Update from the Director
Thomas R. Insel, M.D.
Managing the Aftermath
The initial response to a disaster like Hurricane Katrina rightly focuses on meeting the immediate material needs of survivors. As the nation addresses those needs, it must also prepare to meet the often acute emotional needs of both survivors and responders.
Relief workers can promote mental health by creating and sustaining an environment of safety, calm, connectedness to others, self-empowerment, and hopefulness. Workers should:
- Help people meet basic needs for food and shelter, and obtain emergency medical attention
- Provide repeated, simple, and accurate information on how to obtain these services
- Listen to people who wish to share their stories and emotions and withhold judgment
- Be friendly and compassionate even if people are being difficult
- Provide accurate information about the disaster and the relief efforts
- Help people contact friends or loved-ones
- Keep families together; keep children with parents or other close relatives whenever possible
- Give practical suggestions that steer people toward helping themselves
- If you know that more help and services are on the way, remind people of this when they express fear or worry
We also know there are things to avoid doing, such as:
- Forcing people to share their stories with you, especially very personal details (this may decrease calm in people who are not ready to share their experiences)
- Telling people what you think they should be feeling, thinking, or doing now or how they should have acted earlier
- Making promises that may not be kept (broken promises decrease hope)
- Criticizing existing services or relief activities in front of people in need of these services (this may decrease hope or calm)
Looking to Recovery
It's very important to acknowledge that people often experience strong and unpleasant emotional and physical responses to disasters. Reactions may include combinations of hopelessness, helplessness, depression, sleeplessness, anxiousness, physical pain, confusion, fear, anger, grief, shock, guilt, mistrust of others, and loss of confidence in self or others. If these reactions last for more than a month, however, then a person may have Post-Traumatic Stress Disorder (PTSD).
PTSD is a sometimes debilitating mental health disorder that typically develops in a small percentage of people after exposure to an event in which grave physical harm occurred or was threatened. People with PTSD may repeatedly re-experience a traumatic event through flashback episodes, nightmares, or frightening and intrusive thoughts, especially when something reminds them of the trauma.
PTSD is not a condition that is merely "in people's heads": we know from research that the biological response to danger or threats — the so-called "fight or flight" response — malfunctions in people with PTSD, leaving them unable to turn off the intense emotional and physical sensations. They feel they are in danger even after it has passed.
The good news is that researchers — supported by NIMH, the Department of Veterans Affairs (VA), and other agencies — have developed effective treatments for PTSD. These include medications and cognitive and behavioral psychosocial treatments — talk therapies that teach people to manage upsetting and unwanted thoughts as well as physical symptoms.
NIMH urges its constituents — researchers, mental health providers, advocates, and the general public — to consider how they can aid Hurricane Katrina survivors and responders.
More information about coping with traumatic events.