In the context of climate change, mental health and addiction services must be an integral part of the preparation for catastrophic events such as Hurricane Michael.
The Florida Panhandle is a place of beauty and humility, with coastal towns graced by blue waters and white-sand beaches and a population of mixed income Floridians, natives and others who relocated for the promised sunshine. While southern Florida draws more affluent retirees, the Panhandle is known for its working-class residents. On a smaller scale, the area that encompasses Bay County’s towns of Lynn Haven, Springfield, Parker, Callaway, Panama City, Panama City Beach, and Mexico Beach is known as the Redneck Riviera, though the vacation brochures call it the Emerald Coast. Either way, the Panhandle is sought after for its easy-going, tropicalia-infused, Gulf-centered “Salt Life”— to quote a popular Bay County bumper sticker.
But in the weeks since Michael, the category 4 Hurricane that hit the region in October 2018, this area has been in dire need of emergency and long-term recovery services, including treatment for mental trauma incurred by the devastation of homes, schools, workplaces, and communities; and if this trauma is not treated now, it can linger for years, causing further suffering for hurricane survivors.
Climate Change and Hurricanes
It is easy to link the ferocity and frequency of recent hurricane activity to climate change. A few days before Michael touched down, the UN’s Intergovernmental Panel on Climate Change (IPCC) released a shocking report that predicts dire circumstances, including intensified poverty and drought conditions — if we stay on course — with temperatures increasing 2.7 degrees Fahrenheit by 2040.
Generally, hurricane activity can be connected to climate change because “warmer water provides more energy that feeds them. Hurricanes and other extreme storms will also be wetter, for a simple reason: Warmer air holds more moisture. And, storm surges from hurricanes will be worse, for a simple reason that has nothing to do with the storms themselves: Sea levels are rising.”
These churning warm Gulf waters produced Hurricane Michael, one of the most severe hurricanes to hit the Florida Panhandle in over 100 years, and while Florida is known for a climate denial culture backed by GOP Governor Rick Scott, many Floridians want to prevent catastrophic temperature and sea level increases. They see the changes firsthand, making their living by fishing, boating, and other recreational opportunities on the coastline.
In the days following Michael, people in the Panhandle, and more specifically in hard-hit places like Bay County, spent their days putting up tarps, searching for food, water, gas, and other essentials, and cleaning up their homes, lots, and neighbors’ yards. Many people who were already receiving mental health medications and counseling services had these services interrupted as businesses and government offices were impacted by the hurricane. These kinds of service and medication disruptions are harmful to treatment outcomes as the logistical stress and anxiety produced by the hurricane aftermath exacerbates pre-existing mental conditions. Old cases go untreated while new cases emerge and grow.
In Search of Social Services
Even without post-hurricane difficulties, the Florida Panhandle lacks sufficient mental health resources. In 2017, Florida was identified as the U.S. state that spends the least on mental health services, at $36.05/ person. This is less than one-third the national average, according to the Florida Policy Institute.
The Florida Department of Children and Families concurs that Florida has 784,558 adults and 330,989 children with serious mental illnesses; 1 in 2 Floridians will experience mental illness in their lifetimes. Additionally, Florida has the third highest “mentally ill, homeless, and uninsured” population in the U.S. Hurricanes cause an increase in homelessness, and as a result, displaced residents not only are in search of shelters but medical assistance as well.
A post-hurricane Guardian article highlights Bay County’s large residential hotel on Panama City’s US HWY 98, right near the college and the Hathaway Bridge which housed many Panama City residents, including families with newborns, who survived Hurricane Michael and now live in “squalor.” According to the Guardian: “Rain flooded the upper level and dripped down to the first floor. The place looks absolutely shattered, with tarps strung from the second-floor balcony providing some shade. Rooms reek with the pungent smell of wet clothes and perspiration; windows are missing from many.”
In that St. Andrews neighborhood so close to the bay water, hotel residents can’t even enjoy the hotel courtyard, as it is: “…filled with sticky tar paper from the roof, shattered lumber, empty drink cans and bed linens blown outside by Michael.”
These same conditions can be seen all across the hurricane-affected region, including Bay County. People’s precarious living arrangements, in a housing market notorious for price-gouging and landlord and rental company greed and corruption, become more unsettled in the aftermath of hurricanes.
In addition to housing, people need drug and mental health treatment. “Some people were running out of their prescription medications,” said Diane McClure, a Kaiser South Sacramento RN and member of the California Nurses Association, a progressive labor union. “Pharmacies opened for a few hours for patients to refill their prescriptions. Mental health patients without their medications can end up disoriented or lost, perhaps not know what they are doing.”
Delivering recovery services to people with addiction and mental health issues in post-hurricane conditions presents distinct challenges, according to Gerard Lawson, past president of the American Counseling Association. Lawson’s areas of expertise include trauma and disaster mental health, and crisis preparedness and response.
One scenario involves people who are receiving methadone treatment daily or according to a schedule. Clinics and pharmacies may not be available during a crisis. “It’s a challenge to find out how to keep this person going,” Lawson told The Fix by phone. “I think there’s more understanding when a person with diabetes appears in a shelter and needs insulin.”
Another scenario involves people who are still active in their addiction. Disaster shelters are not treatment centers, and that means people can come and go in search of their drug of choice, possibly bringing it back to the shelter to use. “There’s a possibility for disruption whether they find their substance of choice or not [once they’re] back in the shelter,” Lawson said.
But sometimes this kind of situation can actually open the door to recovery. “I call this the ‘Come to Jesus’ moment,” Lawson said. In other words, disasters can pave the way for new life insights. “With support, people can come through weather disasters to arrive in a better place to progress to long-term recovery.”
Poverty and Climate Chaos
The nation saw southern coastal poverty meet disastrous hurricane weather when Hurricane Katrina surprised everyone on August 29, 2005. Thirteen years later, mental health studies on Katrina survivors indicate what they needed for full community recovery; resources they did not receive. As a result, people endured horrific situations and suffered immensely, and we learned that certain populations have unique needs before, during, and after storms. Even the government cannot deny that wealth protects people from the worst aspects of climate change. The recently released Fourth National Climate Assessment, Volume 2 acknowledges that low-income people: “… have lower capacity to prepare for and cope with extreme weather and climate-related events and are expected to experience greater impacts.”
In the year after Katrina, studies showed a dramatic increase in mental health issues: “392 low-income parents they studied reported symptoms consistent with post-traumatic stress disorder (PTSD).” A (2012) Princeton University study of low-income New Orleans mothers confirmed these earlier results. Home damage especially was “associated with the risk of chronic, long-term PTSS alone or in combination with psychological distress.”
And recovery from this kind of trauma takes years. Five years post-Katrina, “On average, people were not back to baseline mental health and they were showing pretty high levels of post-traumatic stress symptoms. There aren’t many studies that trace people for this long, but the very few that there are suggest faster recovery than what we’re finding here. I think the lesson for treatment of mental health conditions is don’t think it’s over after a year. It isn’t.”
Climate Change’s Mental Health Challenge
Studies show that years later, communities still struggle with problems generated in times of crisis like Florence’s and Michael’s aftermath. Housing and job insecurity are mental health stressors: how can we expect people to recover if they face homelessness or hunger?
Mental health services and addiction treatment must be prioritized in the context of climate change. Continuity of care is crucial in the most crisis-ridden moments, as well as new outreach services for people experiencing mental health problems due to disastrous weather events. As we witnessed from Hurricane Katrina’s aftermath, without an on-the-ground commitment to health, employment, and housing services, pre-existing mental conditions can be exacerbated due to stress, and new mental health challenges can emerge.
Has your mental health or recovery been affected by a natural disaster or weather event? Tell us in the comments.
