Posted in Issue 104 - July 2006 News from PAHO/WHO
Requirements for food, clothing, shelter and medical assistance are well documented aspects of the first response to a disaster. In addition to these basic services, relief organizations should anticipate and prepare for a wide variety of mental health needs. As a site manager for the American Red Cross in Moss Point, Mississippi following Hurricane Katrina, I experienced a desperate need for more trained counselors to intervene in what was a mental health crisis. This epidemic was comprised of two subsets – those with preexisting mental disorders who were no longer managing their illness, and otherwise normal individuals who became overwhelmed with post-traumatic stress. Of the 400-500 people that began lining up every morning at 4 a.m. to receive social services, only one mental health worker was deployed for an average of four hours per day. The consequences of not fully addressing this problem could often lead to catastrophic events, the most dramatic of which was a tripling of the suicide rate in devastated areas for the 10 months following Katrina. However, I witnessed an underreported facet of recovery which involved substance abuse, family disintegration and acts of violence. As first responders began leaving in mid-October these aspects of post-disaster life only intensified.
A few steps would go a long way in solving psychosocial problems following a disaster. First, relief organizations should expand their existing services by recruiting more social workers and clinical psychologists to meet the needs of victims on the ground. Second, long-term mental wellness centers should be established in all towns/cities/shelters affected by the disaster. These centers will serve as a base for individual counseling, group therapy and the training of a local contingent of mental health workers. Third, mental health workers should take a proactive approach by using points of distribution for food, water and other government services as an opportunity to reach out and inform the public of the services they are providing. Finally, workers should train a new generation of counselors during relief efforts so that when they leave, a support network continues to function. Confronting this aspect of response will lessen the self-inflicted destruction following a disaster as well as provide an opportunity to build stronger communities.