Friday, August 28, 2009

Hurricane Katrina and the Help That Never Came

Where were you four years ago? This is an easy one for me, since I was home with a three month-old baby watching "overblown" news coverage about this hurricane that was heading straight for New Orleans. The predictions seemed outlandish. Flooding of an entire city? Don't be silly. In the days that came, my son and I continued to watch as the Convention Center in New Orleans where I had given a talk just a year before filled with people and the spokespeople in Washington incredibly said they were unaware that anyone was there, because they had been told not to go there.

The delay in rescuing the people of New Orleans was a national shame. The delay in restoring essential services got less attention, but was no less appalling and no less a failure of our society to care for those in need. There was another delay, though, that is more understandable. That is the delay -- or absence -- of mental health assistance for those whose lives were demolished by the storm and by the lack of help that followed.

In the days directly after the storm, people's basic physiological needs were not being met. It would have been totally inappropriate to go talk to people who are crammed into the Superdome or the Convention Center without basic food and sanitation about how they are feeling. Anyone who had the time and ability to do that should have been, and mostly was, getting people to safety, feeding them, and finding them someplace to stay.

The rule of thumb is to provide early crisis intervention services when the situation is stable and the incident itself is over, as close as possible in time and location to where it happened. But because of the way this disaster played out and the delays in assistance for physical needs, there was never an obvious opportunity to do that. It took many months, if not years, for many who had weathered the storm to be in a physically stable situation. By the time they were, they were literally scattered all over the country. CISM is designed for people who have been through hell and are now returning to a world that is basically still normal, but they don't feel normal. The world was never "still normal" for many Katrina survivors.

That is not to say that no one ever got help. Those with the most extreme manifestations of Post-Traumatic Stress Disorder are still being served by the mental health system. CISM is not designed to prevent PTSD, so I won't argue that earlier intervention would have made a difference. However, studies of PTSD in Katrina victims show that increased watching of news coverage following the storm was associated with risk of PTSD symptoms, and between 38% and 50% of people who lived in New Orleans when Katrina hit have or had symptoms of PTSD. The only thing I can imagine might have been done early is to advise people not to watch TV. That probably wouldn't have worked.

By the way, it's not that no one got CISM services after Katrina. Teams from around the country were mobilized to work with rescue workers following the storm. They had the possibility of coping with this as a discrete incident. Most of the residents never did.


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Naomi Zikmund-Fisher
is a clinical social worker, former school Principal and a Crisis Consultant for schools and community organizations. You can learn more about her at
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