Mental health of survivors after a natural disaster often overlooked, says expert

A repair worker is silhouetted by a police spotlight as he walks down a darkened street during a Nor’Easter snowstorm on November 7, 2012 in the Rockaway neighborhood of the Queens borough of New York City. The Rockaway Peninsula was especially hard hit by Superstorm Sandy and some are evacuating ahead of the coming storm. Mario Tama/Getty Images

TORONTO – Almost two weeks after the northeastern United States was hammered by Sandy, efforts by New York and New Jersey residents to rebuild and resume their daily lives have been pushed back due to another storm.

Parts of battered New Jersey received over 12 inches of snow Wednesday night, while in New York City and neighbouring Westchester County, more than 70,000 customers were without power. Homes and businesses who just had their electricity restored following Sandy in many cases found themselves without power again Thursday morning.

“My son who just got his power back has lost it again now thanks to this nor’easter,” says Staten Island resident Mark L. Fendrick on Twitter.

Dr. Katy Kamkar, a clinical psychologist at the Psychological Trauma Program at the Centre for Addiction and Mental Health (CAMH) in Toronto, says that while people require survival kits like food, shelter and heat, the need for emotional, social and mental health support cannot be overlooked.

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“Natural disasters represent a significant risk factor to the mental health of trauma survivors,” says Kamkar. “The more direct our exposure is to the natural disaster and the more involved we are, the more it is likely to influence us.”

Many homes were wiped out as Sandy ravaged the Caribbean, eastern United States and parts of Canada, leaving more than 100 people dead. Tens of thousands of people in the affected regions are still in need of finding emergency housing and-in some cases-long term shelter.

“It’s not going to be a simple task. It’s going to be one of the most complicated and long-term recovery efforts in U.S. history,” said Mark Merritt, president of Witt Associates, a Washington crisis management consulting firm to The Associated Press.

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To date, damage from Sandy has been estimated at $50 billion-making it the second most expensive storm in U.S. history, right behind 2005’s Hurricane Katrina.

Kamkar says the mental distress that is associated with natural disasters is often exacerbated by certain stressors, sometimes referred to as “psychological toxins.” Community devastation and destruction, displacement, homelessness, financial and job loss and loss of loved ones can all contribute to immediate or long-term mental health problems.
Kamkar says the mental distress that is associated with natural disasters is often exacerbated by certain stressors, sometimes referred to as “psychological toxins.” Community devastation and destruction, displacement, homelessness, financial and job loss and loss of loved ones can all contribute to immediate or long-term mental health problems.
“[Disasters] can lead to the onset of a range of adverse mental health outcomes,” notes a 2002 study in the British Journal of Psychiatry that followed the long-term mental impact on disaster victims. “It can represent a further burden to any individuals whose physical and emotional resources have already been depleted by their losses.”
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For those still reeling from Sandy, the additional challenges that people might experience following Wednesday’s storm can also significantly impact one’s mental health recovery.

“Any additional stressors and the associated uncertainty likely contribute to worsening of psychological distress,” says Kamkar.

The short-term and long-term mental impact
In the first few days to couple of weeks immediately after a natural disaster, experts say it is common for people to experience upsetting memories, flashbacks, bad dreams and feelings of intense distress. Often, those who have directly survived a natural disaster will shy away from talking about what happened and will steer clear of places that remind them of the trauma they endured.

“Once the symptoms continue, increase, interfere with daily activities or become more distressing over a prolonged period of time, it is vital to seek help as it might reflect some symptoms of PTSD,” says Kamkar.

Post-traumatic stress disorder, or PTSD, is the most frequent and disabling psychological disorder that can occur following disasters. The anxiety disorder can occur when someone experiences, witnesses or is confronted with a traumatic event that has threatened their safety.

It can make them feel intensely fearful, helpless or horrified.

According to a 2006 study that focused on the extent and impact of mental health problems after a disaster, PTSD “has perhaps led to an underestimate of the importance of depression as a source of morbidity, particularly in populations in which there are major levels of loss that have an enduring effect.”

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Kamkar says the more unpredictable and uncontrollable the traumatic event, the more likely the incident is to trigger PTSD.


The psychological phases after a traumatic event
According to several experts, there are three common psychological phases that people can go through after a surviving a traumatic event like a natural disaster.

Phase one is the impact phase. This is when people survive the natural disaster and they try to protect their lives, and the lives of others. It is common for people to find themselves in panic and shock.
Phase two is the post-disaster phase-the rescue phase. People try to withdraw from the impact of the traumatic event. Here, people might feel high anxiety, anger, sadness, and helplessness.

For example, across the New York and New Jersey (regions at the heart of the disaster), tempers were short in long lines for gas. In New York, a man was accused of pulling a gun on a motorist who complained when he cut in line at a gas station. No one was injured.

The recovery-or third phase-occurs when those who have survived the traumatic event try to readjust to their lives. The adjustment depends on the severity of the traumatic event and also on the injuries and losses people have experienced.

“The more severe the event, the more severe the injuries, the more severe the losses that people go through-the more difficult the adjustment phase becomes for people,” says Kamkar.

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While people who have survived a traumatic event often go through the first three places, phase four is not as common. It is in this phase where symptoms of PTSD can occur.


The chance of someone’s symptoms developing into the anxiety disorder depends to what extent the person was affected by the traumatic event,” said Kamkar. “If the person had experienced previous traumatic events and the level of support the person is able to get after the event.”

Safety tips on returning home after a disaster – what now?

While experts say it is difficult to calculate what percentage of the general population is at risk of developing PTSD, the World Health Organization (WHO) estimates that in the general population worldwide, the baseline prevalence of mild-to-moderate and severe mental disorder are around 10 percent and 2 and 3 per cent, respectively.

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After a disaster, WHO says the general overall prevalence rates for mild-to-moderate and severe mental disorder are liable to increase to 20 and three to four per cent, respectively.

Those experiencing any signs of mental distress are encouraged to seek professional help and support from friends, family and the community. In New York, Staten Island Mental Health Society (SIMHS) is providing free service for those affected by Sandy.

“By the amount of losses ahead of time prior to a natural disaster, we can help minimize the mental health problems people experience as well,” said Kamkar. “The more loss we experience, whether it’s our home, jobs or loved ones, the more stressors exist that can increase our risk of developing mental health problems after a natural disaster.”

– with a file from The Associated Press