Science Update - Katrina Mental Health

Introduction

The mental health of Katrina victims isn't improving like it should—and in some cases, it's getting worse.

Podcast Katrina Mental Health

Transcript

Katrina's lingering dark clouds. I'm Bob Hirshon and this is Science Update.

They say time heals all wounds, but in the case of Hurricane Katrina, time isn't working like it should. This according to a recent update on the mental health of those affected by the disaster. Study director Ronald Kessler of Harvard Medical School says that rates of depression, post-traumatic stress disorder, and suicidal thoughts usually spike right after a major disaster but gradually decline over the next few years.

Kessler:
In the case of Katrina, we found not only a failure to see any evidence of recovery, but they actually got worse.

Looking more closely, they found that the worst off were people living outside the New Orleans metropolitan area. Kessler says that in the two years since Katrina, these more isolated communities might have felt increasingly short-shrifted with respect to both charitable aid and national sympathy. I'm Bob Hirshon, for AAAS, the science society.

Making Sense of the Research

This study shows that it's often important to sort information out in several different ways in order to make sense of it. In this case, by separating the mental health statistics of those living in the New Orleans metropolitan area from those outside the area, the researchers gained important insight into the possible causes of the problem.

The findings build on a survey first conducted in early 2006, a few months after Katrina hit. Researchers surveyed over 1,000 people in Alabama, Louisiana, and Mississippi, asking them questions that screened for anxiety, depression, suicidal tendencies, and other signs of mental illness. They asked questions that were identical to those used in an unrelated mental health survey conducted in the same parts of the country a few years before Katrina. Not surprisingly, the researchers found that anxiety, post-traumatic stress disorder, and mood disorders like depression were twice as high after Katrina as they had been before. This increase appeared to be distributed fairly evenly across social and economic classes. One bright spot was that the researchers found relatively low rates of suicidal thoughts, owing to a general optimism that life was going to get better again in the not-too-distant future.

Flash-forward to mid-2007: The researchers followed up with the same 1,000-plus people that they interviewed in early 2006. According to past research, up to half of the mental disorders that result from a disaster are usually resolved within a year, and the vast majority disappear within two years. Not so with Hurricane Katrina: Overall, the percentage of people with mental health disorders actually increased slightly from 2006 to 2007. Although this overall increase was not statistically significant, even no change at all is worse than expected. What's more, the overall prevalence of serious mental illness did increase significantly: by over 25 percent. Finally, thoughts and plans of suicide doubled and quadrupled, respectively, from 2006 to 2007.

Again, social and economic factors didn't have an impact on these statistics; that's a fairly standard thing to check for in any epidemiological study. However, when the researchers decided to compare the New Orleans metropolitan area to the regions beyond it, the differences became much more dramatic. Anxiety and mood disorders, serious mental illness, and post-traumatic stress disorder had gotten much worse in the areas beyond New Orleans than in New Orleans itself. In fact, the rates of serious mental illness and post-traumatic stress disorder hadn't actually changed at all in the New Orleans area. All of the increase, apparently, was being driven by the outlying regions.

Had the researchers looked only at the entire survey population, they would not have discovered that the areas beyond New Orleans had an even more urgent mental health crisis than the New Orleans area. In fact, their findings suggest that our tendency to lump all the areas affected by Hurricane Katrina together might be partly to blame for the problem. Since New Orleans is the best-known city seriously damaged by the hurricane, and received the most national news coverage at the time, people tend to think “New Orleans” when they hear “Katrina.” As a result, it's possible that relief efforts have focused so much on New Orleans that they leave the other areas out in the cold. This isn't to say that New Orleans is getting too much aid, but rather, that the other affected areas could use some more attention as well. However, it's important to note that scientists can only guess right now at the causes of the statistical difference; there may be other factors involved that have yet to be identified.

Now try and answer these questions:

Identify the three different points at which this mental health survey took place. How did the first time differ from the following two times?

How did the overall results of the follow-up survey mask the differences between the New Orleans area and the other affected areas?

Do you agree with the hypothesis that areas beyond New Orleans have been under even greater mental stress since the hurricane? Why or why not?

Why might it be more difficult to address mental health problems in rural areas than in major cities?




Going Further

Check out the December 7, 2007, Science Update Podcast to hear further information about this Science Update and the other programs for that week. This podcast’s topics include: A vaccine for antibacterial-resistant staph infections, future crops use space-age technology, and growing green roofs.

In Poverty-Stricken Mississippi, Katrina's Damage Lingers, is a National Geographic news article about the aftermath of 2005's Hurricane Katrina in the poorer areas of Mississippi. Three weeks after the disaster, some of the poorest and hardest-hit areas were still waiting for aid.

The Science Update lesson on Adaptive Happiness describes a surprising bounce in mental outlook just a few weeks after Katrina. Students might discuss how to reconcile these findings with those discussed in this lesson.