Last week, we at CVN watched in horror along with the nation as the rain began to fall on Texas. We followed the inspiring and devastating stories of individuals, communities, heroes, and tragedies—all while the rain still fell. Perhaps by the time this post is published there will be an accurate count of the lives lost in this terrible storm, but it will be months before the true costs begin to be tallied, and, for many, years before the memories of the floodwaters begin to recede.
Texas has a very high per-capita population of veterans, Guardsmen and Reservists have who retired to the state. Some have lost their homes, cars, clothes, belongings, and even loved ones. First order
interventions need to be focused on these factors as the immediate priority. I lived in Texas during Hurricane Katrina and my community welcomed thousands of evacuees. In our Convention Center, families were fed and housed, clothes were provided, and a makeshift medical facility was set up. Hundreds of volunteers from across the state and country came to help with the functions of resettlement, financial aid, education and housing. Mental health providers came, too.
Those trained in Psychological Health First Aid and disaster mental health offered stress management groups, coping skills sessions and groups, and aid to individuals and families in need. This was not the time for insight-focused psychotherapy; in the aftermath of any disaster, the primary focus must be improving psychological, emotional and physical safety. In the mental health literature that has emerged from psychological interventions following large-scale disasters, we have learned that psychological responses typically have distinct stages. During the earliest stages of a profoundly stressful situation, people may not even know that they are experiencing a stress injury. It is important to be watchful for severe stress symptoms such as sleeplessness, changes in appetite, fatigue, irritability, memory lapses and cognitive challenges. When clients come into our clinics, simple things like having clinic staff help complete paperwork can go far for someone experiencing overwhelming stress. SAMHSA has very helpful resources about how to recognize stress injuries following a natural disaster: . For our clients, staff and communities impacted by Hurricane Harvey, there are some specific things we recommend.
- As much as possible during this stressful time, try to get adequate nutrition and sleep. It is amazing how difficult this can actually be, and how essential it is to self-regulation and resilience. Use sleep hygene tools, but not sleep restriction, during this period.
- The value of physical activity during stress is immense. Even taking small walks can be helpful. A brief regimen of physical activity each day can help to re-regulate hormones, create personal time for recovery, and continue to build self-efficacy
- Expectation management is essential. People will believe that they are supposed to be handling the period following a disaster in any number of ways (“I should be crying over the loss” or “I should really be holding it together more”) but we all know that there is no “right way” to process overwhelming stress. The same goes for clinicians who routinely believe they should be more immune somehow to the impact of stress and trauma. This is a time to foster positive self-talk, unconditional patience with ourselves and others, and very reduced expectations.
After this initial period of recovery, our community members impacted by Harvey will be vulnerable to the same complex psychological injuries we would expect following a trauma or loss. Some may develop PTSD and others may experience prolonged grief, depression and anxiety. It will likely be several months before individuals begin to take account of their psychological and spiritual injuries and seek help to process them. CVN is committed to remaining with our community through its healing. We will learn what obstacles the military families of Texas face in their pursuit of treatment, and we will help meet those obstacles head-on. We will work with community partners to identify resource and referral partnerships and we will work with our clinics to ensure everyone has the training, resources and support they need to care for their communities both now and in the long-term.
By Crystal Shelton
CVN Vice President, Clinical Programs