, focusing on community health, and helping young people cope with violence through the Yale Photovoice project, Barron said she learned “to look at the big picture. Clinical Scholar training prepared me for this work in many ways. It taught me to look broadly at issues. I learned to keep one eye on science and best practices, while carefully considering my role in community work.”
Collaboration, Partnership and Patience are Key
There have been more than 2,000 shooting incidents in the United States since that terrible day in Newtown. For other health care providers who may be faced with helping a community recuperate, Barron said, “all tragedies are unique, but some principles for supporting individuals and groups are universal.”
Reflecting on the long-term impact of the Sandy Hook shooting, Barron said, “eventually, I think Newtown will be the impetus for change along many lines in mental health, education and policy.” But her mission is clear. “My single focus right now is helping this community recover.”
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