After Katrina, a mental resiliency is found

WASHINGTON -- Hurricane Katrina survivors are twice as likely to suffer from serious mental health problems compared with New Orleans and Gulf Coast residents before the storm, according to a Harvard Medical School survey. But most of the survivors say they believe the area and their lives will rebound, despite the slow pace of recovery from the storm a year ago.

The study's authors said they were surprised to find that the number of survivors who had contemplated or attempted suicide was quite low, even in the face of widespread devastation and staggering personal losses. Many participants said that surviving the worst of the storm had helped them realize an inner strength they didn't know they had, according to the study.

But the authors warned that this resiliency and communal optimism is fragile, and could fall apart if the region's reconstruction stalls during the next year.

``Whether that hope for the future is something that's going to be there for the long run" is a major question, said Dr. Ronald Kessler, a Harvard professor of healthcare policy and the lead author of the study. ``What if things aren't better a year from now? Those are the sort of the nagging concerns that we have."

The report is part of a project involving the Hurricane Katrina Community Advisory Group, a demographically representative sample of about 1,000 hurricane survivors who agreed to participate in surveys to monitor the region's mental health. The federally funded project will track the survivors, periodically interview them, and compare their responses with pre-Katrina statistics to determine how well they are coping. The data will be used to help mental health agencies prepare for and respond to future disasters. The initial results released yesterday came from surveys and interviews conducted between Jan. 19 and March 31.

Post-Katrina respondents were found to be significantly more likely to have some form of mental illness than respondents in a similar survey conducted from 2001 to 2003.

But the researchers found that, contrary to expectations given the overall state of mental health, the prevalence of suicidal thinking did not increase. That finding, they said, was largely explained by positive beliefs among the storm survivors -- most of whom said they had felt an increased sense of meaning and purpose in life, and had found an increased realization of their inner strengths.

Nearly 85 percent of respondents experienced a significant loss of money, income, or housing because of the storm, according to the survey. More than one-third said they experienced extreme physical adversity because of Katrina, and about 23 percent said they experienced extreme psychological stress.

Yet only 36 percent said their current living situation was worse than it was before the storm, and 53 percent said it was about the same as before the hurricane. The other 11 percent said their living situation is better.

When asked whether their lives were better, worse, or about the same as before, more than 60 percent of the respondents said it was the same. Only about 25 percent said their lives were worse, and about 14 percent said their lives are better.

``There's this inner core of [survivors'] willingness to pull themselves up by their bootstraps," Kessler said. ``There's a lot of hope for the future."

But the region is still in the midst of an ``ongoing crisis," Kessler said, one that could dramatically affect those survey results over the long term.

He said he would not be surprised if the rate of mental health problems -- and the number of suicides -- spikes in coming days, around the one-year anniversary of the hurricane. ``There's a lot of adversity . . . a lot of problems that still exist," Kessler said.