Photography by Chris Jordan
Let Us Not Forget the Victims of Katrina
About two years ago, I wrote here that the high winds of blame were continuing to circulate around the abhorrently deficient level of the Hurricane Katrina federal relief efforts. Echoing the frustrations of local officials who had complained for days at that time about the slow federal response, the major New Orleans newspaper, The Times-Picayune, called for the removal of every official at the Federal Emergency Management Agency (FEMA). Today, one can hardly say that there have been any marked changes in the living conditions under which many of the Katrina victims have continued to suffer. Let us not forget those victims.
The Psychological Toll of the Disaster
As long ago as August 2006, a year after the Katrina catastrophe, a news release from the Harvard Medical School described some findings from a thorough study that it was conducting on the emotional effects of the Katrina tragedy upon survivors of the flood. That research, which was led by investigators from Harvard Medical School (HMS), was published in a special online edition of the Bulletin of the World Health Organization: http://www.who.int/bulletin/en/. According to the findings of the most comprehensive survey of the mental health functioning of Hurricane Katrina survivors that had been done up until that time, the proportion of people with a serious mental illness doubled in the months after the hurricane, when compared to a survey carried out several years before the hurricane.
Paradoxically, the study found that while mental illness doubled, including a substantial increase in reported cases of serious depression and Post Traumatic Stress Disorder (PTSD), reports of suicidal ideation didn’t increase despite the dramatic increase in psychiatric pathologies. Ronald Kessler, Ph.D., and his co-authors suggested that this low rate of suicide thoughts might have been related to optimistic beliefs at the time about the success of future recovery efforts. “The increase in mental illness among Katrina survivors is not surprising, but the low suicidality is a surprise,” said Ronald Kessler, PhD, professor of health care policy at HMS and lead author of the study. “Our concern, though, is that this lowering of suicidal tendencies appears to be strongly associated with expectations for recovery efforts that might not be realistic.”
In summary, in August 2006 the researchers observed that despite the doubling of mental illness after Hurricane Katrina, positive cognitions or hopes that help would actually arrive appear to have prevented increased suicidal thoughts, plans, and attempts. However, they also concluded that because the positive cognitions were tied to potentially unreliable expectations about a better future, the results might only be a temporary reprieve.
Feelings of Depression Become Enduring and Persistent
More than two years after the storm, it is not Hurricane Katrina itself but the persistent frustrations of the delayed recovery that are exacting a high psychological toll on people who never before had such troubles, psychiatrists and a major study say. A burst of adrenaline and hope propelled many here through the first months but, with so many neighborhoods still semi-deserted, those feelings of inspiration have ended.
Calls to a mental health hotline jumped after the storm and have remained high, organizers said. Psychiatrists report being overbooked, at least partly because demand has spiked. And the most thorough survey of the Gulf Coast’s mental health recently showed that while signs of depression and other ills doubled after the hurricane, two years later, those levels have not subsided, they have risen.
Two years into the Harvard study of Katrina’s emotional effects, Ronald C. Kessler, the professor of health-care policy at Harvard Medical School, who has been leading the study, stated that “It’s really stunning in juxtaposition to what these kinds of surveys have shown after other disasters, or after people have been raped or mugged.” Typically, “people have a lot of trouble the first night and the first month afterward. Then you see a lot of improvement.” But, in New Orleans, the percentage of people reporting signs of severe mental illness, suicidal thoughts and post-traumatic stress disorder increased between March 2006 and the summer of 2007, the survey showed.
While depression is often discussed in terms of chemical causes, interviews with psychiatrists and patients in the Gulf-coast area ascribed its appearance in post-Katrina New Orleans to the stresses of rebuilding. Because of the hurricane, many have lost or changed jobs. Thousands are still living in cramped FEMA trailers and many are living in semi-deserted streets. “If you’ve lost your job, you’ve lost your house and you’ve lost your friends — well, you ought to be depressed, man, or else you’re out of touch with reality,” said psychiatrist Elmore Rigamer, the medical director for Catholic Charities in New Orleans, which runs five city mental health clinics. At this point, the positive cognitions associated with expectations or hopes about a better future that were reported in the 2006 survey turn out to have been only a temporary reprieve.
In The Washington Post, Peter Whorisky described the emotional toll of Katrina, the enduring or unremitting depression experienced by people in the area:
“There’s more depression, more financial problems, more marital conflict, more thoughts of suicide,” said Daphne Glindmeyer, a New Orleans psychiatrist who is president of the Louisiana Psychiatric Medicine Association. “And a lot of it is in people who never had any trouble before.”
Interviews with psychiatrists turn up story after story of people with no history of depression plunged into mental anguish deep enough to require treatment.
A teenager living in a trailer turns homicidal. A woman whose mother died in the car during an evacuation — and then could not be taken to funeral home — suffers post-traumatic stress disorder. A firefighter involved in dozens of rescues seethes with anger at the region’s inability to come back.
“These people don’t necessarily need a good psychiatrist,” Rigamer said. “They need a good contractor or someone to fix the ‘Road Home’ program and good leadership.”
A moving account of the emotional effects upon the survivors of Hurricane Katrina was published in The Washington Post. Readers who are interested in learning more about this aspect of Hurricane Katrina’s toll can access the article here.
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