The Mental Health Impacts of Hurricane Harvey: Examining the Role of Interpersonal Violence

Background:
In August 2017, Hurricane Harvey hit the Texas coast triggering one of the largest disaster responses in the state’s history. Hurricane exposure can cause significant psychological harm and result in a range of mental health disorders such as depression, anxiety, and post-traumatic stress disorder. While a significant amount of research has documented the mental health impacts of hurricanes, much less attention has been placed on understanding the potential mediating role of intimate partner violence (IPV) in the relationship between hurricane exposure and mental health impacts. We conducted a study to assess the prevalence and correlates of IPV before and after Hurricane Harvey. In addition, we explored direct and indirect relationships between gender, disaster stress, and IPV with mental health outcome variables of post-traumatic stress and depression symptoms.

Methods:
Data for the current study was drawn from a cross-sectional study of adult residents in Houston who were exposed to Hurricane Harvey in August 2017. Participants included 380 adults (N=380) who identified as being married or in an intimate relationship with a significant other. IPV was assessed with a series of items asking participants about psychological and physical IPV the month prior to and the month following Hurricane Harvey. To examine the potential mediating role of IPV, structural equation modeling (SEM) was used in R statistical software (lavaan package). Using a two-step procedure recommended by Kline (2005), a measurement model was first tested in order to establish that the latent variables were well explained by the indicators. Next, a structural model was estimated for hypothesized direct and indirect relationships between gender, disaster stress, and IPV with the outcome variables post-traumatic stress and depression symptoms.

Results:
35.6% of participants reported psychological IPV prior to the hurricane and 47.1% of participants reported psychological IPV after the hurricane (32.3% increase). 12.0% of participants reported physical IPV prior to the hurricane and 13.4% of participants reported physical IPV after the hurricane (10.9% increase). In addition, SEM analysis found the hypothesized models achieved acceptable fit according to Hu and Bentler’s (1999) and Browne and Cudeck's (1993) guidelines: χ2(45) = 929.104, p < .01, CFI= .91, TLI = .90, RMSEA=.06, SRMR= .06. Results found that more hurricane exposure was associated with IPV (β= .452, p<.001) and women had a higher risk for pre and post-disaster IPV than men (β=.171, p<.01). IPV was also found to mediate hurricane exposure and was associated with a higher risk for PTS (β= .309, p<.001) and depression (β=.168, p <.05).

Discussion and Implications:
Results in the current study found that experiencing IPV further compounded risk for PTSD and depression severity following Hurricane Harvey. This study’s findings highlight the importance of disseminating IPV and mental health information in communities experiencing a disaster. Additionally, disaster mental health providers should assess for IPV following disasters and assist individuals experiencing IPV in finding resources and services in the community. Findings from this study provide a foundation for informing future disaster mental health interventions and policies to better meet the safety and needs of individuals impacted by IPV and disaster.