Surviving repeated natural disasters can leave people depressed, anxious and at risk of post-traumatic stress. It helps to be prepared

By James Bruggers – June 12, 2021

Butch Segura and his son Stew Segura salvage what they can from their store named Mattress Doctor after it was destroyed as Hurricane Laura passed through the area on Aug. 28, 2020 in Lake Charles, Louisiana. The hurricane hit with powerful winds causing extensive damage in the area. Credit: Joe Raedle/Getty Images.

Experts are forecasting above-normal activity for this year’s hurricane season, which began on June 1 and runs through November. It wouldn’t be surprising if people in Texas, Louisiana and other vulnerable states are already feeling stressed.

The same goes for people in the flood-prone Midwest and in California, where numerous wildfires have already broken out.

Last year, a historic onslaught of 30 named storms hammered the Gulf Coast. And across the United States, there were 22 billion dollar disasters that claimed 262 lives, according to the National Centers for Environmental Information, including California’s worst fire season in history and a record of five named storms that made landfall in low-lying, vulnerable Louisiana. All amid a global pandemic that has killed nearly 600,000 Americans since March 2020. 

Disaster expert Reggie Ferreira, an associate professor of social work at Tulane University, said that the burden of climate change, which is fueling many of these disasters, is adding to people’s stress. Ferreira’s areas of academic interest include the mental health effects of climate change and disaster resilience.

Originally from South Africa, he is a third generation social worker who trained for a year at the Institute for Environment and Human Security at United Nations University in Germany, and earned a Ph.D. in social work from a joint program at University of Louisville and the University of Kentucky, where his dissertation examined social vulnerability related to 2005’s devastating Hurricane Katrina.

Ferreira is also the editor of the American Psychological Association’s Traumatology Journal, a peer-reviewed research publication.

We caught up with him this week, just as Colorado State University’s latest Atlantic hurricane forecast came out. It’s projection for the season: 17 named storms (winds of 39 mph or higher), compared to 14.4 on average; 8 hurricanes (winds of 74 mph or higher), compared to 7.2 on average; 4 of them major hurricanes (category 3, 4 or 5; with winds of 111 mph or higher), compared to 3.2 on average. The National Oceanic and Atmospheric Administration on May 20 also forecast an above-normal season, but said its experts do not anticipate the historic level of storm activity seen in 2020.

“Let’s just be ready,” Ferreira said. “Expect that you could experience something like this, but also mitigate that. You don’t live in constant anxiety, because you won’t be able to function. So it’s just creating a culture of preparedness and anticipation. I know it might sound very simplistic, but that’s really what’s needed.”

This transcript has been edited for length and clarity.

Fueled in part by climate change, last year blew away previous annual records for extreme weather events in the United States. Are these events a form of mass trauma? And what are they doing to people who experience them firsthand?

Ferreira: It’s basically mass trauma events, what we’re experiencing, especially like the past hurricane season that we had in the Gulf. It was this compounding, just hurricane after hurricane and tropical depression after the tropical depression. And then on top of that we had Covid.

One thing that we’re faced with is that our mental health care system is broken and there’s not enough services before a disaster. So then, during a time of disaster, our system is overloaded. There’s not enough people available to provide services, and that’s been a real case for a lot of relief agencies.

Generally speaking, what are the different ways that climate change affects people’s mental health?

Ferreira: I think we’re still trying to figure it out. I think there’s probably going to be similarities between Covid and climate change and impacts on mental health, because it’s sort of unknown, and it’s the prolonged exposure that we’re going under.

Does it boil down to different kinds of stress? 

Ferreira: With a natural disaster, it’s the sudden impact and there’s sort of a normal recovery process, the phases people go through of their recovery; whereas, with something like climate change, and even Covid, it’s these unknowns—that we don’t really know what’s going to happen, and we can’t anticipate the impacts.

You have studied the mental health implications of Hurricane Katrina, the 2005 hurricane that led to devastating flooding, and directly caused more than 1,400 deaths in New Orleans. From this work, what kinds of lessons are there? 

Ferreira: We need to focus on addressing root causes, what’s creating vulnerability, looking at pre-existing conditions of vulnerable populations, and addressing the root causes like poverty, structural racism, inequities.

A disaster just exposes these issues more. A lot of elderly people, especially, unfortunately died. They were waiting for their disability checks and their pension checks to be paid out and then Katrina hit that same day,  so folks weren’t able to leave.

There are really great stories that came about after Hurricane Katrina, and I even experienced myself last year with Hurricane Zeta. My neighborhood wasn’t impacted as severely but there were times when we were without power. But as soon as power went on, people would put out their extension cords and people could come and charge their phones. We put up signs, ‘if you need to come and take a shower, you can come and take a shower.’ I know that’s a little bit of a tangent away from Katrina. But all of these aspects need to be addressed before a disaster. It shouldn’t be like this reactionary approach we take that’s often the case with disaster response.

Last year’s Atlantic hurricane season produced 30 named storms, almost three times what had been the typical number. Some people in Louisiana, your state, went through multiple evacuations. What sort of mental health impacts and responses did the storms last year have on people?

Ferreira: So each individual is unique, but we can have an aggregate sort of experience.

Most folks do experience anxiety, fear and depression. And then especially for folks that experience these repetitive disasters, post-traumatic stress disorder can definitely come about. Folks can experience sleeplessness. There’s a whole spectrum of symptoms. They can be fidgety, they can be under a lot of stress.

So those are sort of like the primary things that you see. And the secondary things that come about include domestic violence and interpersonal violence. Experiencing hurricanes leads to stress between partners. Violence happens, and children see it. So then from that standpoint, it’s like these confounding factors that families experience, and there’s unemployment that happens or temporary unemployment, so then there’s substance abuse coming about.

So it’s really a worst-case scenario type of experience that folks go through, especially when they experience these repetitive disasters.

What can people do to address PTSD? 

Ferreira: Going through therapy, there are ways that it can be addressed. But if we live in high-risk areas we have to build this mental resilience. You live in a hurricane area, you are going to experience hurricanes, so build in that resilience over time. It’s easier said than done, especially if you have pre-existing conditions. But I think it’s just being aware of what risks you have in your community, especially as it relates to climate risk. Then secondly, knowing how to prepare for the risks, and also what resources are available for you, or for your loved ones or community when the disaster happens, or when you’re going through this climate change period, whether it’s drought or intensified hurricanes.

So I’m going to guess that most of the people who have suffered through hurricanes or even other climate-fueled disaster traumas are probably not getting the mental health treatment that they need to deal with it.

Ferreira: Exactly. And especially with Covid, everyone is like, yeah, we pivoted online and we have virtual therapy. If we look at our most vulnerable, and our marginalized, they didn’t have a laptop available or a tablet. And, you know, then how do you actually access that help, and especially for our folks with English as a second language? There might not even be services available. So I think the voiceless need to be provided with a voice, especially during climate disasters.

What are the implications for families and communities if people aren’t getting the access to the mental health care that they need? 

Ferreira: Overall well-being is impacted. Functioning is being impacted, and it’s the cascading effects that happen if mental health is not being addressed. And that’s problematic. There is a lack of resources to start out with. With Covid, there is a fatigue from service providers.

So, yeah, it doesn’t look good. I’m really concerned. I don’t think we’ve really understood the extent of Covid’s impact. And then, you know, if you’re in the firing line, like we are here in the Gulf.

If people aren’t seeking therapy, what other options are there?

Ferreira: Talk about it. There are a lot of people going through what you are experiencing. And then there are measures for building out your social support system, getting emotional support from trusted friends and family members. And then something just as basic as self-care. That can be something as simple as doing regular exercise, meditation, reading, just getting that distraction, but also keeping the body, mind and health in check. Because what we’re experiencing is not normal. Covid is not normal, this changing climate is not normal.

It’s hard sometimes for parents to deal with questions about climate change that their children might have. Because it’s a scary world out there. And climate change can make it more scary.

Ferreira: There is climate anxiety that’s especially among youth that we’re seeing. And they are blaming the elderly generations, you know, that they are causing this and, when we’re your age the planet is going to be unlivable. So that anxiety that kicks in is definitely real amongst the youth.

NOAA is predicting another above normal Atlantic hurricane season this year. Which populations that you see are at the greatest risk of emotional trauma?

Ferreira: Folks with pre-existing mental health conditions. Then also the socially vulnerable: young children, the elderly, marginalized populations. Then, basically, our BIPOC (Black, Indigenous and people of color) populations. As humans, we can only take so much. I believe everyone’s got resilience. But then you reach your breaking point. And that’s then when depression sets in, and you could experience PTSD.

With disasters happening at a faster pace, I am wondering what needs to be done to meet these mental health needs in places that are being repeatedly affected by climate disasters?

Ferreira: So that’s the big, billion-dollar question. If you live in an area like this, you know then you have to be prepared. There’s basic things just from a preparedness standpoint, and ensuring you have enough water available, having a preparedness plan in place, knowing where to evacuate to. But from a decision maker standpoint, ensuring that resources are allocated to our most vulnerable, and our marginalized communities, especially our BIPOC communities.

It’s sort of a top down, bottom up approach. It needs to be a collaborative approach. The Biden administration is really taking the bull by the horns. For instance, the Building Resilient Infrastructure Program that President Biden released and made $1 billion available (for pre-disaster mitigation).

But then we also have to think about it in terms of the sustainability standpoint. Can we provide resources every season? I’m not going to be the person that makes that decision. But in adapting to what we’re experiencing, there is going to be a stage where communities will actually have to retreat. That is inevitable.

And then doesn’t that bring on another level of climate change stress when you are relocating people?

Ferreira: We’re going to, by 2050, see a significant number of climate change refugees that are going to have to relocate as a result of predictions that are being made, either through water increases or water drying up completely.

So we can just think of those communities that have to relocate, their loss of culture, loss of community, the employment that’s going to disappear. Whole communities are going to disappear. So how is that going to play into people’s mental health?

I don’t think we’re planning for that. We are very focused on the now. But we really need to start and think of this mass climate migration that’s going to come about. And it’s not like a Doomsday prophecy. It’s going to happen.