More Than 25% of Sandy Victims Still Experience Mental-Health Aftereffects

Andrew Kitchenman | July 30, 2015 | Health Care, Sandy
Report by state cites need for continued screening and underscores lessons learned for handling future disasters

While Hurricane Sandy recovery efforts often focus on damage done to homes, businesses and infrastructure, a study released yesterday points to another lingering aspect of the storm: More than a quarter of Sandy victims still experience mental-health distress.

The state- and federally funded Sandy Child and Family Health Study found that of the more than 100,000 residents who experienced significant structural damage to their primary homes, 27 percent are still experiencing moderate or severe emotional distress, while 14 percent report signs and symptoms of post-traumatic stress disorder.

The findings are being used by state officials to reinforce the need to extend federal funding to screen residents for behavioral health issues.

The report is also drawing interest from beyond the region, since the study was one of the largest looking at post-disaster mental-health recovery.

The study resulted in two reports. One, titled the “Person” report, focused on the health status of disaster-affected residents, while the “Place” report focused on issues related to providing safe and stable housing.

The “Person” report found that people who experienced structural damage to their homes suffered similar health problems regardless of their income levels – finding. in effect, that the challenges related to their housing made higher-income individuals experience stress levels similar to those of people living in poverty.

In addition, people exposed to problems with mold after the storm experienced higher levels of both asthma and mental-health issues.

And, surprisingly, children whose homes sustained even minor damage were found to be at particularly high risk for psychological and emotional issues.

The “Place” report found that South Jersey residents were more likely to heed mandatory orders to evacuate than North Jersey residents – signaling that more targeted warning messages are needed.

The report also found a need for better measurements of the repair and restoration of damaged housing, and for financial counseling for lower-income residents to help them identify available assistance programs.

The study’s principal investigator — David Abramson, a New York University clinical associate professor — said the link between mold exposure and mental distress was striking.

“In some ways, you would expect it would be associated with the asthmas, because it makes sense – it’s a sort of respiratory allergen,” he said.

Abramson theorized that mold problems can serve as a constant reminder of the storm. He’s the director of the program on population impact, recovery, and resilience at NYU’s College of Global Public Health.

A similar phenomenon may be behind the problems experience by children in homes that had only minor damage.

“You’ve got these lingering reminders of the storm that you just can’t get away from,” Abramson said.

“If this is something that’s weighing on a parent’s mind – when the parents have greater distress, inevitably the kids have greater distress as well,” he said.

Co-principal investigator Donna Van Alst, an assistant research professor at the Rutgers University School of Social Work, added that these children differed from those whose homes suffered more severe damage in that they returned to their homes sooner and saw more of the storm’s effects up close.

“That was one of the more surprising findings for us,” Van Alst said.

State Health Commissioner Mary E. O’Dowd said that the need for the study became apparent soon after the storm, when officials found there was a limited amount of research available to guide the recovery program.

That point was reinforced by an Institute of Medicine-hosted conference less than three weeks after the storm that focused on the lack of data on disaster recovery.

“We made participating in and funding research a priority,” O’Dowd said.

O’Dowd said the state is participating in several different studies, since there’s “no one perfect way to look at these issues.” The newly completed study was funded with $1.1 million in federal Social Services Block Grant recovery funds.

While the state applied for a year-long extension of funding for emergency responders and primary-care doctors to provide screening for behavioral health issues ahead of the release of the study, O’Dowd said officials drew on preliminary information from the report in making their case.

Federal officials have yet to issue a decision on the extension request. If approved, the screenings would continue through next June.

In addition, the state directed that $5.2 million in federal funds be used to connect storm-affected residents with medical and social services.

O’Dowd said that by making the screenings apply to everyone, it’s reduced the stigma associated with mental-health issues and brought potential risks – such as violent behavior, addiction, and other behavioral-health issues — to the attention of both residents and doctors.

O’Dowd noted that the state made exposure to mold a focus of its emergency response from the beginning, including providing training in mold remediation and distributing pamphlets about mold in a dozen languages. She suggested that the study points to a need for making New Jersey’s mold procedures a standard in future disaster responses nationwide.

The study was modeled on a similar five-year study after Hurricane Katrina, which Abramson also worked on. While Rutgers and NYU led the work, they received support from Columbia University and Colorado State University researchers.