Five Years After Katrina Psychological Wounds Reopen on the Gulf Coast

Not long after I returned home from my last trip to the Gulf coast, Captain Allen Kruse, a fishing boat captain from Gulf Shores, Alabama, shot himself. The suicide sent shock waves across the Gulf coast and across the country.

As a public health professional, I was focusing at the time on other immediate community health concerns from the Gulf spill, including air quality, worker safety, and seafood safety. The death of Captain Kruse was a grim reminder that the health effects of disasters are not just physical. That’s no surprise to Gulf residents. When I was down there, people talked about the anxiety and depression they’re feeling. But the pain in the Gulf runs deep because the BP oil spill is the third strike against them. First came Hurricane Katrina (and Rita and Wilma shortly afterward during the fateful 2005 hurricane season); next was the recession that all of us have felt; and now the oil.

According to the U.S. Department of Homeland Security, the displaced population from Hurricane Katrina included roughly 800,000 individuals, and as many as 2.5 million were internally displaced, at least temporarily, according to FEMA numbers. Not surprisingly, the displacement and other stress of the hurricane took a psychological toll. The suicide rate in New Orleans tripled after Katrina, nearly two-thirds of hurricane evacuees met the diagnostic criteria for Acute Stress Disorder, and over forty percent had post-traumatic stress disorder (PTSD) in follow-up studies. In one major study, nearly half of the pre-hurricane residents in Louisiana and about a quarter of the pre-hurricane residents of Alabama and Mississippi had some kind of anxiety or mood disorder. Long-term studies have shown that these effects have still not faded out five years later. 

The BP oil spill hit the people of the Gulf coast while they were down. The spill profoundly affected environmental conditions, employment, community cohesion, and individual health, resulting in a high risk of significant mental health problems. Previous studies of oil spill clean-up workers and local communities have reported increased rates of depression, PTSD, anxiety disorder, suicide, and drug, alcohol and behavioral problems that can persist for many years following the disaster. These effects are the same as those documented after the hurricanes. Although the disasters are different, the mental health toll is hauntingly familiar.

Studies following major oil spills in Alaska, Spain, Korea, and Wales have documented elevated rates of anxiety, depression, PTSD, psychological stress and lower mental health status. A mental health survey of 599 local residents one year after the Exxon Valdez spill found that people in the affected communities were 3.6 more likely to have anxiety disorder, 2.9 times more likely to have posttraumatic stress disorder, and 2.1 times more likely to score high on a depression index. Women, fishermen, and native populations were reported to be particularly vulnerable.  Adverse mental health impacts in these studies were observed from seven weeks to six years after those oil spills.

The history of mental health disorders following other oil spills worries me, but I remain hopeful because I know that people in that region are tough and they don’t go down easily. My hope is that people in the Gulf will get all of the help that they need for their physical, mental, and economic damages, and will be able to move on and finally recover from the legacy of the hurricanes and the oil.