Puerto Rico is trapped in a humanitarian crisis following the devastation of Hurricane Maria. It seems like only yesterday Florida was pounded by Hurricane Irma. And only a few weeks before that, it was Hurricane Harvey punishing the Gulf Coast.
The situation in Puerto Rico looks bleak, and responders will do everything they can to save as many lives as possible during this period of triage and subsequent rebuilding. But eventually things will get better. And if we’re lucky, we will learn from this devastating hurricane season and be more prepared for next time.
Part of the reason the damage in the mainland U.S. was not as bad as it could have been is ironically due to the lessons learned following Hurricane Katrina. After Katrina, building codes changed, regulations changed, and people evaluated their responses to the tragedy and tried to build a better plan for the future. But that self examination and growth was not limited to FEMA and government inspectors. It also included addiction treatment providers.
A new study published in the Journal of Addictions and Offender Counseling looks at how treatment providers dealt with the aftermath of Hurricane Katrina and what they learned from the experience. Researchers spoke with 11 addiction service providers and chronicled their experiences, focusing both on how they thought Katrina affected clients, and on what providers needed in disaster affected areas in the 18 months following the storm. The goal was to understand how a disaster like Katrina impacted the ability to provide services and to help formulate a disaster response plan for the future.
Facing enormous challenges
The treatment providers, who worked in Mississippi, Louisiana, and Houston, Texas, said their main challenges fell into four categories: “client population, staff-related issues, service delivery, and facilities.” They talk about how evacuations and the permanent settlement of displaced people in new cities left some treatment centers overwhelmed with clients, while others had none. They talk about a lack of staff, and of the physical and mental toll working under such duress had on the treatment providers themselves. They chronicled how counselors and other staff had to be as flexible as possible to try to maintain service while connecting clients to the resources they needed.
While issues with transportation and facilities may be fairly obvious, treatment professionals also reported more serious concerns that required providers to adapt both their services and their delivery models. According to the study’s authors, “Mobile treatment teams were developed and, in some instances, were able to prevent suicides related to trauma. Counseling personnel were forced to shift to crisis intervention and short-term intervention methods as emergency rooms were overwhelmed with mental health patients.”
The idea of disaster-related trauma and other mental health issues is a major feature of the study, and one often lost in media coverage of natural disasters. It’s easy to look at a toppled house and talk about what it will take to rebuild it. It’s much harder to look at the homeowner and understand the impact such a loss has on their psyche and what it will take to maintain their overall mental health. As we watch relief efforts unfold in Puerto Rico and the southern states, we must remember that the problems run much deeper than a lack of basic supplies.
Lessons for the future
One of the study’s major takeaways is the need to focus not solely on the physical needs of clients following a disaster, but on their mental health needs as well. As much as treatment providers need to be ready to deploy services in new ways, they also have to be prepared for the onslaught of issues they may see only so often before disaster strikes. Issues of grief, loss, trauma, and PTSD are in abundance following a natural disaster, and treatment providers need to adapt their services accordingly.
The study also speaks to the need for self-care on the part of treatment providers. Unless they are working in a city outside of the affected area and are simply treating displaced persons, treatment providers will have experienced their own trauma and need to be cognizant of that fact as they interact with clients. The lesson is one not of mere physical preparedness, but of mental preparedness as well. We also need lawmakers and government officials to recognize the needs of both providers and clients in times of desperation, and allocate resources accordingly.
As we acknowledge the long road ahead for the people of Puerto Rico and the southern states, the authors’ final message is probably the one that most bears repeating. They write:
“It is very likely that we will see more disasters like the one discussed in this article. The voices of the participants in this study continue to remind us of the importance of preparation, learning from the past, and attention to self-care for counselors in response to disasters. We can honor these voices by training future addiction counselors to be resilient, effective, and compassionate responders.”
You can read the study in full at: http://onlinelibrary.wiley.com/doi/10.1002/jaoc.12032/full