Reestablishing mental health services in St. Bernard Parish, Louisiana, following Hurricane Katrina.

In August 2005, Hurricane Katrina struck the Gulf Coast causing widespread residential displacement, unemployment, and compromised social networks for the residents of St. Bernard Parish, Louisiana. Symptoms of grief, depression, anxiety, posttraumatic stress, adjustment disorders, and psychosis were anecdotally reported among clinic patients during the authors' deployment to the parish in December 2005 (4 months post-Katrina). These anecdotal reports were confirmed through the analysis of survey data that were collected during the authors' follow-up visit in August 2006 (11 months post-Katrina). In collaboration with the United States Public Health Service, the parish has prioritized restoring medical and mental health services to the parish in its efforts to rebuild and repopulate. Implications for mental health practice and public policy are summarized. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health services in Louisiana school-based health centers post-Hurricanes Katrina and Rita.

Following Hurricanes Katrina and Rita, Louisiana school-based health centers (SBHCs) were called on to respond to a sharp increase in mental health needs, especially for displaced students coping with grief, loss, trauma, and uncertainty. To assess the impact of the hurricanes on the students and the needs of SBHC mental health providers (MHPs), we surveyed MHPs in each of the SBHCs under the auspices of the Louisiana Department of Health and Hospitals, Office of Public Health. SBHC practitioners from around the state reported that mental health service utilization rose during the 2005-2006 school year, but utilization of services increased most significantly in schools receiving the majority of displaced students. Anxiety and adjustment problems were noted as increasing the most following the hurricanes. A multitude of other conditions was also reported. By the time of this survey in April 2006, the reported prevalence of most symptoms had declined, but all remained above their pre-hurricane levels. Self-reported needs of SBHC MHPs are also discussed in light of the major natural disasters. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of Katrina: Shedding light on things forgotten.

Volunteering on a disaster mental health team to assist the victims of Hurricane Katrina can affect a psychologist in a number of ways that cannot be known until after the experience has taken place. Such an event will have a unique impact based on who the person is, on his or her life experience, and on what activities he or she conducted. This article shares the impact this experience has had on a psychologist who had never before been involved in a disaster mental health effort. The focus is on how this experience has helped to shape and influence the author's present clinical work, both as a practitioner and program administrator. Rather than learning anything completely novel or foreign, instead, this experience has shed light on things known but that were in some ways forgotten or less fully appreciated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lessons from Katrina: Disaster mental health service in the Gulf Coast region.

In this article, 4 mental health professionals provide firsthand accounts of experiences as volunteers in the Gulf Coast region following Hurricanes Katrina and Rita in the fall of 2006. These accounts are provided with the goal of informing psychologists and other mental health providers about the role of volunteers from a frontline perspective. The authors offer these observations as a compliment to formal training in disaster preparedness that psychologists might receive for volunteer service in the wake of a devastating disaster. Specifically, the authors discuss the training they received, the settings in which they worked, and the client needs and mental health skills they used to meet those needs. Last, the lessons the authors learned about providing disaster mental health services are discussed. It is hoped that these observations might inspire others to lend their expertise and compassion in response to future catastrophic events. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Meeting mental health needs following a natural disaster: Lessons from Hurricane Katrina.

Hurricane Katrina had a devastating impact on hundreds of thousands of Louisiana and Mississippi families. Housing was destroyed, jobs were lost, and family members were separated, sometimes in different states and without communication. Postdisaster stress reactions were common, with vulnerable individuals most affected. Mental health services were not adequate to meet immediate needs, and postdisaster mental health issues often emerge over time. This article describes the mental health needs of dislocated and evacuee children and families and the steps that were taken to develop mental health programs that would be sustainable over time to meet this new level of need. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Working as a psychologist in the Medical Reserve Corps: Providing emergency mental health relief services in Hurricanes Katrina and Rita.

This article details before, during, and after "snapshots" of what it is like to go into a disaster to provide emergency mental health as part of the nation's emerging Medical Reserve Corps. It is a first-time responder's personal account of "lessons learned" and "priorities" for psychologists in similar situations. Twelve recommendations for improving psychologists' effectiveness in addressing widespread mental health disasters are identified. These include (a) team deployment and mission, (b) anticipation of frustrations, (c) prioritization in a disaster, (d) ethical dilemmas, (e) recognition of the benefits, (f) development of rapid screening tools to identify those in greatest need of mental health intervention, (g) training allied health professionals in mental health response, (h) mental health interventions specific to Katrina, (i) the importance of supporting caregivers and systems, (j) identifying and activating one's own support system, (k) slowing down interventions, and (l) training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Louisiana psychologist's experience with Hurricanes Katrina and Rita.

This article was originally written shortly after Hurricanes Katrina and Rita hit the Gulf Coast of the United States. It describes the process through which one local psychologist progressed during the evacuation and immediate aftermath. The final part of the article was written two years later and includes reflections on the recovery process as well as changes in the practice of the psychologist. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Collaborating with African American churches to overcome minority disaster mental health disparities: What mental health professionals can learn from Hurricane Katrina.

The purpose of this qualitative study was to explore how mental health professionals and African American pastors and their churches could collaborate to overcome minority disaster mental health disparities. Forty-one African American pastors of churches located in south Mississippi, in counties directly affected by Hurricane Katrina, participated in semi-structured interviews approximately 1 year after the storm. The majority of participants reported being interested in collaborating with mental health professionals to: (a) develop educational and outreach opportunities, (b) lead assessment procedures, (c) offer consultation activities, (d) provide clinically focused services, and (e) utilize spiritual resources and support. Participants provided further insight into how these collaborative activities could be modified to meet post-disaster needs and offered novel applications. Following from these discussions, the article provides a number of recommendations that can be used to aid in the development of disaster collaborative activities between African American pastors and churches and mental health professionals to serve minority communities while also decreasing disparities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health symptoms in youth affected by Hurricane Katrina.

Natural disasters, such as hurricanes, may cause severe psychological impairment in children and adolescents, which may persist in youth who have survived hurricanes, their effects, or both. To better understand the needs of youth in the community after Hurricane Katrina, officials in St. Bernard Parish, LA, commissioned a youth needs assessment survey. The survey assessed how youth were coping approximately 2 years after Hurricane Katrina. The goal was to explore the prevalence and severity of depressive, anxious, and posttraumatic symptoms reported by youth. Based on retrospective reports from 43 youth, the prevalence of children’s mental health symptoms was 44–104% higher in the 2 years after Hurricane Katrina compared to pre-Katrina. The majority of mental health symptoms reported by youth had an onset after the hurricane, for example, 79% reported new onset of mental heath symptoms in the year after Katrina. The vast majority of these children (56%) continued to experience mental health difficulties 2 years after the disaster. Implications regarding post-Katrina mental health needs, service delivery, public response, and collaboration efforts are summarized and directions for future research are proposed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Introduction: Methodological issues in school-based mental health services research.

New research directions on the effectiveness of mental health services for children and adolescents offer the opportunity for school psychology to apply its knowledge base to the systemic juncture between mental health and school systems. Models of service delivery to children, adolescents, and their families that integrate school, mental health, and other service sectors are being actively studied to answer questions about the outcomes of these services for children with mental health problems. The papers in this journal were first presented at the 6th Annual Research Conference of the Florida Mental Health Institute on "A System of Care for Children's Mental Health: Expanding the Research Base." The papers describe state-of-the art studies of school-based mental health interventions for children, adolescents, and their families. In each of the papers, particular attention is paid to the salient methodological issues researchers face in conducting these studies within school settings. It is hoped that these articles will foreground the healthy and creative tensions that exist between different research paradigms and multiple service communities, especially mental health and school systems, by encouraging new research on important and as yet unanswered questions about the effectiveness of school-based service delivery to children and adolescents with mental health needs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Louisiana Spirit Specialized Crisis Counseling: Counselor perceptions of training and services.

This study examined perceptions of training, supervision, consultation, services provided, and role satisfaction among program personnel (N = 93) providing assistance to children, adults, and families affected by Hurricanes Katrina and Rita through the Louisiana Spirit Specialized Crisis Counseling Services (SCCS) Program. Findings indicated that there was uniform high satisfaction with the training, supervision, and consultation, which included the skills-based intervention, Skills for Psychological Recovery, provided by the SCCS Practice Directorate that included staff from Louisiana State University Health Sciences Center, the National Child Traumatic Stress Network, and the National Center for PTSD. Counselors also made high ratings of their perceptions of the helpfulness of services to survivors and overall satisfaction with their work. The vast majority of counselors, who had themselves been seriously affected by the hurricanes, indicated that their own hurricane-related experiences and losses were extremely helpful to them in relating to survivors and providing services. Fully 90% indicated that they had significantly benefited professionally from their work and would be interested in providing SCCS services in the event of another disaster. Provider perceptions of personal strengths derived from the hurricanes were associated with high levels of SCCS program satisfaction and conversely, difficulties providing SCCS services were associated with lower levels of program satisfaction. Multiple regression analyses indicated that provider's perceived negative impact of the hurricane on survivors predicted increased perceived helpfulness of SCCS provider trainings and services to survivors. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Maximizing the effectiveness of psychology in public mental health services.

Rather than a preoccupation with diagnosis and pathology, psychologists should direct their attention to the capacity of individuals for adaptation and adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychologists and Hurricane Katrina: Natural disaster response through training, public education, and research.

The purpose of this article was to describe a model of clinical/disaster psychology and illustrate how one psychologist applied training in the aftermath of Hurricane Katrina. The primary focus of the article relates to training graduate students of clinical psychology and assisting evacuees, public education and dissemination, and research. Psychologists may find themselves in similar positions when disasters occur in the future, and the linkage of research and theory with anecdotal accounts may provide mental health professionals with ideas regarding avenues of training to pursue and the various roles that may be served in times of disaster. Recommendations are offered to training programs with regard to infusing tenets of clinical/disaster psychology into their curriculum. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

School-based disaster mental health services: Clinical, policy, and community challenges.

The consequences of Hurricane Katrina have far-reaching implications for the mental health system in the Gulf Coast region, with some of the most vulnerable survivors being children and adolescents. School-based services have been proposed as an ideal way to provide care; however, significant challenges remain in providing trauma-informed services in schools postdisaster. The authors discuss the consultation and training activities of the Los Angeles Unified School District Trauma Services Adaptation Center for Schools and Communities following Hurricane Katrina. Issues related to the dissemination of evidence-based treatment in schools following a disaster are discussed, as are the particular needs of providers and school staff and the importance of community collaboration in identifying ways to adapt implementation strategies for specific communities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ecological constraints on mental health services.

Proposes 4 principles for community mental health programing that are consistent with an ecological thesis: (1) Assessment methods are focused on the total population rather than on those persons who presently receive a mental health service. (2) Mental health services are designed to reduce a high risk for community service. (3) Professional and research services are created as local community resources. "By initiating the informal coordination of current services, the community mental health program helps to create specific new community services as needed." (4) The program plans for change; this involves mobilizing anticipatory problem-solving resources not only for clients but for professionals as well. A "conception of community mental health work based upon the ecological thesis that adaptive programs change" is presented. (39 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The dirty dozen: Twelve failures of the Hurricane Katrina response and how psychology can help.

This comprehensive analysis addresses the United States' alarming lack of preparedness to respond effectively to a massive disaster as evidenced by Hurricane Katrina. First, a timeline of problematic response events during and after Hurricane Katrina orients readers to some of the specific problems encountered at different levels of government. Second, a list of the "Dirty Dozen"--12 major failures that have occurred in prior disasters, which also contributed to inadequate response during and after Hurricane Katrina--is presented. Third, this article encourages expanding psychology's role beyond the treatment of trauma to encompass disaster planning and mitigation efforts from a broader public health perspective. Finally, areas for important interdisciplinary research in human behavior that will influence our nation's overall preparedness for future catastrophes are identified, and ways psychologists can become personally involved beyond treating casualties are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Resource loss and relocation: A follow-up study of adolescents two years after Hurricane Katrina.

The long-term psychological impact of Hurricane Katrina was assessed among students (N = 636) at two high schools in southeastern Louisiana. Displaced students from the greater New Orleans area were compared with nondisplaced students on several factors. Displaced students reported higher levels of general psychological distress (GPD) and posttraumatic stress (PTS). Age, resource loss, relocation time, relocation distance, self-esteem, optimism, storm exposure, and gender were then assessed in separate regression models predicting GPD and PTS. Both hierarchical regression models were significantly predictive. Self-esteem, relocation distance, optimism, resource loss, and storm exposure were significant predictors of GPD. Resource loss, relocation time, storm exposure, and self-esteem were significant predictors of PTS. As expected, gender did not make significant contributions to either model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hurricane Katrina’s impact on the Mississippi Gulf Coast: General self-efficacy’s relationship to PTSD prevalence and severity.

Hurricane Katrina survivors (N = 399) on the Mississippi Gulf Coast were surveyed to examine the relationship between posttraumatic stress disorder (PTSD) and general self-efficacy. As hypothesized, general self-efficacy was found to be inversely correlated with PTSD severity and prevalence, women reported greater PTSD severity and lower general self-efficacy, as compared with men, and hurricane impact was found to be positively correlated with PTSD severity and prevalence. Age was not significantly associated with general self-efficacy, PTSD severity, or PTSD prevalence, and sex was not found to be significantly related to PTSD prevalence. Hierarchical multiple regression and hierarchical logistic regression analyses further demonstrated the strong association between PTSD and general self-efficacy. Study limitations, research directions, and practical implications of the findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology and the mental health movement.

The following points are elaborated: "1. Among many other things, mental health is a vast social movement which, for better or for worse, will carry us all along with it. 2. Psychologists, for a number of reasons, have not been enthusiastic participators in this social movement. 3. Psychologists have a great deal to contribute to the mental health movement, and they can contribute mightily without loss of identity." Mental health as a social movement seems due to three factors: (a) The tendency to conceive human behavior in naturalistic terms. (b) The American belief in the almost infinite improvability of almost anything. (c) The rising level of aspiration for health and well-being. The scientific humility of the psychologist "can become maladaptive diffidence, and diffidence sometimes becomes irresponsibility." 6 suggestions for dealing with diffidence are indicated. The psychologists perceptions of mental health, the orientation of the movement toward the "pathological," and the focus on the clinical may have discouraged the interests of psychologists in mental health. The unique contribution of the psychologist to mental health is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)