Sunday, September 18, 2005

The mental health needs of hurricane victims is often overlooked in the struggle to provide food and shelter.

Also, because mental illness is sometimes stigmatized, victims who need psychiatric help are less likely to say so, said Dr. Gary Bawtinhimer, an East Carolina University psychiatrist.

"There's a survival mode that we go into to make sure people have their basic needs taken care of," Bawtinhimer said. "People with mental health needs are not really upfront. Because of the nature of the illness, they tend to put it on the back burner."

Hurricane Floyd's flooding devastated Pitt County six years ago today, and Bawtinhimer said many people who experienced it are having an anniversary reaction.

"We're seeing that as hurricane season begins to approach, anxiety levels go up, people are worrying," he said. "I saw a lot of people after Floyd and for many years after, some I continue to see, that were very devastated from losing so much.

"If we've gone through Floyd, we're all listening a little more intently to the Weather Channel; we're all kind of keyed up and a little bit more alert."

Bawtinhimer has already approached the local Red Cross to offer mental health services for Katrina evacuees in the community.

"It's clear there's going to be an overwhelming need for mental health services," he said. "We're trying to set the stage now for what it's going to be like a month or two down the road, and probably a pretty long process with the amount of devastation."

Bawtinhimer said that it takes at least a month after an incident before mental health officials can determine if someone is having trouble readjusting. Most victims of natural disasters are able to cope and adapt on their own within several weeks.

"Yes, it is stressful for everybody, but not everyone is going to be damaged and traumatized and needing mental health treatment," he said. "As health care providers, we encourage that natural adaptation process. We don't want to interfere with that."

People who experienced severe loss from a hurricane are not the only ones who stand to suffer emotionally. Relief workers deal with long days, tiresome work and sometimes gruesome recovery.

Capt. Sandy Harris with the Greenville Fire-Rescue Department managed an emergency operations team during Floyd. His team used a boat to search every home within Greenville city limits that had more than 18 inches of standing water.

"I think the length of time that a lot of us were involved, there were lots of hours put in beyond what was considered a normal eight to five day," Harris said.

Harris also experienced firsthand how people in the community responded to the tragedy.

"You saw both the best and worst of people," he said. "There were some people who were aggravated that it happened and bitter that they lost everything, and other people gracefully accepted the fact that they'd had a lost and believed that, with help, they'd have a comeback."

Bawtinhimer and his colleagues try to identify people who don't seem to be returning to their normal sleep, work and recreational patterns within a month or more of an incident.

"It really has to be an active process, because if it's not, they can kind of get lost in the background," Bawtinhimer said. "It's a small percentage of people who haven't been able to emotionally adjust to the trauma, and those are the people we are trying to reach."

Bawtinhimer said that natural disasters can sometimes exacerbate symptoms of people who are already receiving treatment or are psychiatric patients. With Katrina victims spread out in shelters hundreds of miles from their homes, access to medication is critical.

"We know that 10 percent of the population has significant mental health issues that can be treated," Bawtinhimer said. "If you've got 100,000 people in the (Houston) Astrodome, then you've got several thousand psychiatric patients that don't have access to their medicine."

During Floyd, Bawtinhimer went to a shelter at Lenoir Community College to write prescriptions.

"We had some pharmacies actually deliver medication to the shelter for patients," he said. "There are some conditions that can deteriorate pretty quickly if you're off your medicines."

Ruth Parish, director of pharmacy services at the ECU Brody School of Medicine, said that after Floyd, the state moved to approve a policy that would allow pharmacists to dispense emergency prescriptions.

"I think a lot of people in Floyd lost everything, so they lost their prescription bottle, they lost everything that had anything to identify them as taking the medication," Parish said.

The policy was created in 1998 and passed through the Legislature in 2000. Under it, patients can receive a 90-day supply of critical medications when a physician cannot be contacted or is unable to respond.

"Floyd was perhaps the first time where the state had really been in a situation where we couldn't communicate with each other on people's health care," Parish said. "They decided we needed a backup plan."

Jennifer White can be

reached at 329-9571

and jewhite@coxnc.com.