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Trends in mental illness and suicidality after Hurricane Katrina

Abstract

A representative sample of 815 pre-hurricane residents of the areas affected by Hurricane Katrina was interviewed 5–8 months after the hurricane and again 1 year later as the Hurricane Katrina Community Advisory Group (CAG). The follow-up survey was carried out to study patterns-correlates of recovery from hurricane-related post-traumatic stress disorder (PTSD), broader anxiety-mood disorders and suicidality. The Trauma Screening Questionnaire screening scale of PTSD and the K6 screening scale of anxiety-mood disorders were used to generate DSM-IV prevalence estimates. Contrary to results in other disaster studies, where post-disaster mental disorder typically decreases with time, prevalence increased significantly in the CAG for PTSD (20.9 vs 14.9% at baseline), serious mental illness (SMI; 14.0 vs 10.9%), suicidal ideation (6.4 vs 2.8%) and suicide plans (2.5 vs 1.0%). The increases in PTSD-SMI were confined to respondents not from the New Orleans Metropolitan Area, while the increases in suicidal ideation-plans occurred both in the New Orleans sub-sample and in the remainder of the sample. Unresolved hurricane-related stresses accounted for large proportions of the inter-temporal increases in SMI (89.2%), PTSD (31.9%) and suicidality (61.6%). Differential hurricane-related stress did not explain the significantly higher increases among respondents from areas other than New Orleans, though, as this stress was both higher initially and decreased less among respondents from the New Orleans Metropolitan Area than from other areas affected by the hurricane. Outcomes were only weakly related to socio-demographic variables, meaning that high prevalence of hurricane-related mental illness remains widely distributed in the population nearly 2 years after the hurricane.

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Acknowledgements

The Hurricane Katrina Community Advisory Group (CAG) is supported by the US National Institute of Mental Health (R01 MH070884-01A2), with supplemental support from the Federal Emergency Management Agency (FEMA) and the Assistant Secretary for Planning and Evaluation, Department of Health and Human Services. The funders had no role in the design or conduct of the study, nor in the collection, management, analysis or interpretation of the data, or in the preparation, review or approval of the manuscript. A published dataset of the baseline CAG survey is available through the Interuniversity Consortium for Political and Social Research (ICPSR) at the University of Michigan. For details on data acquisition, go to www.HurricaneKatrina.med.harvard.edu.

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Kessler, R., Galea, S., Gruber, M. et al. Trends in mental illness and suicidality after Hurricane Katrina. Mol Psychiatry 13, 374–384 (2008). https://doi.org/10.1038/sj.mp.4002119

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