"Certainly the message about the terror threat, the one involving plastic and duct tape, was, from a risk-communication point of view, particularly ill done," Wilkins said. "It told people that they should do something, and it gave them only a very general idea as to why. It didn't provide any cues as to when it may be appropriate to do this ... [and] it was, in many ways, overly broad. ... The notion that we have this one-size-fits-all response when the threat is something airborne--could be chemical or could be biologic--is certainly ill-done and certainly doesn't follow any of the recommendations of the Environmental Protection Agency or anyone else that works with this sort of stuff on a systematic basis."
Acknowledging that Code Orange precautions lacked clarity in the early stages, Ann E. Norwood, M.D., chair of the American Psychiatric Association's committee on psychiatric dimensions of disaster, said that later official communiqu‚s helped demystify the recommendations so people could act more appropriately. Depending on the region of the country, however, people perceived the level of risk differently--and so reactions ranged widely.
For mental health care clinicians working under myriad circumstances and influences, Norwood explained that it is important to watch patients to see if they become unduly anxious and to help them put things in perspective. "On the other hand, I don't think one can offer the false reassurance that nothing terrible is going to happen, because it very well might."
For Frank Ochberg, M.D., clinical professor of psychiatry and adjunct professor of journalism at Michigan State University, who also chairs the executive committee of the Dart Center for Journalism & Trauma, focusing on any single aspect of the message or the messenger is not what is key. "It's about whether in general we have the kinds of conversation between the government and the governed," said Ochberg in an interview with PT. "It's a two-way conversation that either leaves us all feeling as truly informed participants, or has us feeling manipulated and patronized, or has us feeling bewildered, confused and demoralized because there's an appearance that our government leaders are confused or confusing."
The whole population, therefore, is affected to varying degrees, Ochberg said, making the message sent by the government and the way that message is communicated by the media critically important.
"Part of what is going on is some people are legitimately frightened, while others get lulled into complacency or denial and are not as frightened," Ochberg said. "When your coping mechanisms work, they keep your anxiety within tolerable limits while you attend to the task ahead and you maintain your morale and maintain your relationships with significant others. When your coping mechanisms fail, you're not effective; you're alienated from the very people who could support you, understand you, and help you; you are demoralized; and you're anxious."