Shattered Lives
Victims of Katrina lost everything, especially their sense of security and well-being. Can they bounce back?
Long after some semblance of order is restored to the devastated neighborhoods and communities in the Gulf Coast, those who survived Katrina will still have to contend with the emotional effects of their shattered lives. It is not as if the nation hasn't heard it all before. The psychological lessons learned from other disasters--Oklahoma City, 9/11, plane crashes, and tsunamis--are clear.
After a disaster, about 25 percent of the affected population may experience clinically significant mental health needs, while an additional 10 to 20 percent suffer from more transient needs, says Charles Curie, administrator of the Substance Abuse and Mental Health Services Administration of the Department of Health and Human Services. With 1.2 million people affected by the disaster, a conservative estimate is that a quarter of a million people will have some serious mental health needs, such as depression, severe anxiety, or post-traumatic stress disorder.
But Katrina may provide new lessons in the grim textbook of disaster psychiatry. The almost complete eradication of neighborhoods and communities, the separation of families, the tragic destruction of an entire city, the continued danger for many victims for days after the winds died down, the loss of livelihoods, and the stuttering response of the government are hallmarks of this disaster. "The more of these factors that come into play, the greater the emotional impact of the disaster," says Robert Okin, chief of psychiatry at San Francisco General Hospital.
Mastery. The key for preventing, or at least mitigating, some of the long-term mental health consequences of the cataclysm is to limit these elements. "One of the really important factors in traumatic situations is the amount of control that one has during the event," says Steven Southwick, a psychiatrist with the National Center for Post-Traumatic Stress Disorder. "When people talk about stress-induced depression, they are talking about an uncontrollable situation, and one very important aspect for any kind of resilience and recovery for people in a stressful situation is to find some way to master some part of it."
But how can one find mastery in a force of nature so powerful? Henry Necaise of St. Martin, Miss., took refuge with his wife, two sons, a nephew and his son, and two Chihuahuas in the local school where he works as the maintenance man. Even though he figured the school was 60 feet above sea level, he had a plan if the water surged: Head for higher ground. When the water reached the floor of the school, he tied his sons to his body, picked up the dogs in a crate, and he and his family waded in waist-high water to a nearby hill.
Unlike countless others, Necaise was able to do something to improve his fate. But for those in the New Orleans Superdome and the convention center, mastery was impossible. There was no place else to go. In the city, rescue workers dodged bullets fired by the very victims they were trying to save. "People were enraged by their fate, they were enraged by the government's response, and they lashed out," says Jon Allen, a psychologist with the Menninger Clinic in Houston.
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