By Mahshid Abir, Special to CNN
Editor’s note: Mahshid Abir, M.D., is an adjunct behavioral and social scientist at the nonprofit, nonpartisan RAND Corporation. The views expressed are the author’s own.
Last Monday, a massive tornado devastated Moore, Oklahoma, leveling or largely destroying hundreds of homes, businesses and two elementary schools. Plaza Towers Elementary School, where 75 students and faculty had taken shelter, was in the direct path of the tornado. Moore Medical Center lost an entire floor of its facility, requiring many of the injured, including children, some with severe injuries, to be taken to other area hospitals. At least 24 people were killed and hundreds more injured.
The tornado struck only days before the two-year anniversary of the deadly EF5 tornado that hit Joplin, Missouri, causing significant devastation and 155 fatalities. That twister lasted only minutes, but its toll on the mental health of Joplin’s residents lingered much longer. And the incident holds some important lessons for Moore and future disaster areas as they try to recover.
The Joplin disaster was linked to a significant rise in mental health problems among area residents, including general anxiety and stress, depression, post-traumatic stress disorder (PTSD), and at least three suicides. The local mental health crisis hotline received more than 1,700 calls in the six weeks following the tornado, a significant jump from the usual 370 calls per month. Even residents who were not directly affected by the disaster – such as those hit by the loss of loved ones, their home, or job – reported PTSD symptoms and feelings of guilt. And individuals with baseline mental health issues experienced worsening symptoms after the tornado. A behavioral health center in Joplin reported three times the usual number of calls and center visits, more people presented to local emergency departments with psychiatric concerns, and the town saw an increase in the number of people with court-ordered commitments to psychiatric facilities.
The aftermath of the tornado was also marked by an increase in drug and alcohol abuse, gambling, and domestic violence. Freeman Hospital in Joplin established a crisis intervention program, funded by the Federal Emergency Management Agency, to reach out to residents who may not have otherwise sought help. Teams of mental health workers visited local businesses and homes to ensure that those in need were connected with the right resources. This need was particularly great because two-thirds of the area’s acute care psychiatric beds were destroyed by the tornado.
Children were especially susceptible to the psychological consequences of this traumatic event. The State of Missouri provided $2 million to establish the Joplin Child Trauma Treatment Center for children and families affected by the tornado. The center sent trained staff to schools, churches, and other locations where they could identify and work with children experiencing mental health issues as a result of the tornado.
While they have had their hands full dealing with the injuries and devastations, authorities in Oklahoma appear mindful of the emotional wounds that are sure to follow. The Oklahoma Department of Mental health and Substance Abuse Services has opened a center in Moore and is helping people on a walk-in basis. This is an encouraging start.
Physical and mental health challenges are common in communities affected by disasters. In these communities, rates as high as 64 percent have been reported for depression and PTSD, conditions that are hugely expensive to manage. Research shows that abundant social support lowers the risk of these conditions, while studies have also found that early intervention is key for recovery, particularly for individuals at risk for mental health problems.
After the disaster response and cleanup phase in Moore has come and gone, and as the national media packs up and leaves, the town’s residents will likely face challenges similar to those in Joplin. Ensuring the availability of needed mental health resources was critical in the immediate aftermath and recovery phase of that disaster. State and local authorities in Oklahoma must ensure that such services are in place early – and that they are accessible – so that Moore’s residents can begin the long journey to recovery.