Radiation Studies Branch

Psychological First Aid in Radiation Disasters

Psychosocial reactions were also of major concern in a radiation incident that occurred at the Three Mile Island Nuclear Power Generating Plant in 1979.

The facility, located in Middletown, Pennsylvania, approximately 10 miles from the state capital, had an accident caused by mechanical problems and operator judgment errors. The resulting crisis unfolded in several days of uncertainty, during which experts disagreed about the potential for harm. 144,000 individuals living in a 15-mile radius of the plant evacuated the area.

Fortunately the radiation exposure to the public was minimal. Two local residents who lived ten miles from the plant and within view of its towers will describe their reactions to the crisis—Dr. Peter Houts, a social psychologist at the Pennsylvania State College of Medicine, and his son, David, who was 12 years old at the time of the accident.

As they tell the story of what they experienced, listen for their psychological reactions. Bear in mind that they were not exposed to, or contaminated with radioactive materials, but experienced the threat of exposure and contamination.

Using the phases of disaster model, which you see illustrated, we can look at psychological reactions of survivors over time. Let’s review each of these phases in more detail. The model begins with the threat, warning, and impact phases.

The threat phase is the time before impact and involves the hazards or threats that could potentially affect the community. During the warning phase, communities receive notice of a disaster. Disasters that happen with no warning, such as a terrorist attack, leave survivors feeling more vulnerable, unsafe, and fearful of the future as compared to survivors of disasters that have warning.

In addition to the speed of onset, the amount of destruction caused during the impact phase also affects the reactions of survivors. The greater the scope of community losses, the greater the psychosocial effects on the individuals.

In the immediate aftermath of a disaster, there is an intense effort to rescue others, provide safety, and help individuals to survive the event; this is called the heroic phase. Altruism is prominent among both survivors and emergency responders, and adrenaline is high. Individuals do heroic deeds, disregarding their own personal safety. Therefore, safety issues are an important consideration for both survivor and responder.

During the honeymoon phase, which occurs a week to months following a disaster, governmental assistance becomes readily available. In addition, large numbers of volunteers offer help. Survivors experience a short-lived sense of optimism.

During the inventory phase, survivors recognize that disaster resources are limited. They become physically and emotionally exhausted due to multiple stressors. The optimism during the honeymoon phase gives way to discouragement and fatigue.

During the disillusionment phase, survivors may feel abandoned or resentful as they see disaster-assistance agencies and volunteer groups pull out. Gatekeeping regulations and red tape may discourage them from receiving assistance.

The final phase is reconstruction, or recovery. It is in this period that individuals and communities rebuild their physical property and recover their emotional well-being. This phase can take years.

Now let’s review these phases of disaster with a radiation event and note some of the differences. As we discussed earlier, public awareness of radiation threats can be low. In the warning stage, radiation events can be sudden or prolonged and difficult to detect.

In some radiation events, the immediate impact is difficult to assess. In Goiânia, the radioactive contamination went undetected for 16 days. Listen to Dr. Jose Rosental describe how little warning the population of Goiânia had.

We also find significant differences in the heroic and honeymoon phases. Because of extreme fear and the lack of familiarity about protection from radiation, some people may choose not to assist victims of radiation disasters, including medical personnel and even family members.

This is unfortunate since this fear is not founded in terms of factual information about radiation. The lack of social support systems may reduce the heroic efforts often undertaken to assist victims and decrease the sense of optimism. Dr. Jose Rosental describes how this happened in the Goiânia accident.