The tragedy began April 20 when the Deepwater Horizon oilrig exploded about 40 miles southeast of the Louisiana coast, killing 11 crewmembers. Crude oil began flowing freely out of the deep-sea well, and BP, the oil company giant that leased the rig, was unsuccessful in its attempts to cap the well until mid-July. At press time, work continued on a relief well, which officials say is the only way to permanently stop the flow of oil from the ruptured well.

According to government estimates, this is now the largest accidental release of oil into water in history. The final toll the millions of barrels of leaked oil will have on the surrounding ecosystem is still unknown. Also unknown, counselors say, is the exact toll this crisis is taking on those who live in the region and rely on the Gulf Coast for their livelihood.

In July, Louisiana Department of Health and Hospitals Secretary Alan Levine wrote a letter asking BP America to provide $28.9 million to support mental health outreach activities through the Louisiana Spirit program, as well as services through local districts and nonprofit partners through October 2011. “Counselors on the ground have been reporting increased signs and symptoms of behavioral health instability that experience demonstrates will manifest into more clinically significant behaviors if left untreated,” Levine wrote. “The net result could be a preventable tragedy if we do not work together to ensure we address it head-on.”

In a prior letter to U.S. Health and Human Services Secretary Kathleen Sebelius, Levine also pointed out the urgent need for mental health services. “Our Louisiana Spirit crisis counseling teams have already engaged and counseled more than 2,000 individuals and are reporting increases in anxiety, depression, stress, grief, excessive and earlier drinking and suicide ideation,” he wrote. “Community-based organizations report similar findings. We know that, left untreated, these symptoms can quickly develop into behavioral health problems that lead to the breakdown of the familial structures, domestic violence, abuse and neglect.”

The residents of Houma, La., which bills itself as “The Heart of America’s Wetland” in its tourism materials, have been hit particularly hard by the disaster. Carol Benoit, a counselor in private practice in Houma, is already seeing the oil spill’s effects on her clients. Since May, Benoit, who works with children, families, couples and adults, has witnessed an increase in behavior problems in several children, including more frequent tantrums and more severe outbursts. “The anxiety level of some of the adults I see is markedly increased,” adds Benoit, a member of the American Counseling Association. She has also noticed an increase in depression and suicidal ideations among clients, as well as an increase in drug use and domestic violence among clients with prior histories of those behaviors.

“For the adults, the oil spill represents another crisis in a string of crises including [Hurricanes] Katrina, Rita and Gustav, all of which had significant impacts here — flooding, threat to basic safety, etc.,” Benoit says. “All of these crises occurred at the same time of year — summer.” Summer is extremely hot, and residents constantly worry about the “next big storm,” she says. Many people live under constant pressure, feeling an ever-present need to save money, have a backup plan ready and remain prepared to evacuate on short notice. “Many of the children I see are afraid of bad weather because of the destruction they have seen,” Benoit says. “Also, they sense the anxiety of their parents and other adults. That is how it is in the ‘best of times.’ Now imagine all of that with [the oil spill] crisis on top.”

The oil spill represents a severe financial threat to residents, Benoit says, because the community is losing two industries that serve as main sources of employment: seafood and oil production. Benoit notes that the flag of Terrebonne Parish, where Houma is located, features an image of a shrimp boat and an oil well. “How bad it will get as far as the economy is an unknown factor,” she says. “Unknowns are very anxiety-producing because people cannot prepare for what they do not know. What they do know is that people are losing their jobs.”

Margaret Songe, an ACA member who worked as a counselor intern for Terrebonne Mental Health Center in Houma until this past spring, says when livelihoods are affected, it sets off a chain reaction. “Maslow’s hierarchy of needs starts with survival, and if those needs aren’t met, the other higher needs are not likely to be met either, making for diminished lives in several ways,” she says. “Without adequate support from professional counselors, affected people — those seeking/wanting/choosing to get help, of course — may have difficulty responding well to the environment, meaning others around them and themselves.”

Asking for help, Songe continues, isn’t an easy task. “Our people are self-reliant to a fault, in a way. Pride and shame issues arise when they must get financial assistance or have to fight to get BP and/or the government to pay claims, especially because they often meet with resistance and/or red tape from either or both. Not ‘being heard,’ especially when in a desperate situation, creates depressive symptoms, as well as anger and resentment and, at its worst, ‘learned helplessness,’ when the person or group just gives up [and] stops believing that they can affect their situation at all.”

The spill is also a threat to basic safety, Benoit says, because people are afraid of eating seafood due to the possibility of toxicity from the dispersants and oil. “How long will it take to clean up? No one knows. Can it be cleaned up? No one knows. What would happen if or when a hurricane hits now? How much worse would it get? How long will our food supply be contaminated? What kinds of cancers do the toxins cause? Will fertility be affected? These are the questions people are asking,” she says.

Much at risk

The oil spill has put the area’s entire way of life at risk, Songe says. “Grand Isle, our beach in the Gulf, has been closed. Seafood is a staple of our diet. Plus, the sports and recreation — swimming, [water-]skiing, fishing — opportunities have been curtailed. This is how we live. Our region’s way of life, including our recreation, culture, diet, entertainment, livelihood and tourism, is threatened, and it has a traumatic affect. We are all directly affected.”

Benoit notes that in the Gulf region, eating and catching seafood is an integral part of the distinct Cajun culture. Because part of the cultural heritage involves harvesting seafood and wild game from the surrounding area, there is a deep psychological connection to the wetlands, which are now polluted, she says. “On that level, it is a psychological blow to the cultural identity of the people of the region. We have watched the wetlands wash away despite years of efforts by people here to save the wetlands, and now this. It is as if we are watching the disappearance of our culture.”

Another impact less often discussed in the media, Benoit says, is the stress caused in the community by political and social division related to the crisis. “There are various opinions about who is at fault, what needs to be done, what can be done,” she says. “So, when people seek support from each other, they often do not find it.”

In the aftermath of events such as 9/11, Benoit points out, there was a common enemy. Therefore, most people agreed about who did what and how to respond. “But in cases such as this, it is all very debatable,” she says. “This causes conflicts in families and support systems. It is difficult for people to find the kind of emotional support they need while tiptoeing around political hotspots.”

Tammy Cheramie, who worked as a school counselor for Vandebilt Catholic High School in Houma this past year, says the trauma doesn’t end with the oil spill and cleanup. The possibility of a moratorium on oil drilling is yet another effect confronting local residents. “The moratorium threat is causing businesses in the oil industry to rethink hiring, drilling and services,” says Cheramie, a member of ACA who admits she’s slightly biased because her parents worked in oil-related industries and “big oil” has been good to her family. “It is a trickle-down effect the Obama administration apparently is oblivious to right now. It is affecting an industry already impacted by a bad economy.”

Valerie Cooper, a part-time counselor for the Terrebonne Parish Drug Court who also works in private practice, has heard similar worries from her clients. “The clients I see now are anxious due to the uncertainty of job situations,” says Cooper, an ACA member who also teaches at-risk high school students who are earning their GEDs. “The oil spill has made a dramatic impact on the fishing/tourist/restaurant business, but the bigger concern now is the moratorium imposed and oil companies looking elsewhere to drill. Clients understand not to expect things from government but are now becoming angry and discouraged and don’t see a future.” Cooper says she is expecting to see an increase in drug and alcohol abuse, domestic violence, anxiety, depression and even suicide in the near future.

Jessica Fournier, a school counselor at Houma Junior High School who also runs a private practice in Houma, says the spill has sent shock waves through the community because of the uncertainty surrounding the long-term effects. “The clients in my private practice whom I treated throughout this disaster were not directly affected by the spill but did express concerns about the effects,” says Fournier, a member of ACA. “It was and is a topic that everyone discusses. Concerns range from frustration that the spill continued as long as it did [to] the loss of their livelihood and concern over how our environment will be affected in the long term.”

Children aren’t spared from the stress surrounding the situation, Fournier says. “I would suspect that our children will be more affected as they are forced to relocate to different schools in order that their parents may earn a living,” she says. “Parents may also be more argumentative over the stress this incident has placed on our community.”

Fournier predicts the effects on her students will be similar to the post-traumatic stress they experience after the threat or impact of a hurricane. “It is equivalent to an environmental incident beyond our control,” she says. “It increases individuals’ feelings of helplessness and hopelessness at the lack of control [we] have on the environment.”

Benoit agrees that children are absorbing a lot of the impact from the spill. “They feel, see and hear everything that is going on,” she says. “They try to make sense of it. They know something tragic has happened. They know that the adults are worried. They see the adults cry, express anger and have symptoms. And they [the children] worry, they act out, they have trouble sleeping, etc.”

Erin Dugan, an assistant professor in the Department of Rehabilitation Counseling at Louisiana State University Health Sciences Center-New Orleans and clinical director at the center’s Play Therapy Clinic, is anticipating an uptick in referrals after schools are back in session. “Due to past history, we saw children emotionally, behaviorally and cognitively process the effects of such an environmental disaster some time after the initial onset,” says Dugan, a member of ACA. “After 9/11 and Hurricane Katrina, we saw much emotional, behavioral and cognitive turmoil — depression, anxiety, fear, aggression, anger, frustration, etc. — in the months [following those events]. Schools are currently out and … unfortunately, more children are referred while they are in session due to the emotions, behaviors and cognitions that cannot be allowed to continue in the school setting.”

Dugan reports having seen an overall sadness and depression in both parents and children since the spill happened. “However,” she says, “it is uncertain whether this environmental disaster has brought about the sadness, depression and anxiety or whether it’s a double-impact/resurfaced trauma from the past natural disaster, Hurricane Katrina or even the economic decline that this country has been affected by over the past several years.”

The road ahead

Recent cutbacks in social services further complicate an already tragic situation, Songe says. “There have been articles in The (Houma) Courier, our daily newspaper, asking nonprofessional people to volunteer to counsel and receive an afternoon’s worth of training to assist with the mental health crises caused to our residents by the oil spill. These kinds of actions tend to devalue counseling because they give the impression that anyone can do it — no training necessary.” The short-term solution, Songe says, is to help those affected get services from qualified, trained professionals.

Cheramie agrees, adding that the expense of private counselors in a time when families might be slashing their budgets, combined with cutbacks in funding for public mental health services, create a double-whammy for those going through this crisis. “I think counselors and social workers need to go to these people most affected and reach out to them in their communities,” she says. “They are going to be too prideful to seek it out. We will have to reach out in churches, schools and community events. Even if we’re doing it pro bono, we are going to have to do what we have to do to get our state through this time and place.”

As a result of this disaster, Benoit finds she’s putting in longer hours, fielding more calls and seeing more crisis cases. In an effort to help her clients cope, she tells them to get involved. “There are events at various churches that specifically avoid divisive, political bias and focus on bringing people together to pray for all of the people, animals, wildlife, etc.,” she says. She also discourages clients from watching too much media coverage of the spill.

As it concerns children, Dugan recommends that caregivers and schools respect the feelings of their students and are prepared to look at their own mental state before providing support. “Adults should care for themselves in order for the role of the caregiver to be accurately perceived by the child,” she says. “The caregiver who appears out of control to the child may allow the child to take on roles, duties and responsibilities that are not appropriate, ultimately causing undue stress, pressure, anxiety, frustration, anger and resentment.”

Cooper has attended local, state and parish planning meetings with the Department of Health and Hospitals to create strategies for getting mental health information to the affected areas. “People from these areas are self-reliant, humble and proud and find asking or seeking help of any kind difficult,” Cooper says. “Counselors and mental health professionals are being proactive, going into the communities hardest hit [and] bringing information and services to community fairs, concerts and organized events to encourage continued participation in the communities.”

In the near term, Benoit believes there is a need for outside help. “I think there needs to be a program such as the [American] Red Cross program that was in place after Katrina. This allowed people to receive counseling services funded by money donated to the Red Cross. Mental health workers here are psychologically tired and need support from counselors who are not living in a crisis zone.”

Over the long term, Songe would like to see counselors performing outreach in affected communities, researching mental health needs and fostering cohesiveness among citizens. “But this is a key point,” Songe says. “Whatever is done should be done by a professional in the field who knows what to ask and how to help intervene on these folks’ behalf — individually and for families. Especially since this may be a population not accustomed to asking for mental health assistance, it is essential that trained counselors be used — people who know not just how to do interventions, but how to elicit responses from and give support to someone at the same time. Not just someone who pats their hand and says, ‘Everything’s gonna be OK.’ They will certainly see through that and feel dismissed once again.”

Lynne Shallcross is a senior writer for Counseling Today. Contact her at lshallcross@counseling.org.

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