People struggling with mental health issues like anxiety and depression have a difficult time under the best of circumstances. Now imagine them trying to cope after being forced from their homes for more than 10 days -- part of that time without their medication.
Michele Green-Ferrante, a program director at the New Jersey Mental Health Association, doesn't have to imagine. She's working with 20 clients displaced from their Toms River-area homes by Hurricane Sandy, helping them find places to stay and pharmacies that can fill their prescriptions.
“A lot of folks came here very quickly and did not have their medication,” Green-Ferrante said.
While New Jersey’s healthcare system plans for emergencies, providers have often had to make decisions on the fly throughout the crisis. And that exacts a toll: Some residents and providers have faced more than a week of unrelieved stress.
State and local health officials emphasized on Thursday that mental health and other resources are readily available for those who are in need of help.
Leslie Terjesen, spokeswoman for the Ocean County Department of Health, said she advises patience for those who still can’t return to potentially damaged homes, while admitting that the advice is difficult to both take and give.
She added that the storm has brought out the best from service providers, some of whom have lost their own homes. She also expressed gratitude for those who’ve come from other states, including the Alabama electrical workers across the street from the department.
Terjesen was interviewed on her cellphone outside the department office, which lost power and phones late Thursday morning. She half-jokingly said the 40-degree weather outside felt warmer than the inside of the building, adding that the storm that dropped four to eight inches of snow on the area added insult to injury.
“This is a storm that we have never ever encountered here at the Jersey Shore,” Terjesen said of Sandy. “We have a lot of evacuees that have medical needs that are certainly more intense than what we at the health department [normally] deal with."
She added that the demands across the region are “unbearable,” including the need to check the credentials of those who volunteer.
Terjesen also said that there will be an additional need for mental health support when residents return home to find that everything is lost.
“Where are people going to go” remains a focus of the relief effort, she said. “Some people have gone from one shelter to another."
For instance, shelters set up at Toms River schools were closed while the schools prepare to reopen. Evacuees were moved to a shelter at Monmouth Park.
State Health Commissioner Mary O’Dowd emphasized help lines available to residents: 211 will connect them to health experts who can offer advice on food safety, water safety, and house safety issues.
In addition, the state’s toll-free Mental Health Helpline, 1-877-294-HELP (1-877-294-4357), is only a call away. It’s operated by the Mental Health Association and the Department of Human Services.
The association's chief operating officer Robert Kley said the line has received more than 1,000 calls.
“There’s a lot of stress on individuals. They may not see the light at the end of the tunnel,” Kley said. “One of the things about traumatic events is that there’s initial stress, but the real impact comes a month later.”
Kley said this is particularly true for first responders and other service providers, who may not feel the trauma now but will in the coming weeks. He also noted that vulnerable populations have lost their support networks.
“We’re going to continue to work in the field over the next couple of months,” he said, adding that mental health professionals “will be there for the long haul. We’re not going away.”
It isn’t just long-term stress that’s been a negative consequence of Sandy. The state’s only certified burn center, at St. Barnabas Medical Center, has seen a tripling in the number of cases.
St. Barnabas spokeswoman Sally Mallech said many residents aren’t aware of how to handle generators and gasoline containers.
“They’re not using them in a safe manner,” she said.
The hospital offers afor handling generators, including always keeping them outdoors and waiting for them to cool down when refueling and restarting them.
O’Dowd was among the state and federal officials who reviewed the storm response from healthcare providers at a briefing at Jersey Shore Medical Center in Neptune on Thursday afternoon.
She urged healthcare providers pay attention to their own stress levels.
“We’ve all lost our temper here and there, and then when we have a situation where we are fatigued because we’ve been responding to these situations, we’re at greater risk,” O’Dowd said.
U.S. Health and Human Services Assistant Secretary Dr. Nicole Lurie, who oversees preparedness and response, said healthcare providers should be particularly sensitive to the effect of trauma on children, frail elderly residents, and people with chronic mental health problems.
She added that it can be an opportunity to improve the situation of those who were in need of care but hadn’t received it previously.
Jersey Shore Medical Center emergency department chairman Robert L. Sweeney said mental health services will remain a challenge in the coming days.
“The mental health issue is probably where we are most vulnerable in the emergency medicine system across the state, because we have limited mental health resources,” Sweeney said.
“We have plenty of doctors," he continued. "They can suture wounds and take care of sore throats. But we always struggle, even in good times, with mental health issues and people who are under too much stress.”
Residents realizing that “they don’t have home, they don’t have a business, they don’t have a car, is really going to push people over the edge,” Sweeney said, adding that those patients will occupy limited emergency-department space.