Healing body and mind 

How EPA is helping Libby cope with disaster stress

When an environmental disaster comes to town, especially one that involves toxic substances, many citizens are ill-prepared to deal with the emotional ramifications.

That’s especially true in Libby, where widespread asbestos poisoning has already killed an estimated 300 people and more victims are regularly being diagnosed. This national tragedy, made public in late 1999, could result in 1,200 to 1,500 people—an astounding one-half or more of the city’s population—being afflicted with asbestos-related diseases in coming years, researchers say.

To help cope with the intense emotional impacts on victims and their families, as well as other friends and neighbors, the U.S. Environmental Protection Agency (EPA) has embarked on a first-ever national pilot project aimed at easing the psychological stress raised by the disaster. The project weaves extensive community outreach, support groups, referrals, and other services to help citizens regain control over their lives and stay informed about the various efforts to help them.

“There are a lot of people who are suffering in Libby with grief, fear, illness, anger, depression, you name it,” says Wendy Thomi, the EPA’s community involvement coordinator assigned to the area.

“There’s a lot going on up there. It’s just clearly a very emotional issue and still is. It’s not going away anytime soon.”

Unlike a natural disaster where a tornado touches down or floodwaters ruin buildings, revelations that a now-closed vermiculite mine formerly run by W.R. Grace and Company was responsible for inflicting workers, their families, and other unsuspecting citizens with asbestos poisoning for decades is a harder concept for many people to comprehend than the wrath of Mother Nature, Thomi says. “It’s difficult to nail down how much people were exposed,” she explains. “There’s also different susceptibilities. It’s very hard to quantify the risk and to quantify the chances of someone getting sick.

That adds to the stress—not knowing. I think there’s a sense of hopelessness at times. This community really has been split up by this thing, but they’re working hard at coming together and moving beyond that.”

Financial strains, such as not being able to sell a house or business, and related anger over loss of security and safety and a feelings of lost control can also combine to wear down the psyche of victims and non-victims alike. A broader stigma may set in, researchers say, provoking chronic symptoms that can stretch across an entire population.

“There’s so much evidence that they were betrayed and lied to, and that their lives were put at a lower value than corporate profits,” adds Laura Sedler, a medical social worker with St. John’s Lutheran Hospital, home to a new federal clinic to diagnose and treat victims of asbestosis and related illnesses. “We consider that this whole community has potential psychosocial issues. But basically what you’re seeing is normal responses to really abnormal circumstances. Some people are experiencing two or three deaths in their extended families. Some people are having problems with substance abuse and clinical depression. But we’re real lucky we haven’t had a postal-type incident yet. There’s a lot of people with pent-up anger. There’s still a lot of anger at Grace. There’s still a feeling of betrayal.”

The pilot project started last year with a $17,000 EPA grant that allowed Sedler and another social worker to start the first support group for victims and others affected by the disaster. One of the group’s first projects was to make blue ribbons that community members could wear to show their support. A main reason for the campaign was to combat initial denial and anger about what was happening to the town.

“People were furious,” Sedler says. “They were mad at the victims. Some said they were just [filing lawsuits against Grace] for the money. Some said they were bringing a bad name to the community. Some said, ‘If we just wait, they’ll all die off.’ That was a huge, huge thing we saw in the first year of the group.”

After the first medical screenings documented the extent of illness in the community—and that it cut across all ages and education and income levels—she says many detractors were forced by the cold facts to change their attitudes. A second $12,000 EPA grant helped continue the support group’s work. Another $80,000 grant from the federal Substance Abuse and Mental Health Services Administration, secured with help from U.S. Sen. Max Baucus (D–Mont.) is just coming online.

Working hand-in-hand with the Community Psychosocial Stress Project is the Libby Asbestos Community Advisory Group, a panel of educators, religious leaders, government and industry officials, victims and others that largely serves as an informational conduit. The panel has no decision-making authority, but still wields considerable influence.

“It’s really a way for EPA to help keep the people in that group, and hopefully the people they represent, apprised of what EPA is doing,” says Thomi. “Likewise, the group raises issues with EPA,” including the continued need for help dealing with the emotional traumas the community is suffering through.

“The victims are most likely to be the people who have stayed here the longest,” Sedler says. “These are men and women who have hunted all their lives, and now they can’t get out of the truck. It’s financial, it’s economic, it’s social. We consider that everyone in this community potentially has issues.”

“We haven’t ever had anything as extensive as Libby,” adds Jan Shubert, a social worker with EPA’s Community Involvement and Outreach Center, part of the agency’s Superfund program. “Our approach is to help stabilize the situation and look at it as part of our cleanup process. If we can stabilize things in the community, our engineers and others can more quickly get on with their cleanup work.”

Shubert, who helped set up conduct a mental health assessment in Libby last year with psychiatrist Pam Tucker of the Agency for Toxic Substances and Disease Registry, says a big part of helping the community heal is allowing residents to be content with their emotions.

“They’re told, ‘You’re not crazy. What you’re feeling is what anybody in this situation would be feeling,” Shubert explains. “We’re trying to take a low-key approach with this, because it’s not our primary mission. In this part of the country, if you put a mental-health label on things, people will run.”

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