It Ain’t Easy Livin’ in the Big Easy: Down and Dazed but Not Out
By Michael L. Sulkowski, Jill West, & Philip J . Lazarus
In this article, the impact of two major disasters on residents of New Orleans and the Gulf Coast are discussed. An overriding concern as expressed by the recently released report issued by the National Commission on Children and Disasters, 2010 Report to the President and Congress, is that "... meeting the needs of children in disaster planning and management is a national responsibility lacking not only sufficient funding, but also a pervasive concern, a sustained will to act, and a unifying force" (iv).
Round One: Sizing Up a Formidable Opponent
Hurricane Katrina reached category 5 status on the Saffir–Simpson Hurricane Scale on August 27, 2005—the highest possible rating for hurricane intensity. With the strongest recorded winds of any hurricane that had entered the Gulf of Mexico, the storm packed a powerful punch and was heading directly toward New Orleans. Then, while closing in on the coast, Katrina veered to the east of the city and made landfall as a category 3 hurricane on August 29. The eye of the storm passed over the border between Louisiana and Mississippi and devastated communities stretching from Mandeville, Louisiana to Moss Point, Mississippi. However, aside from causing mild to moderate damage across the region, the city of New Orleans and many other Gulf Coast communities endured Katrina’s initial assault stoically.
Round Two: A Devastating Right Hook
Although Katrina’s highest winds were recorded far to the east of New Orleans, the combination of high storm surge and the failure of a poorly fortified levee system contributed to more than 50 levee breaches and the flooding of 80% of the city (McQuaid, Marshall, & Schleifstein, 2005). This crippling blow was almost a knockout punch as the flooding of New Orleans contributed to the deaths of more than 1,800 people, left thousands homeless, and was the most expensive disaster in United States history. Furthermore, some communities were left completely devastated. For example, almost every building in St. Bernard and Plaquemines Parishes was damaged by floodwater, and school enrollment in the local schools dropped to only 3% of their pre–Katrina numbers. After the disaster, thousands of students and families relocated to countless different communities across the United States. At this point, it was unclear if or when the city would get back on its feet. The referee was moments away from ringing the bell.
Round Three: Open Wounds and a Rookie Cut Man
Although the Gulf Coast is no stranger to natural disasters, Hurricane Katrina was an unprecedented catastrophe. The combination of extensive storm damage, widespread flooding, and the forced relocation of thousands of individuals created an overwhelming sense of uncertainty, panic, despair, and disconnect among affected citizens. Furthermore, the local, state, and federal response to the disaster was widely criticized for being too slow, disorganized, and unprepared to meet the needs of a devastated population. Police forces in the region got a "black eye" from the uncovering of a series of inappropriate and tragic incidents that occurred after the flooding of New Orleans. For example, while brandishing firearms, the Gretna police turned back displaced and dehydrated citizens who were attempting to leave their flooded neighborhoods. Additionally, the U.S. Department of Justice has indicted 13 New Orleans police officers for their alleged involvement in crimes that occurred in the immediate aftermath of Katrina, crimes that included shooting unarmed civilians, violating the civil rights of citizens, and covering up police shootings (Purpura, 2008; Spillius, 2010).
Round Four: Stunned but Still Fighting
Many children and families have returned to devastated communities in the Gulf Coast region, yet these individuals still reel from Katrina’s devastating blows. For example, the average displaced family from Louisiana moved 3.5 times during the 6 months following the disaster (Abramson, Stehling–Ariza, Garfield, & Redlener, 2008). Many children from these families experienced serious disruptions in their academic progress and peer relationships as well as mental health problems. For example, one study found 79% of displaced children reported the onset of mental health symptoms (e.g., depression, anxiety, posttraumatic stress) in the year following the disaster. Furthermore, the majority (56%) of these youth continued to experience mental health difficulties 2 years after Katrina (Roberts, Mitchell, Witman, & Taffaro, 2010). Similarly, McLaughlin et al. (2009) found that 9.3% of 4– to 17–year–old youth displayed symptoms of severe emotional disturbance attributable to the effects of Hurricane Katrina, and Weems et al. (2010) found that 41% of 8– to 15–year–old Katrina victims displayed moderate to very severe symptoms of posttraumatic stress disorder (PTSD). Furthermore, rates of PTSD dropped only 2% over the course of 30 months in the latter study. Thus, this suggests that 39% of youth affected by Katrina displayed moderate to very severe PTSD symptoms that persisted for more than 2 years. Despite the obvious need to provide these youth with help and support, fewer than half of these young people actually have received adequate mental health or psychological support in the aftermath of Katrina (Abramson et al., 2008).
Round Five: Regaining Footing
Despite Katrina’s unprecedented devastation and the trauma associated with the disaster, many parts of the Gulf Coast have made considerable progress toward recovery. For example, the population of New Orleans has grown to 80% of its pre–Katrina level, the tourism and food service industries have rebounded, many famously inefficient bureaucratic practices that existed before the storm have been overhauled, and more than $52 billion have been marshaled to provide services such as homeowner grants, emergency food stamps, and small business loans to affected individuals. Perhaps most symbolic of this recovery is the partial transformation of the Superdome from an infamous site that once housed thousands of displaced and dazed citizens to the home of the 2009 Super Bowl champion Saints.
Palpable feelings of recovery also are being felt in many schools in the region. For example, the Recovery School District (RSD), which actually was created by the Louisiana Department of Education in 2003, has tried to revamp public education and underperforming schools in Orleans Parish. One hundred and seven schools have been placed in the RSD, 70 of which are currently operational. The rest have been returned to the Orleans Parish School Board. Overall, the RSD serves about 24,000 students who live mostly in southern Louisiana. The RSD recently has embarked on a national campaign to recruit highly trained educators and rehire teachers who were displaced by Katrina. Similarly, the RSD also provides training opportunities for predoctoral school psychology interns to serve schools that were impacted by the disaster through collaboration with the Louisiana School Psychology Internship Consortium. Against incredible odds and due to the combined local and national efforts to rebuild New Orleans and provide better opportunities to the city’s students, the RSD district already has outpaced many other public schools in the state in student achievement (Beuerman, 2010).
Round Six: The Double Whammy
April 20, 2010 was another fateful day for the Gulf Coast. On this day, the Deepwater Horizon oil rig caught fire, exploded, and sank shortly thereafter to initiate the largest maritime oil spill in United States history. Tension, frustration, and fear continued to mount during the hot summer months in 2010 as it soon became clear that nobody from the public or private sectors knew how to plug the leak on the sea floor. Additionally, it also became apparent that considerably more oil was leaking than initially was estimated and BP was grossly unprepared to manage cleanup efforts. While approximately 53,000 barrels of oil leaked from the wellhead each day and began to cover coastlines ranging from Grand Isle, Louisiana to Pensacola, Florida (Robertson & Krauss, 2010), feelings of helplessness spread among many Gulf Coast residents. However, in addition to helplessness, general feelings of dysphoria also festered in the same vulnerable communities that were affected by Katrina.
According to a preliminary study, the majority (about 60%) of coastal residents in Louisiana "worried constantly" about the oil spill during its occurrence (Lee & Blanchard, 2010). Increases in anxiety, depression, suicidal ideation, and alcohol abuse also have been found in the greater New Orleans area since the oil spill, particularly among individuals under 55 years of age (Dailey, 2010). In addition, over a third (35%) of caregivers who lived within 10 miles of the coast in Louisiana, Mississippi, and Alabama reported that their children experienced either physical ailments or significant psychological distress due to the oil spill (Abramson et al., 2010). Collectively, these findings highlight some of the immediate impacts of the disaster. However, the potential long–term effects remain unknown.
Similar to families affected by the Exxon–Valdez oil spill, significant income and employment losses have been experienced by families from the Gulf Coast (Abramson et al., 2010). As of late July 2010, BP has compensated few (about 5%) coastal residents who were affected by the oil spill and more than a quarter (27%) of these individuals believe that they may have to relocate due to the effects of the spill (Abramson et al., 2010). Furthermore, similar to Hurricane Katrina, the Deepwater Horizon oil spill had the greatest impact on families with few economic resources, especially those who make less than $25,000 a year (Abramson et al., 2010; Masozera, Bailey, & Kerchner, 2007). These individuals are at increased risk to experience significant income losses, to have to relocate, and to experience physical health and psychological problems associated with the oil spill (Abramson et al., 2010).
The situation remains critical for parts of the Gulf Coast. A review of 130 disasters suggests that technological or manmade disasters (e.g., oil spills, chemical leaks) often produce greater long–term psychological distress than natural disasters and violent attacks do in affected communities (Norris et al., 2002). In support of this finding, the United States Surgeon General reported that the Deepwater Horizon oil spill poses a greater threat to long–term mental health than exposure to a hurricane would (Devi, 2010). Perhaps knowledge that a disaster was created due to human negligence makes it more difficult for individuals to recover from manmade ecological disasters. Additionally, these disasters often are associated with postdisaster conflicts of interest (e.g., differences between residents and employees of a culpable corporation), income– loss spirals, and lengthy and stressful litigation (Lazarus & Sulkowski, 2010). Furthermore, manmade disasters often exert a corrosive effect on relationships and community supports, which otherwise help people cope with adversity (Lazarus & Sulkowski, 2010; Nixon, 2010).
Round Seven: A Little Help From Friends
Plaquemines Parish is uniquely vulnerable to the effects of the Deepwater Horizon oil spill due to the local economy’s heavy dependence on fishing and oil extraction. Thus, even though the federal ban on offshore drilling has expired, most areas in the region are open for fishing, and the visible signs of oil have decreased considerably over the last few months, feelings of collective stress and anxiety still pervade residents of Plaquemines Parish. As oil breaks down, seeps into soil, and is less visible in the water or marshland, the connection between the oil spill and problems in the community are becoming less obvious. Although most parish residents have been impacted in some way by the effects of the oil spill, individuals who do not work directly for the fishing or oil industries may struggle to understand how the oil spill is affecting their plight.
The disconnect between the spill and psychosocial dysfunction also has been observed in the parish schools. Meagan Medley, a school psychologist in Plaquemines Parish, surveyed teachers a few weeks after the Deepwater Horizon explosion to assess the mental health needs of the district. Results of this survey suggested that about half of teachers noticed new behavioral or mental health problems in students after the spill. However, Ms. Medley found that some teachers had difficulty connecting the effects of the oil spill with the new problems they were observing in students. Perhaps this disconnect is related to the stress and anxiety teachers also experienced because of the spill. Additionally, because teachers generally have limited knowledge of the effects of technological/ecological disasters (Dean et al., 2008), they may struggle with providing support to affected youth. Thus, to help mitigate this problem and better support students’ needs in the aftermath of disaster, school psychologists can help train other school personnel to recognize the long–term effects of these disasters (Lazarus & Sulkowski, 2010). Consequently, members of the NASP National Emergency Assistance Team, Philip Lazarus, Frank Zenere, and Ted Feinberg, provided initial training in Plaquemines Parish in spring 2010 on short– and long–term effects and how to assist impacted children and their families, and Cathy Paine followed up in the fall on issues related to coping in the aftermath of trauma. Both trainings focused on unique issues related to manmade technological/ecological disasters.
Although the full extent of the economic or psychological effects of the oil spill may not be known for years, lessons from history suggest that the residents of the Gulf Coast may need considerable long–term aid. Individuals who lived in communities that were impacted by the Exxon–Valdez oil spill and heavily depended on fishing displayed elevated rates of generalized anxiety disorder, posttraumatic stress disorder, and depression, as well as substance abuse and domestic violence after the disaster (Palinkas, Downs, Petterson, & Russell, 1993). Furthermore, 6 years after the spill, 37% of affected individuals suffered from clinically elevated symptoms of posttraumatic stress disorder, 30% from depression, and 18% from generalized anxiety. Conversely, compared to individuals with few social supports and who received inadequate compensation for their loses, individuals affected by the Prestige oil spill, which occurred off the coast of Spain, were less likely to develop mental health problems if they had adequate social support and believed they had received adequate financial compensation for losses (Sabucedo, Arce, Ferraces, Merino, & Duran, 2009).
Round Eight: Back Into the Ring
Leaders in Plaquemines Parish have worked diligently to establish relationships with
community mental health service providers to ensure that resources are available for
those in need. In the immediate aftermath of the Deepwater Horizon rig explosion,
the Plaquemines Parish Community Care Center set up a center to provide resources
ranging from food and monetary assistance to individual and family counseling services.
The Community Care Center has also partnered with Tulane University and
the Children’s Health Fund to create a mobile health unit that provides free medical
and behavioral health services to children in the parish. Similarly, the Louisiana Spirit
Coastal Recovery Counseling Program was created to address the needs of St. Bernard
and Plaquemines Parish residents following Hurricane Katrina and the oil spill. The
program provides short–term behavioral health interventions (e.g., crisis counseling,
substance abuse treatment) to assist individuals to return to their predisaster levels
of functioning. However, years may pass before affected parishes actually return to
their predisaster state.
Most recently, in collaboration with the National Center for Mental Health Promotion and Youth Violence Prevention, NASP cosponsored a free webinar to inform school administrators and staff members of behavioral health resources that they could use to help children and families manage distress associated with the oil spill. As an attempt to reach a broader audience, this webinar followed up with a virtual town meeting that was conducted by the same organizations and provided school administrators along the Gulf Coast with practical information and resources to share with affected students and families. The webinar and virtual town meeting, which also contains PowerPoint slides, can be accessed at http://edc.acrobat.com/p60584331/?launcher=false&fcsCont ent=true&pbMode=normal and additional oil spill resources can be accessed at http://oilspilldistress.samhsa.gov.
The National Commission on Children and Disasters (2010) submitted a report to the President and Congress in October 2010 on the status of disaster preparedness in the United States. In the introduction of this report, the Commission noted that they have "a sobering assessment of the national state of disaster and emergency preparedness for children." The Commission stated, "serious deficiencies" were found “in each functional area where children were more often an afterthought than a priority" (iii). The Commission goes on to emphasize that, "programs and practices for managing disasters are fragmented and unaccountable to children; instead they are designed primarily to help able–bodied adults" (iv). Thus, although current crisis management efforts in the Gulf region are well intentioned, children still may be excluded from receiving the benefits.
Despite the enormous challenges children, families, and residents of the Gulf region face from being exposed to the effects of two major disasters, these individuals still have a fighting chance at recovery as they enter the later rounds. Community health providers and school–based mental health professionals are helping to hasten this process. Many residents of New Orleans and the Gulf Coast—including mental health professionals—may be down and dazed but they are not down for the count. They still have a fighting spirit. If you come to visit, these resilient individuals will tell you that they are ready for anything and that they aren’t going anywhere.
Abramson, D., Redlener, I., Stehling–Ariza, T., Sury, J., Banister, A., & Soo Park, Y. (2010). Impact on children and families of the Deepwater Horizon Oil Spill: Preliminary findings of the Coastal Population Impact Study. National Center for Disaster Preparedness Mailman School of Public Health at Columbia University August 3rd, 2010. Retrieved December 15, 2010 from http://www.eoearth.org/article/Impact_on_children_and_families_of_the_Deepwater_Horizon_oil_spill?topic=50364
Abramson, D., Stehling–Ariza, T., Gar?eld, R., & Redlener, I. (2008). Prevalence and predictors of mental health distress post–Katrina: Findings from the Gulf Coast Child and Family Health Study. Disaster Medicine and Public Health Preparedness, 2, 77–86. doi: 10.1097/ DMP.0b013e318173a8e7
Beuerman, J. (2010, June 11). LEAP results bolster case for charters: Will legislature follow suit? The Pelican Post. Retrieved December 15, 2010 from http://www.thepelicanpost.org/tag/recovery-school-district
Dailey, K. (2010, July). In the Gulf Coast, the spill slows but mental health concerns continue. Newsweek. Retrieved September 23, 2010, from http://www.newsweek.com/blogs/the-human-condition/2010/07/29/in-thegulf-coast-the-spill-slows-but-mental-health-concerns-continue.html
Dean, K. L., Langley, A. K., Kataoka, S. H., Jaycox, L. H., Wong, M., & Stein, B. D. (2008). School–based disaster mental health services: Clinical, policy, and community challenges. Professional Psychology: Research and Practice, 39, 52–57. doi: 10.1037/0735–7028.39.1.52
Devi, S. (2010). Anger and anxiety on the Gulf Coast. The Lancet, 376, 503–504. doi:10.1016/ S0140–6736(10)61237–8
Lazarus, P. J., & Sulkowski, M. L. (2010). Oil in the water, fire in the sky: Responding to technological/environmental disasters. Communiqué, 39(1), 1, 16–17.
Lee, M. R., & Blanchard, T. C. (2010). Health impacts of Deepwater Horizon oil disaster on coastal Louisiana residents. Retrieved on December 12, 2010 from http://www.lsu.edu/pa/mediacenter/tipsheets/spill/publichealth report_2.pdf?id=329
Masozera, M., Bailey, M., & Kerchner, C. (2007). Distribution of impacts of natural disasters across income groups: A case study of New Orleans. Ecological Economics 63, 299–306. doi:10.1016/j.ecolecon.2006.06.013
McLaughlin, K. A., Fairbank, J. A., Gruber, M. J., Jones, R. T., Lakoma, M. D., Pfefferbaum, B., et al. (2009). Severe emotional disturbance among youths exposed to Hurricane Katrina 2 years postdisaster. Journal of the American Academy of Child and Adolescent Psychiatry, 48, 1069–1078. doi:10.1097/ CHI.0b013e3181b76697
McQuaid, J., Marshall, B., & Schleifstein, M. (2005). Human error blamed for making New Orleans’ flooding worse. Newhouse News Service. Retrieved December 14, 2010 from http://www.levees.org/research/sources/Newhouse%20A1.htm
National Commission on Children and Disasters. (2010). 2010 Report to the President and Congress. AHRQ Publication No. 10–M037. Rockville, MD: Agency for Healthcare Research and Quality.
Nixon, R. (2010, June). Psychologist: Oil spill worst disaster in U.S. history. Live Science. Retrieved September 23, 2010, from http://www.livescience.com/health/oil-spillpsychological-impact-100603.html
Norris, F. H., Friedman, M. J., Watson, P. J., Byrne, C. M., Diaz, E., & Kaniasty, K. (2002). 60,000 disaster victims speak, Part I: An empirical review of the empirical literature, 1981–2001. Psychiatry, 65, 207–239. doi: 10.1521/psyc.184.108.40.20673
Palinkas, L. A., Downs, M. A., Petterson, J. S., & Russell, J. (1993). Social, cultural, and psychological impacts of the Exxon Valdez oil spill. Human Organization, 52, 1–13.
Purpura, P. (2008, September 24). Two testify about Gretna police bridge blockade after Hurricane Katrina. Times–Picayune. Retrieved December 14, 2010 from http://www.nola.com/news/index.ssf/2008/09/2_testify_ about_bridge_blockad.html
Roberts, Y. H., Mitchell, M. J., Witman, M., & Taffaro, C. (2010). Mental health symptoms in youth affected by Hurricane Katrina. Professional Psychology: Research and Practice, 41, 10–18. doi: 10.1037/a001833
Robertson, C., & Krauss, C. (2010, August 2). Gulf spill is the largest of its kind, scientists say. New York Times. Retrieved December 13, 2010 from http://www.nytimes.com/2010/08/03/us/03spill.html?_r=2&fta=y
Sabucedo, J. M., Arce, C., Ferraces, M. J., Merino, H., & Duran, M. (2009). Psychological impact of the Prestige catastrophe. International Journal of Clinical and Health Psychology, 9, 105–116.
Spillius, A. (2010, July 14). New Orleans police officers charged with shooting civilians after Hurricane Katrina. The Telegraph. Retrieved December 14, 2010 from http://www.telegraph.co.uk/news/worldnews/northamerica/usa/7888999/New-Orleans-police-officerscharged-with-shooting-civilians-after-Hurricane-Katrina.html
Weems, C. F., Taylor, L. K., Cannon, M. F., Marino, R. C., Romano, D. M., Scott, B. G. et al. (2010). Post traumatic stress, context, and the lingering effects of the Hurricane Katrina disaster among ethnic minority youth. Journal of Abnormal Child Psychology, 38, 49–56. doi: 10.1007/s10802–009–9352–y
Michael L. Sulkowski is a doctoral candidate in the University of Florida school psychology program and an intern in the Louisiana School Psychology Consortium at Louisiana State University. Jill West is a doctoral candidate in the Tulane University school psychology program and an intern in the Louisiana School Psychology Consortium at Louisiana State University. She provides mental health services to students attending public schools in Plaquemines Parish. Philip J. Lazarus, PhD, is the president–elect of the National Association of School Psychologists and the director of the school psychology training program at Florida International University. He served as the team leader of the National Emergency Assistance Team in their response to Hurricane Katrina and the oil spill disaster. Correspondence concerning this paper should be addressed to Michael L. Sulkowski at Louisiana State University Health Science Center, Human Development Center, LAS*PIC Program, 1900 Gravier Street, New Orleans, LA 70112, Phone: (716) 472–5836, Fax: (352) 392–2655, E–mail: email@example.com.