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)     

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)     

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)     

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)     

In the aftermath of Hurricane Katrina: A personal story of a psychologist from New Orleans.

The author, a psychologist living in New Orleans and specializing in trauma work, describes her personal story in the aftermath of Hurricane Katrina. The immediate response to the crisis, her personal feelings related to the devastation of her community, and ways to organize a mental health response are elaborated. The author describes the work of the trauma team from the Louisiana State University Health Sciences Center in providing immediate outreach and mental health services on the cruise ships set up to house first responders in New Orleans, in schools, and in the community. The author describes psychological first aid in crisis response and provides vignettes illustrating the experiences of first responders, children, and families. Finally, the lessons learned by the author are elaborated. Along with negatives, positive lessons can be learned with such a life-transforming experience. The importance of recognizing vicarious traumatization is emphasized as well as the crucial need for self-care for victims, survivors, and mental health providers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

After the storm: Katrina's impact on psychological practice in New Orleans.

The impact of Hurricane Katrina on 4 senior New Orleans-based psychologists, both professionally and personally, is described. The authors are pediatric, adult, and family therapists and neuropsychologists; by employment, they are medical center academics, independent practitioners, administrators, and staff/consulting psychologists at medical and psychiatric hospitals. Their diverse experiences following Katrina are similar to the experiences of many individuals in the professional community of the Gulf Coast. In the face of the storm, they departed New Orleans and afterward returned at varying intervals. The homes of all of the 4 New Orleans authors were damaged or destroyed. All of their practice locations were closed for varying periods, and 2 were closed permanently. Of the 4 who returned to New Orleans, only 2 remained 18 months after the storm; the others had relocated to other states. This article reflects on their collective experience as mental health professionals living in New Orleans after Katrina and lessons learned from that experience. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hurricane Katrina: Experiences of psychologists and implications for future disaster response.

The landfall of Hurricane Katrina marked not only one of the most significant and destructive natural disasters for the United States in recent history, but also a new benchmark in challenges faced by psychologists providing services. The authors explain their roles following the hurricane, describing not only local activities for recovery but efforts conducted in the Gulf Coast as well. Experiences and perceptions of the first author, who was deployed to the Gulf Coast on numerous occasions, are highlighted. In addition, psychological assessments were carried out with a small number of displaced Katrina survivors who were relocated to the authors' local community. The authors document many of the challenges faced by psychologists and other mental health workers during relief efforts in the Gulf Coast, concluding with a set of recommendations for future disaster-relief initiatives regarding such issues as ways in which psychologists can participate in disaster-relief efforts, challenges faced when implementing interventions, cultural competency, community preparedness, and scientific research. (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)     

Public mental health: The role of population-based and macrosystems interventions in the wake of Hurricane Katrina.

Policy makers and decision makers are struggling to recognize the needs of shattered communities in the wake of unimaginable devastation. Professional psychology is providing some of the answers as it examines the consequences of disaster. The authors, 6 U.S. Public Health Service commissioned officers, describe their experiences in this new arena. Working at the federal, state, and local levels of government during the national response to the Hurricane Katrina disaster, the authors strive to identify high-value practice areas and define new roles for professional psychologists. The authors suggest that traditional crisis and trauma interventions are expanding to include nontraditional population-based and macrosystems-level interventions. Such roles are explored in narrative form, providing professional and personal insight into the impact that psychologists can have on decision makers who recognize their value and position them effectively. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

After the storm: Recognition, recovery, and reconstruction.

On August 29, 2005, when Hurricane Katrina made landfall near the Louisiana-Mississippi border, it exposed a large number of people to extraordinary loss and suffering. The enormous swath of physical devastation wreaked across the marshes of Louisiana's Plaquemines Parish to the urban communities of New Orleans and the coastal landscape of Mississippi and Alabama caused a notable change to the demographics of the Gulf Region, making it the most expensive natural disaster in U.S. history. This article describes a disaster responder's experiences of working with displaced survivors of Hurricane Katrina, providing crisis and mental health support in the acute phase of the disaster. This is followed by a discussion of the importance of a multicultural approach to helping survivors of a natural disaster; several guidelines to improve multicultural competence are proposed. In particular, the importance of attending to survivors' racial, socioeconomic, language, and religious differences is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A tale of two studies of two disasters: Comparing psychosocial responses to disaster among Oklahoma City bombing survivors and Hurricane Katrina evacuees.

Purpose: An accumulation of disaster mental health research literature in the last few decades has contributed knowledge to direct disaster mental health interventions. However, no single set of principles can necessarily outline all anticipated mental health needs to be encountered in a particular disaster. Methods: To illustrate how different disaster scenarios may yield a divergence of mental health needs, this article compares mental health findings from two distinctly different studies of two very different populations affected by two very different disasters: directly exposed survivors the Oklahoma City bombing and sheltered evacuees from Hurricane Katrina. Results: Research on the two disasters reviewed illustrates many facets and complexities of postdisaster mental health needs in different populations in different settings after different types of disasters. The major findings of the Oklahoma City bombing study related to posttraumatic stress disorder and the main findings of the Hurricane Katrina study involved need for treatment of preexisting chronic mental health and substance abuse problems. Conclusion: The disaster studies in this review diverged in type of disaster, affected populations, setting, and timing of the study, and these studies yielded a divergence of findings. One disaster mental health model clearly cannot adequately describe all postdisaster scenarios. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Helping African American clergy and churches address minority disaster mental health disparities: Training needs, model, and example.

Using an action participatory research approach, the authors conducted qualitative interviews with 41 African American clergy 1 year after Hurricane Katrina in severely affected areas of south Mississippi. These interviews revealed how mental health professionals can work with African American clergy and their churches by providing training that targets minority disaster mental health disparities. A 3-tier training model for equipping African American clergy and churches to respond to disasters in hopes of reducing minority disaster mental health disparities is offered. Identified training needs and suggested training delivery formats are discussed. A sample outreach and educational training project designed to equip African American clergy and churches in their response to minority disaster mental health disparities is also highlighted. (PsycINFO Database Record (c) 2011 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)     

Organizing chaos: Crisis management in the wake of Hurricane Katrina.

Applying the model of crisis management (D. Smith, 1990), this case study of the Louisiana Society for the Prevention of Cruelty to Animals in New Orleans chronicles the organization's response to Hurricane Katrina and illustrates the unique aspects of this crisis, as well as the well-worn patterns this organization faced in the year following the storm. We describe the organizational challenges associated with various stages of crisis and identify the strengths that facilitated this organization's successes. Practical and theoretical suggestions are provided for how organizations and organizational psychologists can learn from the Hurricane Katrina catastrophe. Five lessons are summarized for helping organizations better prepare for future crises. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Inmate Perceptions of Mental Health Services.

With the increasing rise in the U.S. prison population, meeting the mental health needs of inmates before, during, and after incarceration remains an obstacle. What are the mental health experiences of inmates? For what types of problems are inmates willing to seek help, and what are the barriers to their service utilization? This study investigated inmates' attitudes and perceptions toward mental health services and examined whether these attitudes and perceptions vary with respect to ethnic group membership or among inmates of differing security levels. Implications of these findings for psychologists, including psychologists not employed in correctional settings, are highlighted. (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)     

Supporting children's mental health in schools: Teacher perceptions of needs, roles, and barriers.

There is a significant research to practice gap in the area of mental health practices and interventions in schools. Understanding the teacher perspective can provide important information about contextual influences that can be used to bridge the research to practice gap in school-based mental health practices. The purpose of this study was to examine teachers' perceptions of current mental health needs in their schools; their knowledge, skills, training experiences and training needs; their roles for supporting children's mental health; and barriers to supporting mental health needs in their school settings. Participants included 292 teachers from 5 school districts. Teachers reported viewing school psychologists as having a primary role in most aspects of mental health service delivery in the school including conducting screening and behavioral assessments, monitoring student progress, and referring children to school-based or community services. Teachers perceived themselves as having primary responsibility for implementing classroom-based behavioral interventions but believed school psychologists had a greater role in teaching social emotional lessons. Teachers also reported a global lack of experience and training for supporting children's mental health needs. Implications of the findings are discussed. (PsycINFO Database Record (c) 2011 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)     

Postdisaster supervisor strategies for promoting supervisee self-care: Lessons learned from Hurricane Katrina.

The purpose of this article is to provide supervisors with postdisaster strategies for promoting supervisee self-care. These recommendations are based on relevant disaster mental health and supervision research along with the authors' experiences of supervising and teaching in a university setting following Hurricane Katrina in South Mississippi. Supervisory examples from the authors' hurricane experiences are also provided to highlight each recommendation. A supervisee self-care tool is offered to aid supervisors in their efforts to help supervisees develop positive coping responses in the event of a disaster. (PsycINFO Database Record (c) 2010 APA, all rights reserved)