In the days and months following Superstorm Sandy, as New Yorkers surveyed the damage to their property, moved into and out of shelters, and tried to find new homes for their children, at local and national helplines the phones stayed largely silent. At the National Alliance on Mental Illness (NAMI), the New York chapter hotline braced for an onslaught of calls. They didn’t come. Same at the Disaster Distress Helpline, where the phones remained quiet for months, in what director Christian Burgess refers to as an emotional “honeymoon phase.”
Immediately after a disaster, Burgess says, “often people feel stronger, they feel unified.” Then the enormity of the situation hits, and those caught in the worst of it slowly drift, sometimes over years, through the emotional narrows left in the wake.
Manhattan residents and first responders who survived the 9-11 attacks had statistically higher rates of frequent binge-drinking five and six years later, a Columbia University study revealed. Researchers studying the deadly 2011 tornado in Joplin, Missouri, found an increase in rates of post-traumatic stress disorder, even over two years later; they also found that young children (ages four to ten) struggled more than their older peers, according to their parents, particularly if the parents themselves were experiencing PTSD. After Hurricane Katrina, numerous studies found that symptoms of post-traumatic stress persisted for years, as did heightened rates of anxiety, depression, and addiction, all linked to exposure to the storm.
Following such catastrophes, city and state agencies tend to approach psychological cleanup the way they do rebuilding homes and infrastructure: after the fact, focusing on emergency situations first. In November 2012, the Federal Emergency Management Agency funded an $8.2 million mental health outreach program for Sandy survivors, carried out by the New York State Office of Mental Health and a constellation of city agencies. In many ways it looked similar to Project Liberty, a FEMA-backed post–9-11 mental health outreach effort that provided free crisis counseling in two dozen languages at sites across the city. Project Liberty, which operated through 2004, also provided employment referrals and public education classes on mental health topics such as common responses to trauma, how to recognize distress in children, stress reduction techniques, and coping skills.
Nobody is quite sure, though, about the size and scope of lingering traumas after the shelters and hotlines and crisis centers have been shut down. Dr. David Abramson, director of NYU’s Program on Population Impact, Recovery, and Resiliency, calls the long-term effects of catastrophic climatic events on mental health “curious,” acknowledging the difficulty of predicting just how they will surface. For example, one study of New Orleans after Katrina found that suicide rates had fallen but that rates of mental illness had doubled.
Wendy Brennan, the executive director of NAMI’s New York office, was so surprised not to get a sharp increase in calls after Sandy that she consulted her counterparts in New Orleans. The answer: It was the same after Katrina. As was the case then, the effects were more diffuse, longer-lasting, and harder to track — it took years for the NAMI hotline to establish a gradual upward trend in call volume during dramatic weather and thunderstorms. (The organization even says it has noticed increases when people start hearing a lot of sirens nearby.)
NYU’s Abramson also says the emotional effects are evident, but hard to pin down. Rather than full-blown post-traumatic stress syndrome, Abramson says he sees a “complex [of] grief, anxiety, depression, all of which are clinical expressions of mental health problems. Or it can be a subclinical problem: You’re not happy, not feeling right, not feeling like you have meaning and purpose.”
Just as the forms that post-disaster mental illness takes are subtle and unpredictable, it is hard to determine the groups most likely to be affected. The immediate effects of climate disaster invariably hit those with the fewest resources. But the long-term psychic ramifications are far less certain. “One thing we’ve found as a beginning finding is that those who are the most impoverished aren’t necessarily the ones that will do the worst,” Abramson says. “In part, they have the lowest expectations and the least to lose.”
Preliminary results from the studies he has led have suggested that things are toughest for those who are “climbing the economic ladder and just about to make it,” Abramson says. “Even folks who are middle-class and still scrambling, they often have very little in terms of actual assets and resources to hold on to. If the catastrophe destroys those, they are particularly vulnerable to mental health distress. I think of it as the ‘falling from grace’ problem.”
The question for New Yorkers in the future may be how to respond to not just one Sandy, but a Sandy every few years. It’s become clear that climate disaster will be an increasingly frequent occurrence. What is not clear are the consequences of living with it as a permanent condition. If riding out a hurricane makes us shudder at a thunderstorm, what happens when the hurricanes come every year?