This August marks the two-year anniversary of Hurricane Katrina, and the Mississippi Gulf Coast, among other areas, is still struggling to rebuild, both physically and emotionally.
In her ongoing efforts to help the region recover, Carol Buchanan Jones, a member of the Mississippi Counseling Association, a state branch of the American Counseling Association, is working diligently with the Mississippi Coast Interfaith Disaster Task Force, a coordinating organization located in Gulfport that helps vulnerable community members. Jones is the founder of Project Relief, a coalition of mental health professionals providing free services to residents in three Mississippi counties along the coast. Her organization partnered with the task force and other service providers shortly after the hurricane. Since that time, they have aided thousands of individuals and families. Unfortunately, resources are dwindling.
For most people not personally affected by Hurricane Katrina, the memories and images of destruction have faded into the background as more immediate headlines have grabbed the spotlight. Those who live along the Gulf Coast are still haunted by the specter of Katrina, however, and for many, the storm’s after-effects are much more than just nightmarish memories.
“We are seeing that those who initially thought they didn’t need mental health services are now reaching out,” Jones says, “but we expected this. The PTSD (post-traumatic stress disorder) symptoms (started) coming out around 15 to 18 months after the storm.”
Those trying to provide for the storm’s survivors are not immune. A number of caretakers have committed suicide recently, Jones says. Many of the physicians and mental health workers along the Mississippi coast are burned out and are just walking away because the widespread devastation and enormous need seems too overwhelming, she adds.
“Many people don’t realize that there are still 76,000 people living in FEMA (Federal Emergency Management Agency) trailers (in Mississippi),” Jones says. “We want to raise awareness that we still have many problems. This is a long-term recovery. The two greatest needs right now are permanent housing and mental health services. When a person moves out of their FEMA trailer and into permanent housing, they realize that nothing has really changed other than a street address. They still have the same issues and problems coping.”
Jones says even those simple tasks that are associated with daily life almost everywhere else in the nation are still a challenge to those living along the Mississippi Gulf Coast. The few grocery stores that have reopened have very limited stock, and general merchandise stores usually run out of items the same day they receive new shipments.
“Going about your daily life has changed 180 degrees. It’s a struggle,” Jones says. “We certainly don’t have access to merchandise the way we did before the storm. Most of the stores are still leveled.” She notes her town was all abuzz recently over the opening of a new Burger King.
Furthermore, just getting around the Gulf Coast is still difficult because many bridges and roads are still closed. “The infrastructure of our community has been destroyed,” she says. “Getting to work is difficult, so I do much of my work out of my home office rather than at the campus.” Jones still works out of a FEMA trailer at William Carey University, where she is a counselor educator and department director. She doesn’t see a change in prospects anytime soon.
To take a breather from the painful devastation of her hometown, Jones often travels to a friend’s condo in Florida. “I have to do it,” she says matter-of-factly. “I have to get out of here periodically. We all do that in our mental health group. We take the time to step back and just get away.”
New perspective, new plan
To help determine who needs mental health services, Jones and other Mississippi Counseling Association members are looking to implement a new diagnostic and treatment model. The Mental Health Integration (MHI) model, created by Brenda Reiss-Brennan and others, has been used effectively at Intermountain Health Care, a not-for-profit health care system in Utah and southeastern Idaho. The model utilizes primary caretakers to initially assess mental health issues.
“We are looking at taking this model and adapting it to this area to implement a long-term recovery plan,” Jones says. “The entire mental health community here has really just come together on this issue. In addition to stabilizing current mental health services, we are looking to the future in an effort to redesign the delivery of services. We truly have a clean slate here on the Mississippi Gulf Coast and an opportunity to get it right this time. In this attempt, several members in our group have reviewed the MHI model and believe that it might be adapted to provide family-centered, long-term crisis recovery, primary and mental health care services on the coast.”
Under the model, as soon as primary care doctors observe or have mental health issues reported to them, they determine whether the patient needs further treatment and the level of treatment necessary. Based on that recommendation, the patient is sent to a licensed professional counselor, a psychologist or a psychiatrist. “It’s a very family-friendly and family-focused model,” Jones says. “We hope to establish this new plan and receive additional funding to move forward with mental health services in this area.”
‘Rampant’ substance abuse
Carolyn Anderson is a retired counselor and the executive director of the Long Beach Substance Abuse Task Force. Her team is also part of the Mississippi Coast Interfaith Disaster Task Force, and she works closely with Jones to coordinate counseling services.
“We are seeing a huge increase in alcohol consumption and marijuana,” Anderson says. “We have both parents and adolescents using.” She notes that the use of methamphetamines among the adult population has also risen sharply. Fortunately, she says, meth use does not yet appear prominent among area youth.
Last May, many of the youth detention centers and all of the alternative schools in the area were filled to capacity. Most of the referrals to the detention centers and alternative schools were for substance abuse, possession or possession with intent to distribute. But post-Katrina, Anderson says, all students are considered “at-risk.”
“The traditional social activities and places for teens to hang out have been destroyed and have not been rebuilt,” she points out. “They can’t even hang out at friends’ houses. That aspect has been lost because many of them are still living in FEMA trailers. You have a 10 x 10 (foot) box with a family living in it, and then you try to add a couple of teenagers — you just can’t do it. They are frustrated and depressed.”
Anderson’s task force was awarded a grant to provide individual counseling and also established a group counseling program in the Long Beach School District, which includes one middle school, one high school and three elementary schools. “Alcohol abuse among middle schoolers is rampant,” Anderson observes. “They say, ‘I survived Katrina. Don’t tell me this is bad for me.’”
At the middle school, she has contracted with counselors to come in and provide group counseling sessions to several students. The sessions are divided by gender and grade level and are tailored to the students’ developmental levels. During the last school year, one counselor provided group therapy twice a week for three 10-week cycles. Out of nearly 800 students, 224 were referred to the program, and approximately 100 completed the cycle.
The counseling groups address the following areas:
- Coping with anger, grief and loss
- Developing improved communication skills
- Teaching students to identify at-risk behaviors
- Establishing positive peer networks and support
“Our thought was if we could curtail what was going on in the middle school, then we would make a difference when those students entered high school,” Anderson says. “It’s sort of ‘let’s lay the foundation and follow it through.’”
Elizabeth Rogers, a licensed professional counselor, facilitated the group sessions. She says she used an eclectic approach to the group process with a heavy emphasis on reality therapy and brief therapy. “With the younger students, I used many exercises out of the Hazelden series on substance abuse group work for those who are using, those who have family members using or those who are high risk for using,” she explains. “We played games such as The Big Wind Blows and Take What You Need that focused on self-disclosure and identification with others in the group.” Additionally, she used art therapy to help with self-disclosure of values and identification of stress points in the body.
“The most common thread among the participants had to do with their extreme immaturity. They lack skills to deal with stress and resort often to inappropriate outbursts and fighting,” she says, adding that these behaviors tend to manifest later as experimentation with alcohol, tobacco and other drugs, as well as sexual promiscuity. “A few of the students appeared to have enough insight to be able to really examine behavior, but most will continue to experience problems, and many would benefit from further care.”
After finishing the group program in the school, students are referred to appropriate aftercare or community programs. With the new school year set to begin shortly, the program already has a waiting list of referrals.
In conjunction with group counseling, the Long Beach Substance Abuse Task Force has partnered with local church groups to provide positive social activities for older teens. “The youth pastors have planned interfaith youth nights,” Anderson says. “We would provide something that was fun along with a very brief drug prevention message. Primarily, we wanted to give (the teenagers) an outlet.” In the past, she adds, the Long Beach Substance Abuse Task Force has hosted a battle of the bands and brought in guest speakers and entertainers.
Preparing for the future
Jones is ardent about working with both the Mississippi Counseling Association and ACA to better prepare counselors for the next crisis. “It’s not if, but when this will happen again,” she emphasizes. “And this isn’t the only (type of) natural disaster. We have tornadoes and floods to think about. MCA has a history of service in crisis intervention. They were one of the first groups to go into Pearl High School after the 1997 school shooting there. They developed a plan of action for crisis intervention for the K-12 arena. I would love to see ACA form a disaster response network that involves disaster response training. We — ACA — need to develop our own model of training for crisis intervention. Our state organization is already doing that.” ACA currently offers American Red Cross disaster mental health training each year at its annual conference.
Jones believes populations traumatized by natural disaster would be better served by counselors who have completed specialized crisis response training tailored to the unique skills of professional counselors. “The Red Cross training is great, but I’m a professional — we are professionals — and we go above and beyond the training provided by the Red Cross,” she says. “They are not a mental health organization, so the training is lacking.”
Funding human recovery
“Our governor has done a wonderful job with economic recovery, but what we want to focus on now is the human recovery that will sustain that economic recovery,” Jones says.
Fortunately, at press time, the Mississippi Coast Interfaith Disaster Task Force was awarded a social services federal block grant based on its continued commitment to addressing mental health needs and proposed implantation of the MHI model. The grant will be divided as follows:
- Gulf Coast Mental Health Center — $1.6 million
- Project Relief/Mississippi Counseling Association — $500,000
- Coastal Family Health Centers — $300,000
- Long Beach Substance Abuse Task Force — $70,000
“Things are happening every day,” Jones says. “We are kind of excited. We have the momentum going down here, and we have a chance to get mental health services done correctly.”