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Katrina weighs heavily on first responders

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Evacuees from Hurricane Katrina have at least some access to mental health counselors in most shelters, but there's particular concern about police, paramedics, firefighters and other first responders who may suffer serious, long-term trauma, government officials said Wednesday.

"The need is very great" for more therapists, though many already are volunteering, says Daniel Dodgen, emergency coordinator for the Substance Abuse and Mental Health Services Administration.

Stress reactions such as insomnia and trouble concentrating "are magnified 100-fold" in those who recover human remains and deal with children whose parents are nowhere in sight, Dodgen says. Past experience with disasters shows that rescue workers may try to cope with heavy alcohol or drug use, and may suffer from stress months after their duty ends, he says.

Some states applying for government disaster funds are making these first responders a top priority, Dodgen says.

Among others affected by Katrina, the mental health impact will be most severe in those with pre-existing mental illness, about 6% of adults, says Thomas Insel, director of the National Institute of Mental Health. Relief workers immediately had to scramble to solve serious problems for such adults, Insel says. For instance, some fled their homes without needed anti-psychotic medication.

For some, "the second wave of this hurricane will come later," as stress symptoms surface months and even years after their trauma, Insel says. But as has been true for every U.S. disaster, "most will recover completely. ... We are a very resilient species."

Some therapists are working in shelters as part of a Red Cross disaster response network. Others are working for government agencies or independently.

"It's a rough time down here. Everybody is having acute stress responses. They're numb, they're crying. But who wouldn't be if you lost your house," says psychiatrist Alan Manevitz of New York Presbyterian Hospital/Weill Cornell Medical Center. He's been in the Gulfport, Miss., area for a week.

"They're not freaking out, though, and I'm impressed with how neighbor is helping neighbor," Manevitz says. "I see resilience and determination."

He thinks 9/11 caused greater trauma because of all the unknowns and fears of future terrorism.

Many college students have come through a frightening time in Starkville, site of Mississippi State University, says Starkville psychologist Kristine Jacquin, who teaches at the school.

"With roads blocked and phone lines down, they couldn't get in touch with their families," she says. "Now, even if they've heard that their house is gone and parents lost offices, they seem relieved to at least know what's going on."

Children seem to be the most emotionally upset residents of shelters close to hurricane damage, says Jacquin, who says she's spoken to psychologists all over the state.

"Kids are displaced from homes and not in school," Jacquin says. "While their parents are attending to practical matters, they're very agitated and responding emotionally in a way their parents might like to."

Volunteers provide shelter, 9D

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