Responding to Post-Disaster Mental Health Needs of Hurricane Survivors

Background and Purpose

Following Hurricanes Katrina and Rita, Louisiana residents faced unprecedented mental health challenges. In response, the InCourage Program was initiated by a philanthropic foundation in Baton Rouge in partnership with 19 community partners/stakeholders comprised of mental health organization administrators and direct staff, internationally known disaster crisis intervention specialists, LSU School of Social Work, marketing experts, and more than 100 clinical experts. This 16-month pilot program using a manualized cognitive-behavioral therapy (CBT) intervention provided up to 10 free/confidential counseling sessions to adults affected by Hurricanes Katrina and Rita. This study evaluated community partners' responses, providers' experiences, and clients' symptomatology following the hurricanes. It was hypothesized that participants would experience decreased intensity of emotional reactions. Community partners' and providers' commitment to the collaborative efforts to meet mental health needs of survivors was expected to increase.

Methods

This study utilized a mixed-methods survey research design and nonprobability sampling methods. InCourage participants: Data were collected on all InCourage participants using the Sprint E Assessment & Referral Tool. Clients were assessed at five stages: baseline (referral), enrollment, beginning of third session, beginning of last session and 4-month follow-up). Among the 201 survivors enrolled in the InCourage program, 82 completed the program. Sixty-two percent of the completers indicated moderate to severe traumatization/symptomatology. The sample was 58 % African American with 67% between 40-64 years of age. InCourage providers: One hundred eight mental health professionals were trained in the protocol, 86 agreed to serve as InCourage providers. The provider instrument was comprised of demographics, treatment protocol, and administration. Twenty of the eighty-six providers completed a survey of their experiences, 15 of which were included in the final sample. Community Partners: (N=19) were contacted by the researchers for interviews; 17 agreed to participate and 1:1 interviews were conducted. The partner instrument consisted of two sections: collaboration (of the foundation and other partners) and the InCourage program (i.e., the program's worth and effectiveness).

Results/Conclusion & Implications

Post intervention rates in all areas of intense traumatic reactions had significantly decreased among participants. Providers agreed that they were able to translate the protocol training into practice, but they expressed that they had too few clients assigned to them. Overall, providers were satisfied with the clinical applicability, but less with administrative aspects.Twelve community partners agreed that they had a stake in contributing to the improved mental health of survivors of Hurricanes Katrina and Rita and also that their organizations benefited from participation. Most (n = 14) agreed that the sponsoring foundation facilitated the collaborative process. The majority (n = 9) of partners felt that program had been implemented effectively; however, only three were convinced the program was reaching those in need. A primary concern was that (73%) of clinicians would not travel to clients' homes for sessions. All partners agreed that the program was a replicable one in the event of future mental health disaster response needs. The unique private-public partnership using the CBT intervention model merits further research and attention to the realities of disaster survivors' mental health needs.