In more than six years as director of marketing and communications for the Mile High Chapter of the American Red Cross, Matt Bertram has seen more than 100 disasters up close, including the Oklahoma City bombing and Columbine High School shootings.

Even with all of that experience, he was still hit hard by a plane crash that took the lives of several Oklahoma State University basketball players and officials on a snow-covered Colorado prairie last January.

“I mentally prepared myself, but it was very gruesome,” Bertram said. “You see plane crashes on TV, but they’re totally different in reality. First, it’s shocking, then you just do your job, then you go home.”

Recognizing the traumatic impact of the crash, the mental health practitioner on the scene immediately put Red Cross workers, including Bertram, on four-hour shifts. In fact, the mental health person was already on the scene before Bertram arrived to set up a family assistance center.

“The priority of the Disaster Mental Health Services function of the Red Cross is providing emotional support to Red Cross workers,” said Dan Mosley, a psychologist who chairs the Mile High Chapter of the American Red Cross Disaster Committee. “Because if our workers are not doing well, they won’t be doing as good a job providing emergency relief.”

A growing number of relief organizations recognize the importance of trauma counseling. Despite a 1999 British Medical Journal (BMJ) study that found that some relief organizations were neglecting the psychological welfare of their field workers, most do have some sort of system in place to check the emotional wellbeing of staff. For some, that means having a mental health practitioner on site or holding monthly meetings for workers.

In Bertram’s case, when he returned from the scene of the Oklahoma State plane crash, he was offered two debriefing opportunities: With a group or individually.

“After the crash, the mental health workers themselves were debriefed by an outside mental health practitioner,” he said. “You know people are there and they’re concerned about you. You’re not going to be put someplace dangerous, and you’re not going to be overburdened.”

The type of mental health support offered to relief workers varies widely among organizations, depending on its mission and the scope of its work. CAM International, a Dallas-based evangelical, nondenominational mission agency — most recently involved in relief efforts in El Salvador after January’s earthquake — offers on-site pastoral care to its workers. But because CAM is more involved with the rebuilding of a community after a disaster than immediate relief, it focuses on helping workers adapt culturally, said CAM President Dan Wicher.

“Generally people who are involved in a one to two-week exposure during the intermediate stage of relief are not traumatized by the heartache or shock of the event,” Wicher said. “Instead, they’re more devastated by cross-cultural issues. There’s always on-site cultural differences from country to country.”

Mental health support for on-site workers is built into CAM’s organizational structure. Supervisory staff visit workers regularly to debrief and provide spiritual support. In addition, regular vacations for intermediate or long-term workers are scheduled.

At Life Span, a small domestic violence agency in suburban Chicago that offers counseling and legal services for battered women and their children, workers provide support for each other on a day-to-day basis, rather than within a set mental health program.

“It helps a lot to have the validation, encouragement and support of people who are doing the same work,” said Diane Wetendorf, director of counseling. “Working with this issue can be very frustrating. Women do go back to their abusive husbands. You feel like you’re banging your head against the wall.”

Like CAM, Life Span builds mental health into its core structure. Volunteers who staff a 24-hour hotline for battered women must complete 40 hours of state-mandated domestic violence training and are always just a telephone call away from a staff person who can lend emotional support. Wetendorf also holds monthly meetings where volunteers can debrief about problem calls. “We don’t do counseling from a clinical aspect,” Wetendorf said. “Instead, we offer information and support. It’s more women talking to women.”

Mosley defined what he does on the scene of a disaster as “schmoozing.”

“Oftentimes, if you were to observe us doing our work, you would find mental health workers doing a lot of things not traditionally associated with mental health,” he said. “A lot of time we’re ‘chatting it up’ with folks and in chatting it up, we’re monitoring their wellbeing and looking for some fine tuning that will help the whole operation. We’re encouraging them to take care of their own health — eat right, sleep well, get exercise, take a break — and we’re making recommendations about some adjustment in the work environment. We serve an advocacy function. All of this is part of providing emotional support for our workers.”

Although the results of the BMJ study indicate that the mental health of relief workers has been studied little, Mosley said support for relief workers is not even debatable.

“There are fewer and fewer people within the Red Cross who ask why there is a mental health function,” Mosley said. “It has really become an accepted part of the whole Red Cross operation and is respected as critical to the successful operation of a disaster relief.”

Gina Bernacchi is a reporter for the Denver News Bureau.