Hurricane Katrina was the deadliest US hurricane in seven decades and the most expensive natural disaster in US history. Over 500,000 people were evacuated. Nearly 90,000 square miles were declared a disaster area (roughly equal to the land mass of the United Kingdom).1
More than 1,600 confirmed deaths occurred and over 1,000 others remain missing.2
The destruction caused Katrina has lingered much longer than in previous hurricanes.3
An extensive literature documents adverse mental health effects of natural disasters.4, 5
Although these effects vary greatly, the effects of catastrophic disasters are consistently large.6, 7
For example, studies after Hurricane Andrew found 25–50% of respondents afflicted with disaster-related mental disorders.8, 9
Based on these results, and given the extraordinary array of stressors that occurred in conjunction with Hurricane Katrina (e.g., bereavement, exposure to the dead and dying, personal threat to life, massive destruction),10–12
we would expect the mental health effects of Katrina to be at the upper end of the range of previous disasters.
Due to the wide geographic dispersion of the displaced population, comprehensive mental health assessment of Katrina survivors is nonexistent. The Louisiana Department of Public Health documented substantial psychopathology among the 50,000 Katrina survivors cared for in evacuation centers (ECs) shortly after the hurricane,13
but these individuals represented fewer than 1% of survivors. Seven weeks after the hurricane, CDC carried out a household needs assessment survey that found half of adults still living in New Orleans to have clinically significant psychological distress,14
but no information was obtained on the much larger number of pre-hurricane residents who no longer lived in New Orleans. Two public opinion polls, one carried out jointly by Gallup, CNN, and USA Today in a sample of people who sought American Red Cross (ARC) assistance,15
and the other carried out by the New York Times in a sample from the ARC safe list,16
asked a handful of questions about mental health, but without attempting to assess clinical significance. A probability survey of families with children still residing in FEMA-sponsored trailers or hotel rooms in Louisiana as of mid-February, 2006 found 44% of adult caregivers to have clinically significant psychological distress.17
As with the earlier CDC EC survey, though, the sampling frame represented less than 1% of pre-hurricane residents of the affected areas.
Public health decisions cannot be based on such a narrow empirical foundation. The current report presents initial results of an ongoing tracking survey designed to provide broader coverage of the population affected by Hurricane Katrina. The first phase of the study aimed to enroll and carry out a baseline mental health needs assessment survey with a representative sample of 1000 adult (ages 18+) pre-hurricane residents of the FEMA-defined Hurricane Katrina impact areas in Alabama, Louisiana, and Mississippi.18–20
Subsequent phases of the study will monitor evolving needs in follow-up surveys. The focus of this report is on the effects of the hurricane on the prevalence and correlates of mental illness and suicidality. Before-after comparisons are approximated by using baseline data from a 2001–03 national survey that included a probability sub-sample of respondents in the two Census Divisions subsequently affected by Katrina.21
The questions used to assess mental illness and suicidality were identical in the two surveys.