Tuesday, November 7, 2017

Doctors Warn of Hurricane Harvey’s Hidden Aftermath

There is a hidden danger beyond the piles of debris and damage left behind by Hurricane Harvey, and it might come as a surprise. Besides mold-related respiratory illnesses, disease from exposure to floodwaters and even mosquito-borne sickness like West Nile and Zika viruses, Texas physicians warn of another, unexpected post-hurricane health concern: Mental and emotional health. Texas physicians warn that stress and grief in the aftermath of the storm may have longer lasting effects on the mental health of some hurricane survivors than storm-related injuries and physical ailments.

After a natural disaster, grief over the loss of homes, jobs, schools, friends, and neighbors takes its toll on a large share of the population. A November Texas Medicine magazine article covering Harvey’s aftermath says some survivors will be diagnosed with varying degrees of post-traumatic stress syndrome (PTSD), experience higher levels of family stress, suffer injuries from domestic abuse, and even see flashback memories of past traumas.

“I think the increase in family stress surprises some people,” said John Mutter, PhD, professor at Columbia University’s Earth Institute, who studies the impact of natural disasters. “It shouldn’t surprise you, but it does. People who live in a [Federal Emergency Management Agency] trailer who used to live in a house get sick of each other quickly, and that leads to trouble. … Post-disaster health issues are as much mental health issues as they are physical health issues.”

Many survivors will endure the five stages of grief: denial, anger, bargaining, depression, and acceptance of loss. As many as one-fifth to one-third (20 percent to 30 percent) of people even go on to meet the full criteria for PTSD. Valerie Rosen, MD, an assistant professor of psychiatry at Dell Medical School at The University of Texas and an expert in PTSD, said most people will have some symptoms consistent with PTSD, but most of these will recover without medical help and not suffer full-blown post-traumatic stress. However, she recommends primary care physicians in Texas, especially those in the coastal areas, screen their patients for signs of emotional distress. “If someone has not recovered on their own, they probably do need to seek treatment to prevent it from being lifelong,” Dr. Rosen said in the Texas Medical Association (TMA) magazine. “But it is something that is very treatable.”

Natural disasters also can kick up memories of past traumas like childhood sexual abuse. A person might function well under normal circumstances but face difficulty after a major storm. Jeffrey Levin, MD, professor of occupational and environmental medicine at The University of Texas Health Northeast in Tyler, said survivors of past traumas deal with stress and loss in their own way. “We’ll be progressing through that, and everyone does that at a different rate,” said Dr. Levin, a former chair of TMA’s Council on Public Health. “There will be a sense of being physically and emotionally drained. People may experience difficulty making decisions, staying focused.”

Dr. Rosen says while there is reason for concern about the mental health of Texans in the aftermath of Hurricane Harvey, not all of the storm’s effects will be harmful or create more problems; some outcomes even could be beneficial.

“There’s also post-traumatic growth, or positive outcomes, where people can really prioritize their lives differently and get a different perspective on things,” she said. “They can also increase their faith in humanity with all the volunteers and increased social connectivity. I think sometimes people are surprised at their own ability to skillfully manage new challenges or adversity.”

TMA’s Disaster Relief Program Awards $83,000 More to Medical Practices Damaged by Hurricane Harvey

Even as physicians anticipate long-term effects of Hurricane Harvey, many of them along the coastal bend are struggling to reopen their own practices and serve their patients — so TMA is offering help. TMA Disaster Relief Program officials recently distributed $83,000 to nine practices damaged by Hurricane Harvey.

This second funds distribution amounts to $424,590 in total that TMA has sent to help physicians with Harvey-damaged or destroyed practices. The funds have assisted 37 medical practices throughout federally designated disaster areas, including Beaumont, Columbus, Houston, Orange, Aransas Pass, and Victoria. The practices employ 116 physicians and 967 nonphysician staff.

The TMA Disaster Relief Program has collected almost $1 million in donations to help physicians whose practices sustained physical Harvey-related damage not covered by insurance or other sources of assistance.

TMA’s Disaster Preparedness & Response Resource Center has guidance on how to donate and for physicians who need assistance for their practice.

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