Three months before the 10th anniversary of Hurricane Katrina and the federal floods, local and national media outlets began to pay tribute to the storm with a flood of images, personal narratives and how-far-we've-come graphics designed to honor the past.
Since May, The New Orleans Advocate has devoted its Sunday front page to remembering the storm. NOLA.com | The Times-Picayune has done stories on everything from "Katrina tattoos" to "My Katrina Story." WWNO-FM started a "Katrina: The Debris" series. Podcasts have interviewed locals about the sights and scenes of Aug. 29, 2005. More local and national coverage is not far behind; at least two local TV stations are planning a week's worth of nightly specials leading up to the anniversary. National media will be here by the hundreds.
The city of New Orleans is ramping up activities as well with its "Katrina 10" (www.katrina10.org) initiative, which will culminate in a series of forums, conferences, memorials, a gala at the Saenger Theatre and a "resilience festival" in the 9th Ward in the days before the anniversary.
While active remembering plays a critical role in recovery, some mental health experts worry about the psychological impact these kinds of retrospectives have in a city where mental health care has been drastically reduced since the storm.
"Post Traumatic Stress Disorder (PTSD) is often triggered by sensory experiences," says Robert Laird, a University of New Orleans psychology professor who specializes in behavioral health. "It could be images, sound, being in places. The thunderstorms that we experience during the summer, for some people, are triggering events."
Laird says it's likely that people who suffered PTSD after the storm will find their stress is triggered by the influx of images, stories and reminders. It's like reliving the trauma, he says, and it can make those who suffer its effects feel isolated and alone. Symptoms of PTSD include fear, anxiety and a sense that sufferers are in danger all over again — not an unrealistic fear during hurricane season.
"I think it's particularly challenging for the PTSD folks because they're the ones who those images still bring up that disproportionate response," Laird says. "So if you're sitting there with your family, everyone probably has some bad memories of that time. But for most people, they've been resolved, so it becomes difficult for the people still struggling with it because everyone around them is saying, 'I got over it. Why can't you get over it?'"
Yolanda Webb, director of Metropolitan Human Services District, which has partnered with the City of New Orleans to provide mental, behavioral and developmental health services in five walk-in clinics across Orleans Parish, says her office anticipates heightened sensitivity among her patients as the city remembers the days after Katrina. The Louisiana Legislature created the state-funded Metropolitan in 2003 to serve the mental health needs of the community, particularly those with inadequate or no insurance. The district includes five clinics for residents of Orleans, Plaquemines and St. Bernard parishes.
"We have seen in our clinics people who are experiencing some of the results, the trauma and stress-related issues of Katrina," she says. "We also are aware and on alert because reliving or re-experiencing that kind of trauma would certainly cause those who already suffer from mental illness to have forms of flashback."
June is National PTSD Awareness Month, and Webb is using the added attention to the disease to prepare patients for the anniversary of Hurricane Katrina.
"Some folks might experience symptoms of sadness or depression, particularly in regards to loss, whether it was loss of loved ones or loss of everything they've accumulated or invested in over the course of their entire lives," Webb says. "There are folks who suffer from guilt or shame, meaning, 'Why am I still here and someone else is not?' Anger and irritability, we see that quite often in folks ... particularly in the workforce, where people are starting to feel angry because it's a period of time [that] they lost and they can never get that back. So they still hold some of that anger and are really uncertain as to why they still hold that anger."
There is no cure for PTSD; it can last a lifetime. Webb and Laird recommend therapy, and in some cases medication. Laird says exposure therapy has proved particularly helpful for PTSD patients.
"Exposure therapy is repeated and gradual exposure to the triggers themselves, so that they become desensitized and lessen over time," Laird says. "But it's tricky with PTSD people, because it needs to be very gradual and start at a very low level, because if the exposure is sufficient to produce the PTSD reaction, then ... you're starting all over again."
Images of Katrina may bring on feelings of sadness or depression even without a diagnosis like PTSD. Charlotte Parent, director of behavioral health for the City of New Orleans, says the anniversary might simply weigh heavily on those who lived through it the first time.
"The whole issue for the anniversary for people who actually lived through it, even though they might not have what we consider to be a mental illness at this point, (is that they) are going to relive an experience that has a sense of grief and loss," Parent says, adding that it's important people know such feelings aren't unusual. "Do not think you have a mental illness at that point because you are now experiencing what is part of the grieving process."
Parent says the city is prepared to deal with mental traumas ranging from sadness to illness, but she acknowledges that mental health resources in the City of New Orleans are not what they were before the storm. Parent attributes most of the city's decline in mental health resources to the loss of Charity Hospital, which was shuttered after the storm.
"Since Katrina there's been decreases in the number of inpatient beds and the opportunities for people to have access to treatment," she says. "But one of the things we have tried to focus on is ensuring through Metropolitan and other [groups] that we have those outpatient pieces identified and in place."
Janet Hays, a mental health reform advocate and community organizer who operates the website Save Charity Hospital (www.savecharityhospital.com), pushed for greater attention to mental health in a series of meetings she held across the city last week, inviting those with mental illness to share their stories. Before those meetings, Hayes told NOLA.com | The Times-Picayune that she expected people to say that their mental health needs were not being met, particularly in the wake of Gov. Bobby Jindal's refusal to expand Medicaid under the provisions of the Affordable Care Act.
Parent says the only thing her team can do is ask: How do we utilize the things we do have?
"After the loss of some of those [psychiatric] beds, Metropolitan created a crisis step-down unit and created additional beds," Webb says. Metropolitan oversees New Hope, a short-term stabilization program, that provides another five beds, she says.
Metropolitan also offers a round-the-clock crisis line for people in need of mental health support, in addition to operating a mobile crisis response team. (The phone number is 504-568-3130.)
"We don't turn anyone down or away," Webb says. "While our mandate is for the uninsured and folks who are Medicaid-eligible, we will treat anyone that is in crisis, so if someone comes into our clinic, we will treat that person, get that person stabilized and then help them through the system of care."
Expect to see the Metropolitan mobile booth at the various ceremonies and events the city has planned for the anniversary of Katrina, Parent says.
"Is it concerning? Yeah, it's concerning, because people see images and it can trigger a lot of emotions — not just (in) the people with PTSD, but in general," Parent says. "The reality is that the lead-up to such a momentous occasion, we shouldn't be surprised that this is what's going to happen. ... It's loss. We love our city."