|
The aftermath
of tragedy
September
11 and Hurricane Katrina continue to leave their marks
(August/September
2008 Issue)
By Catherine Robertson Souter
As the anniversaries of two of the biggest disasters ever to
hit the U.S. approach, New England Psychologist takes a look
at how the victims and survivors are doing and what lessons have
been learned from the tragedies.
September 11 and Hurricane Katrina are two very different situations
and, tellingly, psychologists in each region have different stories
to tell. Recovery from the first has been as expected, diminished
reports of mental illness over the years. Recovery from the second?
Not as good.
"It is a different situation," says Priscilla Brailsford, Ed.D.,
an assistant professor at Lesley University who has worked with
the American Psychological Association's Disaster Response Network
and has been among the on-site volunteers after both 9/11 and Hurricane
Katrina.
"At the end of the day after 9/11, survivors were able to go back
to their homes, be with families. That made a huge difference. New
York City has a lot of mental health counselors and people were
volunteering all over the place," she adds. "It got absorbed by
the system, the care."
As Brailsford points out, the infrastructure that was destroyed
following Hurricane Katrina tore apart the basic community and familial
support that would have helped transition people back to normalcy.
Mental health workers themselves were dealing with the issues of
residency and office space. Or, when they were not directly affected,
like William Gasparinia, Ph.D., a clinical psychologist at the Applied
Psychology Center in Biloxi, Miss., the clients just couldn't get
to them.
"No one could come in because the roads were all closed," he says.
Immediately following the storm, reports Mardi Allen, director
of clinical services for the Mississippi Department of Mental Health,
mental health issues were last on everyone's to-do list.
"We had so much support coming in from outside," she says. "There
was a wave of optimism. Then, after they got some housing, FEMA
trailers or whatever, we started seeing more severe distress. At
first, they had no time for depression."
In a study conducted by Harvard Medical School, funded by the National
Institutes for Health (NIH), there was a high prevalence of hurricane-related
mental illness even two years after the storm.
"The rates of mental illness are still very high compared to other
disasters," says Ronald Kessler, Ph.D., head of the survey team,
a professor at Harvard Medical School and director of the World
Health Organization's World Mental Health Survey Initiative. "And
it is not just the poor or the old; this was an equal opportunity
disaster. There is a lot of unmet need for treatment still, a lot
of suffering."
The problem, says Joseph P. Tramontana, Ph.D., a clinical psychologist
in Baton Rouge and New Orleans, is that the rebuilding of the destroyed
properties is slow. Residents have had trouble finding materials,
people to do the building and the financial assistance to do it.
Tramontana, who has previously spoken to this publication in past
articles, says that a low interest loan he applied for shortly after
the hurricane to repair his damaged New Orleans home came through
only two months ago.
The city of New Orleans seems to be doing worse than the Mississippi
coast, where his wife has a vacation home.
"On the Gulf Coast, the properties are cleared out to make room
for new homes but in New Orleans there are so many houses damaged
beyond repair and just sitting there."
Brailsford described a home she saw in New Orleans last fall that
had an outside wall ripped off of it. Inside, all covered in mud,
clothes and other personal items still hung in closets, two years
after the storm.
"It felt like a third world country," she says.
In New England Psychologist's original story about how psychologists
were faring after the storms, Tramontana explained he'd lost both
his family home in New Orleans and his office/apartment in Pass
Christian, Miss. He had moved, temporarily, to Baton Rouge. Today,
three years later, he is still there.
"I met a Baton Rouge woman, got married and stayed. As bad as the
hurricane was, it has a silver lining for me because I met my wife.
We probably never would have met otherwise."
There are silver linings all over the place, if you look hard enough.
Allen points out that, although 52% of the homes and 400 schools
in the lower three counties had been destroyed, and the unemployment
rate had skyrocketed to 25%, some good had come out of it.
"The housing is still a problem but it is coming along. The unemployment
rate is back to pre-Katrina levels and all of the schools are back
running and we even have higher achievement test scores than pre-Katrina."
None of this is to say that those who dealt with the losses of
September 11 had it any easier than those affected by Hurricane
Katrina. Philip Bonifacio, Ph.D., a professor of psychology at John
Jay College of Criminal Justice and a clinical psychologist who
worked with police and fire fighters in the months and years after
the tragedy, saw a lot of trauma-related illness. Many first responders,
he says, dealt with guilt or the recurrence of previous traumatic
events triggered by 9/11.
"One officer had had an alcohol abuse problem and he was afraid
the stress was getting to him. He was starting to think about drinking
again during the recovery process."
Alan Dustman, Ph.D., who works with the NYPD's Police Organization
Providing Peer Assistance (POPPA), which provides confidential peer
counseling and referrals to a panel of psychologists, has seen
a lot less stress as the years pass. Most of his clients do not
mention 9/11. If it comes up at all, 9/11 is mostly mentioned on
the anniversary of the date.
"Some people still have reactions," he says. "When they look up
and see a cloudless blue sky, they feel it still. But, the vast
majority is doing fine. Most people came out the same as they went
in," he adds. "These are first responders. This was just the most
significant event that they will ever respond to."
The lessons we need to take out of these two different situations
are important if not always easy to define. Why are the 9/11 victims
faring better than those who were caught in the path of the hurricane?
Can it all be attributed to the slower physical recovery of the
region and the loss of basic infrastructure?
As the NIH study shows, more is needed in way of preparation for
future disasters with disaster preparedness programs and evacuation,
rescue and relief plans along with plans for addressing ongoing
mental health issues. In Mississippi, the state government has instituted
interagency cooperative agreements, streamlining human services
and law enforcement procedures.
"We are very prepared now," says Allen. "We hope we will never
have to show how prepared we are."
The outpouring of help from across the country and across the world,
for both events was mentioned by everyone involved in this article.
"The nation just turned out," Allen adds. "There was a steady stream
coming down the highway of people to help us out. We just can't
thank you enough for that."
One of the best ways that individual psychologists can be prepared
for future disasters is to get crisis and multi cultural competence
training from the Red Cross. Psychologists are needed immediately
following a disaster as well as in the months (or years) to come.
For information on training, visit the Red Cross Web site at: www.redcross.org.
|
