top of page
Search
Writer's pictureDavid Newby
Nov 219 min read

Mental Health Recovery After Natural Disasters


This fall, Americans saw the enormous destructive power of nature at work as hurricanes Helene and

Milton struck communities throughout the Southeast. The news cycle moves quickly, and it’s easy to

forget about the lost lives and homes when the next story comes down the pike. But the work of

Written By: David Newby – Life Sciences Editor, Writer, and Translator

recovery is still ongoing, and I’m not just talking about restoring electricity and healing broken bones.

Even if it’s not visible, the emotional impact of a terrifying experience can cause damage that lasts as

long as any physical injury. Care for that damage is a crucial part of the recovery process.



Post-Traumatic Stress Disorder and Its Prevention


There’s nothing wrong with having a stress reaction to a life-threatening experience. In the early stages

of recovery, it’s very common to be agitated, fearful, or detached or to have trouble sleeping,

concentrating, and getting along with others. It’s a normal reaction to an abnormal experience, and it

happens to most people in this type of situation (Common Reactions After Trauma). But when these

symptoms are still causing distress and interfering with daily life months or years later, the problem may

be post-traumatic stress disorder (PTSD).


PTSD is typically diagnosed in people who have had these symptoms for at least a month:


  • Re-experiencing the traumatic event (having flashbacks, nightmares, etc.)

  • Avoidance (staying away from thoughts, situations, or experiences that provide reminders of the

    traumatic event)

  • Arousal and reactivity (feeling restless, easily startled, or engaging in negative behavior)

  • Cognition and mood symptoms (negative thoughts or emotions like numbness, guilt, or

    depression) (PTSD Basics)


Living through a terrible experience like a natural disaster is difficult for anyone—there’s no getting

around that. But it doesn’t have to end in the long-term damage of PTSD. Most Americans have had a

traumatic experience, but the percentage with PTSD is in the single digits. Experts in psychological

recovery from disasters increasingly see PTSD as a pathological state in which the normal process of

assimilating new information to help us live safely is blocked (Trauma-Informed Care). It’s a problem we

can prevent by providing disaster victims the right tools.



The MHPSS Model: Giving Everyone the Kind of Support They Need


A key concept for the people who provide them with those tools is the mental health and psychosocial

support (MHPSS) model. This was established in 2007 by the United Nations’ Inter-Agency Standing

Committee in order to establish a consensus on the best practices for protecting mental health after

disasters and conflicts. This approach views the types of services needed as a pyramid, with each layer

consisting of different types of support needed by different populations. Basic services that meet

everyone’s physical needs constitute the base. Above that sit supports for families and community

groups and then non-specialized mental health supports like psychological first aid (PFA Manual). At the

top of the pyramid are the specialized services needed by those with severe mental disorders. All of

these services are important, and all of them are provided simultaneously to the various populations

who need them (MHPSS Interventions).


Everyone who’s followed the response to hurricanes Helene and Milton has heard heartrending stories

of people who’ve suddenly lost access to shelter, clean water, and food, and may be unable to contact

loved ones. The longer people endure those conditions, the more psychological stress they face. That’s

why meeting these basic needs underpins everything else in the MHPSS model. A study of survivors of

Hurricane Ike in 2008 found that financial difficulties after the storm had a particular association with

later PTSD (Pietrzak, 2013), and a study of survivors of Hurricane Katrina found that those who couldn’t

return home after the storm suffered more PTSD symptoms and other problems than those who could

(McGuire, 2018).

Once those most basic needs are met, disaster victims still have community and social needs. A cohesive

community and social support help people solve practical problems and maintain psychological health.

The loss of social connections has been shown again and again to increase the risk of PTSD, and this can

become a vicious cycle as the avoidance caused by PTSD leads to further social isolation (Risk and

Resilience).



Talk Therapy and Other Approaches to PTSD


The passage of time and the support of family and community are enough to help most people get back

on their feet after a disaster. Some still suffer, though. Fortunately, there are many therapeutic tools to

help them. One of the most widely used tools is cognitive behavioral therapy (CBT). This is considered a

“must try” intervention that can dramatically shorten PTSD symptoms (Qi, 2016). It’s a type of talk

therapy that provides patients with a safe and supportive space to take another look at how they think

about their experiences. After a frightening experience, patients may feel that everything in their

environment is more dangerous than it is, or may avoid anything that reminds them of their experience,

like news stories. Unhelpful reactions like these can feed the symptoms of PTSD. CBT aims to help

patients overcome them by helping them explore distortions in their thoughts or exposing them to their

fears in a way they know is safe (American Psychological Association, 2017).


While CBT and related approaches are the most common strategy for preventing and alleviating PTSD,

other innovative approaches have gained attention in recent years. Many of these are what are called

“somatic” approaches—those that focus on the mind/body connection and the ways that emotions are

expressed by the body. They use a wide variety of methods to encourage patients to become aware of

and overcome the physical effects of stress. They have gained much attention due to the runaway

success of Bessel van der Kolk’s book The Body Keeps the Score (Salamon, 2023).


Somewhat similar is an approach called Eye Movement Desensitization and Reprocessing (EMDR). In this

approach, patients are asked to briefly process a traumatic memory while also focusing on an external

stimulus—usually by moving their eyes as directed by their therapist. This is believed to provide access

to traumatic memories in a way that makes it easy to reprocess them and remove their power. EMDR is

not as well-established as CBT and it’s subject to some controversy, but many patients credit it with

rapid relief from PTSD that other methods couldn’t cure (Cleveland Clinic, 2022).



Caring for the Heart With Land Cruisers and Soup: An Example from Japan


Watching the coverage of the recent hurricanes here in the United States, it was hard for me not to

think back to the early morning of March 11, 2011, when I watched the early coverage of the Tohoku

earthquake in Japan. As I saw the enormous tsunami waves inundate the peaceful and charming area I’d

vacationed in a few years beforehand, it was hard to see how anyone there could recover. But even at that moment, the process of rescue and rebuilding was already beginning. One of the most important

parts of that process involved care for the mental health of the people who were most affected.

Before this disaster, mental healthcare in Tohoku was in a poor state. Patients had few options

outside of hospitals and the region had suicide rates high enough to make it the focus of national policy.

In order to maintain care for those already in the mental healthcare system, dozens of teams were

dispatched to the area. This began in the first few days, when any access to more than a hundred miles

of coastline was difficult. These teams included psychiatrists, psychologists, and nurses and were

designed to be entirely self-supporting. They travelled by Land Cruiser and provided all of the

medication and care they could, even in remote areas where all medical records had been lost (Suzuki

and Kim, 2012).


Previous disasters showed the Japanese authorities that protecting mental health is a long-term project

that requires long-term investment. This has taken the form of what are called “Kokoro no Care

Centers.” This means “care for the heart” in Japanese, with “heart” used in the wider sense of the spirit

or mind. This somewhat ambiguous name was chosen carefully. Mental health issues are still subject to

a heavy stigma in Japan, and it was important to give these centers a name that was broadly appealing.

They were established in the regions that were most heavily impacted in the months after the disaster,

and their operations are based on the MHPSS framework. As such, they combine psychological and

psychiatric care with non-medical initiatives to provide food, housing, and community development

(Suzuki, 2015). A survey of professionals involved in this kind of disaster response indicate that they

consider their role to be closer to public health than the medical treatment of specific disorders, and

that they don’t see trauma and grief as inherently disordered (Kayano, 2022).


This approach means that many of the activities of Kokoro no Care Centers might not seem at first

glance to have much connection with the serious mental problems disasters cause. In Fukushima

prefecture, which suffered the worst nuclear disaster in decades in addition to the earthquake and

tsunami, some of the most successful activities the local Kokoro no Care Center carried out in its first

year were parties (FCDMH, 2012). Called “imoni,” these are an autumn tradition in which friends gather

outdoors to enjoy a hearty soup of taro root and meat when the weather gets chilly. Being able to enjoy

a beloved activity like this was a crucial way of refreshing the heart and mind and rebuilding communities.


This doesn’t mean that care for people with serious mental health challenges isn’t a major part of the

Kokoro no Care mission. Many of the clients served by these centers have severe illnesses like

schizophrenia that predated the disaster (FCDMH, Three Years). But providers indicate that the most

common type of activities they carried out was collective activities ranging from memorial ceremonies

to handicrafts clubs. These activities serve a crucial role in supporting the community, but they also

provide an opportunity for outreach to people who might need more support. A simple activity like

teatime or an exercise class is an opportunity to listen to participants when they’re relaxed enough to

say what’s on their mind (Seto, 2019).



Help Close to Home


If you or someone you know are feeling the emotional effects of a disaster in the United States, there’s

help available:


  • The US Substance Abuse and Mental Health Services Administration operates a disaster distress

helpline that provides counseling to disaster victims in over 100 languages.


  • First responders bear a mental health burden that often rivals that of the people they protect,

and there is an increasing number of services dedicated to them. Those who have worked in

North Carolina after hurricane Helene can contact the Hope4NC helpline to receive support and

counseling.


And if you are able to provide help to those who need it, I hope you’ll do so. Donating to almost any

charity you care about can provide support in the next disaster that strikes. As I’ve explained above, help

of all kinds, even the most unlikely, can benefit the mental health of the people who need it the most.


References

 

Hi, I'm David Newby. In my career as a translator, editor, and writer in the life sciences, I’ve focused on communicating complex scientific and regulatory material, with a particular emphasis on the Japanese market. To succeed in that, I’ve cultivated precision and rigor, but also the empathy and curiosity you need to communicate with different audiences, cultures, and disciplines.

Tags:

9 views0 comments

Comments

bottom of page