HOUSTON — Many of the people who survived Katrina will face significant mental health issues over the next few months and even years. While the health issues are quite clear — many suffered death, physical injury, infection and exposure to toxic substances — what may not be so apparent are the mental health issues, which are just starting to emerge as a result of the storm.

Generally, when people are exposed to severe stress, they are able to marshal their resources to face the crisis. Only later do the effects of traumatic stress become noticeable. Many soldiers suffer from what is termed “post-traumatic stress disorder.” PTSD was diagnosed in many individuals involved in the Vietnam War.

We can expect to see large numbers of people who will experience PTSD as a result of the catastrophe in New Orleans. Many were traumatized by their experiences in the Superdome. One woman I talked with reported she had stepped on a dead baby in the Superdome before coming to Houston.

Traumas require treatment

Many survivors were suddenly separated from loved ones, either through death or just being lost. Some witnessed shootings by thugs or the authorities. They will need, but likely not get, long-term specialized psychiatric and psychological treatment for these emotional injuries.

So far, I have only addressed new mental health injuries that resulted from the catastrophe. But prior to the storm, New Orleans, like other major metropolitan areas, already had a large population of people with the full gamut of mental health problems, including schizophrenia, bipolar disorder, anxiety, etc. These individuals were deprived of their medication, psychotherapy, as well as community and family support as a result of the storm. It will take years to help them put their lives back together. It can be expected that some will not be able to cope, and without adequate treatment, suicides will increase.

I heard an interview with New Orleans Mayor Ray Nagin in which he talked about the drug problem prior to the storm. After Katrina, addicts were suddenly deprived of drugs to which they were addicted and experienced “cold turkey” withdrawal. When a person is addicted to drugs, particularly opiates, benzodiazepines and/or alcohol, sudden withdrawal can leave them vulnerable to seizures, heart attacks and strokes as well as severe mood problems and psychosis.

Other vulnerable populations should be considered also. People with mental retardation have been separated from supportive families and treatment programs.

Privatization compounds crisis

Prior to the storm, the city of Houston already had a serious crisis of availability of mental health treatment. With the increasing privatization of mental health care over the last 20 years, resources are stretched beyond the limit. Commercial insurance coverage for mental health treatment has dwindled to next to nothing. Other state programs such as Medicaid and CHIPS have been stripped of mental health benefits. The influx of a whole new city of people with extraordinary mental health treatment needs will inundate an already swamped mental health care system.

Meanwhile, doctors in Houston have stepped up to the plate and volunteered their time to treat the mentally ill. The need for mental health treatment of the people affected by the storm is tremendous now and will continue for a long time to come. There is a tremendous need for a team of government-employed mental health professionals, including psychiatrists, psychologists, psychiatric nurses and social workers to be trained and equipped, ready to meet disasters like this in the future.

Paul Hill (phill2 @ houston.rr.com) is a mental health worker in the Houston area.