"Storms make trees take deeper roots." - Dolly Parton
Image by the author.
Ginkgo Leaf Health Services is located in Asheville, NC. Over the course of the past month, we witnessed the intersection between natural disasters and adverse medical events firsthand. Without power, medications such as insulin could not be refrigerated, increasing risk for medical complications. As the roads were cleared, we saw a rise in chainsaw injuries and puncture wounds. Without water, we saw dehydration and decreased ability to engage in personal hygiene habits such as handwashing, leading to disease spread.
We are on the road to recovery, and every little bit helps. If you are able, please consider making a donation to the North Carolina Disaster Fund, which supports local nonprofits assisting with acute and long-term recovery needs.
As stated by Heanoy and Brown (2024):
"By definition, natural disasters are sudden and extreme weather events that can unfold within a brief amount of time, e.g., from minutes to hours (earthquakes or cyclones) or slow-paced events that can last days, weeks, or months (floods or wildfires). The frequency and severity of natural disasters have increased over recent decades, and there has been a growing concern that they will continue to increase in the coming years. In 2020, approximately 100 million people were affected by disaster events, and these events caused an estimated USD 190 billion in global economic losses."
Post-traumatic Stress Disorder is the most common post-disaster mental health condition, followed by depression. Both of these diagnoses are intimately tied to grief. Here in Asheville, the community is grieving loved ones, homes and property, pets, income, hopes and plans. It is very possible to experience what clinicians call "post-traumatic growth," as the communities come together to develop stronger and more resilient connective networks. That said, this type of growth takes time.
The Federal Emergency Management Agency (FEMA) has studied this process of grief and growth extensively, and the authors go on to describe FEMA's six-phase model of disaster and recovery (reprinted from Heanoy and Brown's article below).
As stated in Heanoy and Brown's work, the pre-disaster phase includes warnings and threats related to the looming disaster. During the disaster impact phase, events such as displacement or injury occur. After that, we enter the heroic response phase, which involves saving others, temporary relocation of disaster survivors, promoting safety, and the presence of support from government and insurance agencies. Following that, there is a honeymoon phase where external assistance remains, and community bonding increases due to a shared catastrophic experience. The honeymoon phase is followed by a disillusionment phase characterized by disappointment, as agencies and volunteers pull out their assistance. During this phase, we also see the impacts of privilege and luck. The least impacted and better-resourced neighborhoods return to life as usual, which can discourage and alienate people living in more severely impacted neighborhoods. Survivors may become exhausted during this phase due to ongoing demands such as financial pressures, relocation or living in a damaged home, family discord, bureaucratic hassles, and lack of free time or available resources for recreation or self-care. We see new onset mental or physical health problems, or the exacerbation of pre-existing health conditions as a result of ongoing stress and fatigue. Typically, the disaster anniversary experience occurs during the disillusionment phase, and failure to address this experience can further demoralize survivors, exacerbate underlying psychological distress, and worsen the trajectory of community recovery.
Finally, the reconstruction phase—including short-, intermediate-, and long-term recovery—begins a few days after the disaster, but can last up to several years depending upon the level of the disastrous effect. Survivors attempt to restore their lives by rebuilding homes, returning to old jobs, finding new employment, and resuming or forming new social support systems. Some can accept new circumstances, including losses and changes, whereas others may instead focus on resentment and anger, identifying themselves as victims.
Throughout this process, individuals with medical conditions may be particularly vulnerable, as they contend with challenges to both physical and mental health.
What we are working to do locally:
Volunteering with disaster recovery efforts
Educating other mental health providers regarding the need to prepare for long-term impacts
Reaching out to underprivileged areas and vulnerable populations to offer aid and assistance
What can be done from afar:
Donate items or offer financial assistance to disaster survivors
Help the helpers by offering virtual mental health treatment to local emergency responders at a reduced rate
Assist with environmental recovery efforts such as reforestation, water recovery, or wildlife refuges
If you are a healthcare provider, reach out to local hospitals to offer ongoing support even after the acute stages of crisis
Thank you for reading and for your support, now and in the future.
Citation:
Heanoy EZ, Brown NR. Impact of Natural Disasters on Mental Health: Evidence and Implications. Healthcare. 2024; 12(18):1812. https://doi.org/10.3390/healthcare12181812
Additional organizations assisting disaster recovery can be found here: https://ncdisaster.ces.ncsu.edu/2024/10/ways-you-can-help-in-hurricane-helene-recovery/
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