Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-11T06:10:46.388Z Has data issue: false hasContentIssue false
  • English
  • Français

Hurricane Katrina's First Responders: The Struggle to Protect and Serve in the Aftermath of the Disaster

Published online by Cambridge University Press:  08 April 2013

Howard J. Osofsky ,
Joy D. Osofsky ,
James Arey ,
Mindy E. Kronenberg ,
Tonya Hansel  and
Michele Many
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: Hurricane Katrina highlighted both the crucial role of first responders in times of disaster and the resultant stress on them and their families. The primary objective of this study was to describe the mental health status and symptoms of first responders in the New Orleans area. We further hypothesized that given the extent of the disaster and slowness of recovery, symptoms of posttraumatic stress and depression would not decrease after the first-year anniversary of Hurricane Katrina.

Methods: A total of 1382 first responders, including respondents from police, fire, emergency medical services, and city workers, participated in this longitudinal study. The first screening was conducted between 6 and 9 months after Hurricane Katrina and the second round of data collection was conducted 13 to 18 months after the hurricane. A subsample of the respondents (n = 87) were matched at both time points, which allowed for paired sample comparisons. We measured all of the respondents' levels of traumatic experiences, alcohol use, partner conflict, requests for services, posttraumatic stress, and depression.

Results: More than one-quarter of the first responders reported the following traumatic experiences: witnessed injury or death (70%); damage to home (93%); injury to a friend (25%); and previous loss or trauma (30%). Data also revealed that at least 10% of the respondents had significant levels of posttraumatic stress symptoms; 25% of the participants reported significant levels of depression; and more than 40% reported increased alcohol use and conflict with partner (41%). A statistically significant decrease in the symptoms of posttraumatic stress or depression was not found within 18 months of Hurricane Katrina.

Conclusions: Results suggest that the severity of the traumas experienced from both the impact of Hurricane Katrina and the subsequent recovery has important mental health implications for first responders. Reports of symptoms of anxiety or depression should be attended to so as to prevent increasing symptoms that could negatively affect the first responder and his or her family. These findings highlight the importance of not only providing mental health services for first responders but also having adequate plans in place before natural or technological disasters strike.

(Disaster Med Public Health Preparedness. 2011;5:S214-S219)

Keywords

first responderdisasterHurricane KatrinaKatrina, Hurricanedisaster responsestress disorders, post-traumaticmental healthNew Orleansmental health servicesoccupational health
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 5 , Issue S2 , September 2011 , pp. S214 - S219
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Garrett, BL, Tetlow, T.Criminal justice collapse: the Constitution after Hurricane Katrina. Duke Law J. 2006;56:127–178.Google Scholar
2.Deflem, M, Sutphin, S.Policing Katrina: managing law enforcement in New Orleans. Policing. 2009;3:41–49.CrossRefGoogle Scholar
3.Kronenberg, M, Osofsky, HJ, Osofsky, JD, Many, M, Hardy, M, Arey, J.First responder culture: implications for mental health professionals providing services following a natural disaster. Psychiatr Ann. 2008;38:114–118.CrossRefGoogle Scholar
4.Fernando, DM, Hebert, B.Resiliency and recovery: lessons from the Asian tsunami and Hurricane Katrina. J Multicult Couns Devel. 2011;39:2–13.CrossRefGoogle Scholar
5.Mason, V, Andrews, H, Upton, D.The psychological impact of exposure to floods. Psychol Health Med. 2010;15 (1):61–73.CrossRefGoogle ScholarPubMed
6.Kessler, RC, Galea, S, Gruber, MJ, Sampson, NA, Ursano, RJ, Wessely, S.Trends in mental illness and suicidality after Hurricane Katrina. Mol Psychiatry. 2008;13 (4):374–384.CrossRefGoogle ScholarPubMed
7.Assanangkornchai, S, Tangboonngam, S, Edwards, JG.The flooding of Hai Tai: predictors of adverse emotional responses to a natural disaster. Stress Health. 2004;20:81–89.CrossRefGoogle Scholar
8.Briere, J, Elliott, D.Prevalence, characteristics, and long-term sequelae of natural disaster exposure in the general population. J Trauma Stress. 2000;13 (4):661–679.CrossRefGoogle ScholarPubMed
9.Zwiebach, L, Rhodes, J, Roemer, L.Resource loss, resource gain, and mental health among survivors of Hurricane Katrina. J Trauma Stress. 2010;23 (6):751–758.CrossRefGoogle ScholarPubMed
10.Norris, FH, Murphy, AD, Baker, CK, Perilla, JL.Postdisaster PTSD over four waves of a panel study of Mexico's 1999 flood. J Trauma Stress. 2004;17 (4):283–292.CrossRefGoogle ScholarPubMed
11.Wadsworth, ME, Santiago, CD, Einhorn, L.Coping with displacement from Hurricane Katrina: predictors of one-year post-traumatic stress and depression symptom trajectories. Anxiety Stress Coping. 2009;22 (4):413–432.CrossRefGoogle ScholarPubMed
12.Cieslak, R, Benight, C, Schmidt, N.Predicting posttraumatic growth among Hurricane Katrina survivors living with HIV: the role of self-efficacy, social support, and PTSD symptoms. Anxiety Stress Coping. 2009;22 (4):449–463.CrossRefGoogle Scholar
13.Smith, BW, Freedy, JR.Psychosocial resource loss as a mediator of the effects of flood exposure on psychological distress and physical symptoms. J Trauma Stress. 2000;13 (2):349–357.CrossRefGoogle Scholar
14.Glass, K, Flory, K, Hankin, BL, Kloos, B, Turecki, G.Are coping strategies, social support, and hope associated with psychological distress among Hurricane Katrina survivors? J Soc Clin Psychol. 2009;28:779–795.CrossRefGoogle Scholar
15.Sutker, PB, Corrigan, SA, Sundgaard-Riise, K, Uddo, M, Allain, AN.Exposure to war trauma, war-related PTSD, and psychological impact of subsequent hurricanes. J Psychopathol Behav Assess. 2002;24:25–37.CrossRefGoogle Scholar
16.Gittelman, M.Disasters and psychosocial rehabilitation. Int J Ment Health. 2003;32:51–69.CrossRefGoogle Scholar
17.North, CS, Kawasaki, A, Spitznagel, EL, Hong, BA.The course of PTSD, major depression, substance abuse, and somatization after a natural disaster. J Nerv Ment Dis. 2004;192 (12):823–829.CrossRefGoogle ScholarPubMed
18.Shelby, JS, Tredinnick, MG.Crisis interventions with survivors of natural disaster: lessons from Hurricane Andrew. J Couns Dev. 1995;73:491–497.CrossRefGoogle Scholar
19.Dowling, FG, Moynihan, G, Genet, B, Lewis, J.A peer-based assistance program for officers with the New York City Police Department: report of the effects of Sept. 11, 2001. Am J Psychiatry. 2006;163 (1):151–153.CrossRefGoogle Scholar
20.Perrin, MA, DiGrande, L, Wheeler, K, Thorpe, L, Farfel, M, Brackbill, R.Differences in PTSD prevalence and associated risk factors among World Trade Center disaster rescue and recovery workers. Am J Psychiatry. 2007;164 (9):1385–1394.CrossRefGoogle ScholarPubMed
21.Centers for Disease Control and Prevention (CDC). Mental health status of World Trade Center rescue and recovery workers and volunteers - New York City, July 2002-August 2004. MMWR Morb Mortal Wkly Rep. 2004;53 (35):812–815.Google Scholar
22.Gersons, BP, Carlier, IV, Lamberts, RD, van der Kolk, BA.Randomized clinical trial of brief eclectic psychotherapy for police officers with posttraumatic stress disorder. J Trauma Stress. 2000;13 (2):333–347.CrossRefGoogle ScholarPubMed
23.Carlier, IV, Lamberts, RD, Gersons, BP.Risk factors for posttraumatic stress symptomatology in police officers: a prospective analysis. J Nerv Ment Dis. 1997;185 (8):498–506.CrossRefGoogle ScholarPubMed
24.Osofsky, HJ, Holloway, H, Pickett, A.War correspondents as responders: considerations for training and clinical services. Psychiatry. 2005;68 (3):283–293.CrossRefGoogle ScholarPubMed
25.Weiss, D, Marmar, C, Metzler, T, Ronfeldt, H.Predicting symptomatic distress in emergency service personnel. J Couns Clin Psychol. 1995;63:361–368.CrossRefGoogle Scholar
26.Bartone, PT, Ursano, RJ, Wright, KM, Ingraham, LH.The impact of a military air disaster on the health of assistance workers. A prospective study. J Nerv Ment Dis. 1989;177 (6):317–328.CrossRefGoogle ScholarPubMed
27.Benight, CC, Bandura, A.Social cognitive theory of posttraumatic recovery: the role of perceived self-efficacy. Behav Res Ther. 2004;42 (10):1129–1148.CrossRefGoogle ScholarPubMed
28.Crawford, E, O’Dougherty Wright, M, Masten, AResilience and spirituality in youth.In: Benson P, Roehlkepartain E, King P, Wagener L, eds. The Handbook of Spiritual Development in Childhood and Adolescence. Newbury Park, CA: Sage; 2009.Google Scholar
29.Ursano, RJ, Fullerton, CS, Norwood, AE.Psychiatric dimensions of disaster: patient care, community consultation, and preventive medicine. Harv Rev Psychiatry. 1995;3 (4):196–209.CrossRefGoogle ScholarPubMed
30.Luthar, SSResilience and Vulnerability: Adaptation in the Context of Childhood Adversities.New York: Cambridge University Press; 2003.Google Scholar
31.Masten, AS.Ordinary magic. Resilience processes in development. Am Psychol. 2001;56 (3):227–238.CrossRefGoogle ScholarPubMed
32.Benedek, DM, Fullerton, C, Ursano, RJ, Ursano, RJ.First responders: mental health consequences of natural and human-made disasters for public health and public safety workers. Annu Rev Public Health. 2007;28:55–68.CrossRefGoogle ScholarPubMed
33.Centers for Disease Control and Prevention (CDC). Community needs assessment of lower Manhattan residents following the World Trade Center attacks--Manhattan, New York City, 2001. MMWR Morb Mortal Wkly Rep. 2002;51 (Spec No):10–13.Google Scholar
34.Centers for Disease Control and Prevention (CDC). Health hazard evaluation of police officers and firefighters after Hurricane Katrina--New Orleans, Louisiana, October 17-28 and November 30-December 5, 2005. MMWR Morb Mortal Wkly Rep. 2006;55 (16):456–458.Google Scholar
35.Weathers, FW, Huska, JA, Keane, TMPCL-C for DSM-IV.Boston: Boston National Center for PTSD-Behavioral Sciences Division; 1991.Google Scholar
36.US Department of Veterans Affairs. National Center for PTSD.PTSD checklist (PCL). http://www.ptsd.va.gov/professional/pages/assessments/ptsd-checklist.asp. Accessed April 21, 2011.Google Scholar
37.Weathers, FW, Litz, BT, Herman, DS, Huska, JA, Keane, TMThe PTSD Checklist (PCL): Reliability, Validity, and Diagnostic Utility.Presented at the International Society for Traumatic Stress Studies meeting; San Antonio, TX; 1993.Google Scholar
38.Roberts, RE, Vernon, SW.The Center for Epidemiologic Studies Depression Scale: its use in a community sample. Am J Psychiatry. 1983;140 (1):41–46.Google Scholar
39.Brackbill, RM, Thorpe, LE, DiGrande, L.Surveillance for World Trade Center disaster health effects among survivors of collapsed and damaged buildings. MMWR Morb Mortal Wkly Rep. 2006;55:1–18.Google ScholarPubMed
40.Andresen, EM, Malmgren, JA, Carter, WB, Patrick, DL.Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med. 1994;10 (2):77–84.CrossRefGoogle Scholar
41.North, CS, Tivis, L, McMillen, JC.Coping, functioning, and adjustment of rescue workers after the Oklahoma City bombing. J Trauma Stress. 2002;15 (3):171–175.CrossRefGoogle ScholarPubMed
42.North, CS, Tivis, L, McMillen, JC.Psychiatric disorders in rescue workers after the Oklahoma City bombing. Am J Psychiatry. 2002;159 (5):857–859.CrossRefGoogle ScholarPubMed
43.Zimering, R, Gulliver, SB, Knight, J, Munroe, J, Keane, TM.Posttraumatic stress disorder in disaster relief workers following direct and indirect trauma exposure to Ground Zero. J Trauma Stress. 2006;19 (4):553–557.CrossRefGoogle ScholarPubMed
44.Daly, ES, Gulliver, SB, Zimering, RT, Knight, J, Kamholz, BW, Morissette , SB.Disaster mental health workers responding to Ground Zero: one year later. J Trauma Stress. 2008;21 (2):227–230.CrossRefGoogle ScholarPubMed
45.Fullerton, CS, Ursano, RJ, Wang, L.Acute stress disorder, posttraumatic stress disorder, and depression in disaster or rescue workers. Am J Psychiatry. 2004;161 (8):1370–1376.CrossRefGoogle ScholarPubMed
46.Federal Emergency Management Association. Robert T.Stafford Disaster Relief and Emergency Assistance Act, as amended, and related authorities. FEMA 592. http://www.fema.gov/pdf/about/stafford_act.pdf. Published June 2007. Accessed October 10, 2010.Google Scholar