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Hurricanes Take Heavy Toll on Mental Health of Survivors

Storms can worsen condition of those with existing disorders, trigger new illness

Local residents form a chain to deliver food and water to their community during humanitarian aid efforts in Puerto Rico following Hurricane Maria in 2017
Courtesy of U.S. Customs and Border Protection, Ozzy Trevino

In the aftermath of tropical cyclones, images of flattened buildings, uprooted trees, and flooded streets dominate news coverage.

But some storm damage can’t be captured in photographs: Hurricanes also inflict profound harm to the mental health of people in their paths.  

Two articles coauthored by NCEI’s James Kossin detail the effects of tropical cyclones on the mental health of survivors. The articles, in Lancet Psychiatry and Psychiatric Services, suggest that strong storms can lead to mental disorders among previously healthy people and worsen the health of those with preexisting mental illness.

These articles call attention to the mental illness that follows in the wake of the storms—and suggest ways communities can prepare. 

Worsening Storms 

Both articles note that increased storm activity has been observed since the 1990s, as warmer ocean temperatures have contributed to storms with stronger winds, more rainfall, and an increased tendency to stall over land, which exacerbates wind damage and flood risk.

“Global environmental climate change is now making these storms ever more extreme and damaging,” according to the Psychiatric Services article, from lead author Zelde Espinel of University of Miami Miller School of Medicine and coauthors including Kossin.

As the storms become more severe, so do the mental health consequences. In fact, the storms do more widespread damage to minds than to bodies, the article argues: “Simply stated, more people are affected psychologically than medically after any given hurricane.”

Mental Health Toll

Hurricane damage to mental health is inflicted in many ways. Hurricanes destroy power grids and communications networks, halting medical care for vulnerable populations, including psychiatric patients who rely on uninterrupted care and steady medication schedules.

Patients taking certain psychiatric medications are more likely to have problems with thermoregulation, a situation that becomes particularly dangerous when power failures cut off air conditioning and other cooling technologies. Power outages lead to higher rates of heat-related hospital admissions among this population, according to the Lancet Psychiatry article, also from lead author Espinel and coauthors including Kossin.

According to their work, exposure to hurricanes is a well-documented risk for new-onset major depression, generalized anxiety disorder, and post-traumatic stress disorder (PTSD). People with substance-use disorders may increase consumption or relapse if they are in recovery.

Threats to mental and physical health are tightly interwoven, a situation illustrated by the aftermath of Hurricane Maria, which struck Puerto Rico in September 2017. High rates of mortality extended at least six months after the storm, causing mental disorders including traumatic bereavement and prolonged grief among survivors. Parents of children with Zika virus infection—a mosquito-borne illness that spread widely after the storm—had heightened risks for major depression. And in a sample of Puerto Rican citizens who relocated to Florida after Hurricane Maria, two-thirds showed symptoms of PTSD, and half showed signs of major depression.

Need for Action

The Psychiatric Services article suggests a number of steps that mental health workers can take to alleviate suffering.

First, they can share their expertise with government and community leaders to help prepare for storms and minimize overall health risks, including the public’s exposure to trauma. As a storm approaches, health workers can warn patients with current mental illness to take protective actions. When a storm hits, and in its aftermath, they can provide care to those people whose mental health has been affected, and also lead studies to document the mental health effects of the storm.

The authors of the Psychiatric Services article urge that the time to act is now, because increasingly powerful storms are inflicting more suffering than ever: “Recent Atlantic hurricanes illustrate the compelling need for psychiatrists to prepare and respond to the mental health consequences of increasingly dangerous climate-driven storms affecting their communities.”