The government's leading mental health services agency describes the $110
million federal response to the mental health needs that followed the
devastating 2005 hurricanes.
A year after Hurricane Katrina devastated much of the Gulf Coast, mental
health advocates have many good things to say about the short-term mental
health response by federal health officials. They are, however, still waiting
for plans and funding for a long-term response.
In the wake of hurricanes Katrina, Rita, and Wilma, officials with the
Substance Abuse and Mental Health Services Administration (SAMHSA) stated that
their goal was to ensure the ready availability of mental health and substance
abuse assessments and crisis counseling for residents and evacuees of areas
impacted by the storms.
Thanks to nearly $110 million in SAMHSA grants to support mental health
services for hurricane victims, federal officials maintain that an
unprecedented level of federal assistance was provided for recovery from
“Most survivors of Katrina, Rita, and Wilma are demonstrating
remarkable resiliency and are rebuilding their lives,” said Assistant
Surgeon General Eric Broderick, D.D.S., M.P.H., acting deputy administrator of
SAMHSA, in a press release describing the grants.
Additional SAMHSA goals included creating a longer-term plan to address
posttraumatic stress disorder (PTSD) among hurricane survivors and ensuring
that Gulf Coast residents with “serious mental illnesses and/or
addictive disorders and children with serious emotional disturbances continue
to receive ongoing treatment for their chronic disorders,” according to
an agency statement.
Critics said that the agency was much less successful with these larger
The agency's response to the hurricanes included making the SAMHSA
Emergency Response Grants (SERG) available. These grants fund crisis mental
health and substance abuse services when local resources are overwhelmed and
other resources are unavailable. SAMHSA describes SERG as “funding of
last resort,” because it was traditionally provided in rare emergency
situations. These funds went to areas that the impacted states determined to
be the areas of highest need and were allocated for clinical services
including methadone treatment.
Another source of funds for the cash-strapped region was the Federal
Emergency Management Agency's Crisis Counseling Grants and Crisis Counseling
Training and assistance Program, which fund mental health assistance and
training activities in federal disaster areas. The funds were available to
states and Indian tribes. SAMHSA conducted 91,000 counseling sessions,
according to agency officials, and referred 700 people to mental health,
substance abuse, and social services.
Critics questioned, however, why crisis-counseling funding was not used to
restore the many services hurricane victims with serious mental illness
“Large numbers of people receiving psychiatric care in hospitals or
groups homes did not benefit from these programs,” Ron Hamburg, legal
director of the National Alliance on Mental Illness (NAMI) told
Among the higher-profile, short-term SAMHSA efforts were two public service
announcement (PSA) campaigns, which provided print, radio, and television ads
to local media to encourage “individuals who may be experiencing
psychological distress from last year's hurricanes to seek mental health
services,” according to SAMHSA.
NAMI officials supported the PSA campaigns, but they were disappointed that
the help they offered was limited to a referral to a toll-free national help
In a speech in May on the post-hurricane federal mental health response,
Charles Curie, M.A., former SAMHSA administrator, defended the PSA campaigns
as a way the agency was able to work with limited funding to encourage those
in need of mental health care at least to seek
Joe Spraggins, director of Harrison County's Emergency Management
Agency, holds flags that were draped on the caskets of “Will” and“
Strength” before they were buried in August in Gulfport, Miss.
The two Katrina victims were given symbolic names because their identity was
AP Photo/Photographer: Rogelio Solis
Critics of the federal response said the short-term effort was positive,
but SAMHSA's longer term approach—despite its stated goals to address
PTSD and other long-term problems—comes up short.
“What that represents is the failure to foresee the longer mental
health needs—that trauma, which is by definition long term,” Ralph
Ibson, vice president for government affairs at the National Mental Health
Association, told Psychiatric News.
SAMHSA officials have described in the months since the hurricanes that the
previous research on the mental health consequences of such traumatic events
found extensive and long-lasting psychological effects. Agency officials noted
that individuals' distress over the loss of possessions, homes, and
communities was often exacerbated by the
lossFIG2 of loved ones and the pain
of destruction and violence.
Students who would have atttended the Dr. Martin Luther King Jr. Charter
School for Science and Technology in New Orleans prepare for a rally led by
the Southern Christian leadership Conference last month at the students'
temporary school. The King school, located in the lower Ninth Ward, was
heavily damaged by Hurricane Katrina.
AP Photo/Photographer: Alex Brandon
Despite the agency's concerns about the long-term mental health
consequences of the disasters, it was unable to secure sufficient federal
funding to provide this type of care.
Critics noted that federal officials made little mention of the fact that
the storms exacerbated existing mental illness among the many adults and
children in the region. The mental health systems in several Gulf Coast states
were overwhelmed, and Hamburg and others described these systems as“
woefully underfunded” even before the storms. But little federal
assistance was directed toward the restoration of these systems of care.
Federal officials countered that SAMHSA has provided some funding for grant
programs that help localities rebuild their mental health “service
One such grant awarded in June to Louisiana and Mississippi provides a
total of $2.4 million over three years to rebuild their youth suicide
“These grants will enable two of the hardest-hit states to reach out
to young people who are still having serious problems coping with the
devastating effects of the hurricanes on their lives.” SAMHSA's
One effort that mental health advocates hope will bear fruit is a federal
plan to amend Medicare and Medicaid to better support improved access and
quality of health care for the poor and aged in the region. Federal officials
supported the creation of the Louisiana Health Care Redesign Collaborative,
for instance, which hopes to present its blueprint for redesign by
More information on SAMHSA's postdisaster efforts in the Gulf states
is posted at</www.samhsa.gov/Speeches/katrina052206.aspx>.▪