Science Update December 17, 2007
Hurricane Katrina Survivors Lack Access to Mental Health Services
The majority of Hurricane Katrina survivors who developed mental disorders after the disaster are not receiving the mental health services they need, and many who were receiving mental health care prior to the hurricane were not able to continue with treatment, according to an NIMH-funded study published online ahead of print December 17, 2007, in the American Journal of Psychiatry.
Philip Wang, M.D., Dr.P.H., formerly of Harvard University, and now director of the NIMH Division of Services and Intervention Research, and colleagues conducted telephone surveys in early 2006 with 1,043 adults who had been affected by the hurricane in Alabama, Mississippi and the New Orleans metropolitan area. Respondents were asked if they had a diagnosed mental disorder, such as depression or anxiety, prior to the hurricane for which they received professional treatment. Those who did not have a pre-existing disorder were asked if they had developed and been treated for a mental disorder since the hurricane struck. Treatment included medication and/or psychotherapy from mental health professionals, general medical providers, religious or spiritual advisors, or complementary and alternative medicine professionals.
Nineteen percent of people surveyed said they had developed a mental disorder after the hurricane. Among them, only 18.5 percent were receiving any treatment. Among the 21 percent of respondents who said they had been in treatment for a mental disorder prior to the hurricane, 23 percent were having difficulty maintaining treatment after the storm, and were receiving reduced treatment or no treatment at all.
Respondents with pre-hurricane mental disorders cited loss of financial resources, such as unemployment and loss of insurance, as a significant barrier to maintaining treatment. In addition, they noted that many mental health care facilities and personnel were lost after the hurricane, especially in the New Orleans area. Those who were identified as having a post-hurricane mental disorder commonly indicated they felt no need to seek treatment. The majority of the respondents who did get treatment after the hurricane received it from general medical providers. Many of these respondents received medication, but few had access to psychotherapy.
The researchers note that their study sample likely underrepresented those who were most disadvantaged or ill because people unreachable by phone were excluded. Wang and colleagues conclude that future disaster management plans should anticipate the mental health care needs of people with pre-existing disorders who need to maintain treatment, as well as survivors who may be vulnerable to emotional difficulties and mental disorders triggered by the disaster itself.
Wang PH, Gruber MJ, Powers RE, Schoenbaum M, Speier AH, Wells KB, Kessler RC. Disruption of existing mental health treatments and failure to initiate new treatments after hurricane Katrina. American Journal of Psychiatry. Published online ahead of print Dec 17, 2007.
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