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Ghost of the Hurricane: Suffering Still Strong

FRIDAY, Aug. 11 (HealthDay News) -- Almost a year after hurricanes Katrina and Rita devastated the Gulf Coast, mental-health issues still remain a critical and unmet challenge for those who live in the region.

The lingering problems were ironically spotlighted this week by the plight of John McCusker, a photographer for 20 years for the New Orleans Times-Picayune newspaper, who was arrested by police after being stopped for erratic driving. McCuster had lost his home and all his possessions during Katrina, but had stayed to photograph the storm and its aftermath.

According to the story in his own paper, McCuster begged officers to kill him and was finally subdued with a Taser gun.

"The individual is a really fine professional who was so depressed that he set out today to commit suicide by cop," the Times-Picayune quoted James Arey, commander of the police negotiation team during SWAT and other emergency situations.

And that one incident focuses in microcosm what so many Gulf Coast residents are feeling a year after their hometowns were devastated.

Other dramas are playing out across New Orleans and surrounding areas, and this week the American Psychological Association (APA) starts its annual convention in none other than The Big Easy.

Not surprisingly, several presenters will focus on the mental-health challenges left by the most devastating natural disaster in U.S. history. Some 2.5 million residents were displaced and at least 1,800 died.

A report released earlier this month claimed that half a million survivors in areas devastated by both Katrina and Rita may still need mental-health assistance. At the same time, the area faces a critical shortage of doctors and other experts, particularly psychiatrists.

A report this month in the Journal of the American Medical Association found that only 140 of 617 primary-care physicians have returned to practice in New Orleans. And only 22 of 196 psychiatrists continue to practice in the city, while the number of psychiatric hospital beds has been sharply reduced: As of June 14, there were only two such beds within a 25-mile radius of New Orleans.

Nine months after Katrina, Priscilla Dass-Brailsford, associate professor of counseling and psychology at Lesley University in Cambridge, Mass., found cars still overturned, houses knocked off their foundations and entire neighborhoods devoid of residents.

The hardest hit were low-income, black communities, Dass-Brailsford said in an APA presentation. "The devastation was just immense, and what struck me were the class differences in the level not only of devastation but also in recovery," she said.

Dass-Brailsford, a native of South Africa, was the only black member of a disaster mental-health team sent to an area where 98 percent of the victims were non-white.

The main shortcoming of mental-health efforts, she said, was the lack of culturally appropriate offerings. One Latino man who had lost his wife and two children in the floods was forced to recount his story in halting English.

Children also are suffering in the wake of Katrina. About 189,000 children were displaced by the catastrophe, according to government estimates. One survey found that 49 percent of children in grades four through 12 met the cut-off to quality for referral for clinical services. Thirty-one percent reported feeling depressed, and 31 percent said they had disturbing memories, thoughts or images about the hurricane.

One-third of children in pre-kindergarten through third grade met the cut-off to qualify for referral for clinical services. Parents reported that 14 percent of these children were depressed, and 31 percent re-experienced the hurricane by talking repeatedly about the storm.

"Fourteen percent of children in grades four through 12 have specifically requested talking to someone. That's not typical of that age group," said Joy D. Osofsky, a professor of pediatrics and psychiatry at Louisiana State University Health Sciences Center in New Orleans. "Thirty-eight percent of parents of younger children said they wanted their child to talk to someone, which is unusual." Osofsky and her husband, Howard, who is also a professor of psychiatry at the New Orleans center, conducted the surveys.

Despite best efforts, no sense of normality has been restored. "They're living in trailers," Osofsky said. "Children are often not back in the same school they were before. They don't have the same friends, the teachers are often different, so the environment is different. People who have lost their homes are not living in the same place."

Authorities have put as many resilience and clinical services within schools as possible to "destigmatize the whole process of delivering mental-health services to children and families," Osofksy said.

First responders, such as police, firefighters and EMTs, were also hard hit. About 80 percent of New Orleans' first responders lost their homes. One in 20 reported the death of a family member. Two New Orleans police officers committed suicide the week after Katrina.

Another survey conducted by the Osofskys found that about 10 percent of first responders reported symptoms of post traumatic stress disorder, and nearly a quarter symptoms of depression. Forty percent reported an increase in alcohol consumption and 41 percent an increase in marital conflict. Forty-four percent said they did not want mental-health services while a surprising proportion indicated that they did.

For Dass-Brailsford, the images of devastation aren't likely to recede any time soon. She saw in the yard of one destroyed house an apron stuck high up in a tree.

"You could tell that people once lived here, people who cared about nice things and had homes and families and cooked meals and were just vibrant, passionate, living people, and they were all gone," she said. "Katrina continues to haunt me."

More information

For more on mental health awareness and the hurricane aftermath, visit the U.S. Substance Abuse and Mental Health Services Administration.