State Tries to Reach People with Post-Sandy Mental Health Issues

Andrew Kitchenman | May 29, 2014 | Health Care, Sandy
Past disasters have shown NJ entering critical period when long-term effects emerge

State Children and Families Commissioner Allison Blake and Dr. Ramon Solhkhah, pediatric and adolescent psychiatrist at Jersey Shore University Medical Center.
New Jersey mental-health professionals know there are many residents affected by Hurricane Sandy who have yet to seek help. Now the state is increasing efforts to reach them.

Using federal funds, the state Department of Health is funding $4 million in grants to community health centers and hospitals to provide behavioral health screenings for depression, post-traumatic stress, alcohol and substance abuse, domestic violence, and child abuse.

In addition, the state is distributing $10 million to county health departments, hospitals, and community agencies to help children with special needs. The money also will go to supplement programs that support families, such as those that assist pregnant women and families with young children in vulnerable populations.

The state has reached a point — 19 months after the storm — when other areas struck by disasters saw an increase in residents with post-traumatic symptoms, according to Dr. Joseph Miller, Meridian Health’s corporate director for neuroscience, behavioral health, orthopedics, and rehabilitation medicine.

Miller noted that residents with emotional difficulties are more likely to visit a primary-care provider than a mental-health provider.

“There’s often a delay, sometimes for months or years, in the development of symptoms following a disaster,” said Miller, who noted that many people started showing problems about 18 months after September 11, 2001. “Now is really when we’re really going to see people who are struggling.”

Meridian has received a grant to screen 15,000 residents for potential problems. The organization hosted a roundtable discussion of the issue with senior state officials and other healthcare professionals yesterday at Riverview Medical Center in Red Bank.

The consequences of disaster on children can be particularly troubling, since stress can effect brain development.

Dr. Margaret Fisher, a pediatric infectious disease specialist with Monmouth Medical Center, said she was pleased that the state made the health consequences for children a priority from the first days after the storm.

“We found out immediately that children were not going to be forgotten,” said Fisher, who added, “I think that that makes New Jersey a unique place.”

As president of the state chapter of the American Academy of Pediatrics, Fisher has been working with state officials on a program to teach local pediatricians how to identify children who continue to suffer from storm-related stress.

While there are positive forms of stress — such as when children learn to overcome a challenge — or tolerable levels of stress, mental-health providers have also identified “toxic stress,” which can lead to developmental problems.

“We have more and more information that childhood adversity has lifelong consequences,” Fisher said.

State Children and Families Commissioner Allison Blake emphasized the importance of the partnership with the pediatricians. She added that the state has targeted funding for additional pediatric nurses for child protective services agencies, and worked to make services for children’s health more accessible in Sandy-struck communities.

The emotional consequences of the storm often can’t be separated from physical symptoms, said Dr. Cheryl Bettigole, chief medical officer for CompleteCare, a federally qualified health center that serves low-income residents in Gloucester, Cumberland, and Cape May counties. That adds to the value of the federally funded screenings, she said.

“We are picking up lots and lots of folks that did not come in complaining of depression and never mentioned it,” but who test positive for depression or other behavioral health issues based on a questionnaire, Bettigole said. This prompts further questions.

“When I come into the room and want to talk with them, [they] are really happy to have those conversations and you can see the relief on their face, that this is something we can actually discuss,” Bettigole said. She added that these issues are most severe for low-income residents.

Dr. Ramon Solhkhah, pediatric and adolescent psychiatrist at Jersey Shore University Medical Center, said recovery from traumatic events like Sandy can be more difficult for children, since they are exposed to reminders of the storm through TV and social media.

“Everything is constantly experienced and constantly re-experienced and re-experienced,” said Solhkhah, who noted that a Meridian study found that 20 percent of families had sought mental health treatment within six months of the storm.

The emotional consequences of the storm could be long-lasting. State Health Commissioner Mary E. O’Dowd noted a RAND Corp. study that found that New Orleans families that experienced Hurricane Katrina were twice as likely to break up after living through the storm as similar families who didn’t. The World Health Organization found a fivefold increase in traumatic brain injuries to children under age 2 after Hurricane Floyd.

O’Dowd said the 10 organizations that received grants to screen residents are expected to reach 48,000 people. In addition to Meridian, the recipients are: Visiting Nurses Association of Central New Jersey; AtlantiCare Regional Medical Center; Ocean Health Initiative Inc.; Jewish Renaissance Medical Center in Middlesex and Essex counties; Southern Jersey Family Medical Center; Newark Community Health Center; CarePoint Health Foundation; North Hudson Community Action Center; and CompleteCare Health Center in Cape May County.