Monday Morning Crisis Quarterback

Last week, the Monday Morning Crisis Quarterback brought you thoughts on the experiences of the crew of US Airways Flight 1549. Today, we look at the passengers. More specifically, we look at the experience of Tess Sosa, who, according to Keith Olbermann at MSNBC, was on board the flight that landed in the Hudson in January with her husband and two children.

If Olbermann's report is accurate, and frankly it sounds about what you would expect, when Ms. Sosa contacted the insurer for US Airways seeking insurance coverage for mental health therapy for herself and one of her children relating to the trauma of the accident, the person she spoke to hadn't a clue what she was calling about. Then the insurance company told her to use her private insurance. Then they offered to cover three, but only three, mental health visits. And of course, they keep changing who the contact person is. Oh, and for frosting on the cake, the insurer is AIG.

This is one of those stories that could appear on any number of blogs. It takes a critical incident (which is why the Quarterback is interested) and mixes it in with poor customer service, the mess that is dealing with health insurers, the complete failure of the American medical system to deal in any way that makes sense with mental health issues. Then for fun you throw in the financial crisis and government bailouts. This thing ought to be all over the airwaves. But of course, it isn't. I'm not going to go on about why it isn't, but I am going to comment on Ms. Sosa's continued need for mental health care.

As my regular readers know, one of the best predictors of traumatic stress symptoms is believing that you or your loved one is about to die. Ms. Sosa certainly believed, as the plane was going down, that she was going to die. In fact, statistics indicate that she was more likely to be right than wrong on that one. There aren't all that many plane crash survivors walking the earth these days. She had her husband and two children with her, and she also believed they would die.

Once the plane "landed" on the river, water came in through the tail section of the plane. The passengers and crew evacuated onto the wings and into the water, which was cold. As she was pulled out of the water, she looked back and saw her husband holding one of their children above the water line. She had every reason to believe they might not make it.

I have no idea what immediate crisis support was given to the passengers on this flight. I also have no way of knowing whether more or different early intervention would have helped Ms. Sosa (there is lots of evidence to show that CISM reduces alcohol use and depression, but it isn't intended to magically ward off PTSD). Statistically, it's likely that some percentage of the passengers would need to be referred for further care and some of them wouldn't. Ms. Sosa did, and she's trying to get the help she needs. Good for her.

Ms. Sosa was injured in that accident, just as surely as if she had broken her leg or her nose. And she needs treatment, just as surely as if she needed surgery or physical therapy. Even in the arbitrary world of mental health insurance, three sessions is arbitrarily short. Five with the possibility of renewal would be much more the norm (and that's probably not sufficient coverage for a lot of folks, either).

AIG should thank its lucky stars they aren't paying hefty death benefits to the families of those who were on that plane, suck it up, and cover their mental health treatment. It's just plain the right thing to do.