Harvard to study Katrina's long-term psychological toll

Harvard Medical School next week will launch the most comprehensive study ever of the psychological impact of a major disaster, recruiting 2,000 survivors of Hurricane Katrina for at least two years of regular interviews on how they are coping.

The study will document the levels of depression, anxiety, and post-traumatic stress among the survivors, levels that mental health specialists say are likely to reach all-time highs because the death and destruction was so far-reaching. Four months after the hurricane, there are reports of an unusual number of suicides among survivors and a sense of gloom so pervasive that people call it ''the Katrina blues."

The research will also provide snapshots of how well recovery efforts are helping the 2 million families affected by the disaster, a population that, until now, has been too spread out to monitor. Harvard expects to post the results of the first round of interviews on the Internet by the end of February, giving policy makers insight into how many people are going hungry, not getting adequate medical care, or feeling overwhelmed by the task of rebuilding.

''The situation is worse here than in a lot of other disasters," said Ronald Kessler, professor of healthcare policy at Harvard and director of the project, called the Hurricane Katrina Advisory Group Initiative. Survivors of Katrina ''are spread out all over God's creation. There are people in Los Angeles and Oshkosh and in Florida and in New Jersey, so . . . we have to beat the bush all over the country."

Data on the psychological impact of Katrina's destruction are still scarce, but a small survey by the Centers for Disease Control and Prevention last fall showed that more than 40 percent of survivors had signs of post-traumatic stress disorder, in which sufferers have recurring experiences of traumatic events. That is a higher rate than the 25 percent to 33 percent who suffered post-traumatic stress after Hurricane Andrew struck Florida in 1992.

The number of reported suicides of Katrina survivors is too small, seven in New Orleans over the past four months, to detect a trend. But health officials say they are concerned that some of the people who killed themselves do not fit the profile of a suicide.

Louisiana officials said mental health conditions are likely to deteriorate for many victims as they become discouraged at the pace of recovery while mental health services in the storm-affected region remain crippled.

Even among the vast majority who do not require hospitalization, Anthony H. Speier, director of Disaster Mental Health Operations for the Louisiana Office of Mental Health, said Katrina-weariness is setting in, making the survivors vulnerable to depression and other problems. He said psychological counselors for the state have had 425,000 requests for help, a number that is sure to grow, he said.

''A lot of people are having trouble reconciling the extreme breadth of their loss," said Speier, who is collaborating on the Harvard survey. ''People's homes are gone. Their sense of tradition is gone. Their sense of community is gone. . . . A lot of people need to talk about their situations."

To assemble the Katrina Community Advisory Group -- funded by a $1 million grant from the National Institute of Mental Health -- the researchers will rely heavily on cellphone numbers and other contact information from the 1.34 million families that turned to the Red Cross for help. Survey-takers will also visit hotels and motels where the Federal Emergency Management Agency houses evacuees, and make random calls around the country in hopes of contacting displaced victims who did not get help from these agencies.

Once they've identified 1,000 participants from the New Orleans area and 1,000 from other regions affected by the disaster, the researchers will conduct two-hour introductory interviews and shorter follow-up interviews every three months for two years, Kessler said.

Kessler said he is not worried about finding Katrina survivors willing to invest the time in his project. As researchers have tested their survey questions on hurricane survivors, he said, ''We've had a unique problem. We can't get people off the phone."

Scott Allen can be reached at allen@globe.com.