Mentally Ill Suffer amid Katrina-forced Evacuations

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Among the last evacuees arriving at the triage in Louis Armstrong New Orleans International Airport are those with mental illnesses. They were slow to leave because they did not understand the danger, or their illness made them uncooperative. Many patients are without medication and their conditions have deteriorated.


Louis Armstrong New Orleans International Airport is the city's only working hospital. Medical workers there are starting to see more and more survivors with psychiatric problems as NPR's Joseph Shapiro reports.


A little girl in a long white T-shirt pulls Carol Madura(ph) this way, then that on a zigzag through the airport terminal. The girl has a psychiatric illness. Madura is the mental health worker for a medical team. She's having a hard time keeping up with the seven-year-old who runs and stops, falls on the ground, gets up and then takes off again. The little girl won't stop moving. Her father won't wake up. Madura explains.

Ms. CAROL MADURA: Her father is an elderly man who's got kidney issues.

SHAPIRO: But the last time he had dialysis was seven days ago, and now he's unconscious. Madura explains that the man is the girl's only relative.

Ms. MADURA: She was poking him in the face a few minutes ago and trying to wake him up, but he's not waking up. So she was screaming pretty loudly. So we just moved her and tried to distract her a little bit and give her something to do, but she's a handful.

SHAPIRO: There are no dialysis machines in the field hospital that's been set up at the airport. So the father was put on a priority list for a flight to a hospital in a distant city, but the girl did not get on that plane with him. She was too wild to go without someone to watch her. She was placed in foster care. Seven other children were put into foster care on one day this week either because they had a psychiatric illness or because their only guardian did. Most people who come here are adults with a range of illnesses. Among the most common are people with schizophrenia and ones who are hallucinating simply because they've become dehydrated. Dr. Eric Larson explains why this field hospital seems to be seeing more patients now with psychiatric problems.

Dr. ERIC LARSON: We've had a number of people who normally function just fine. They ran out of their medications.

SHAPIRO: Larson is the director of medical operations here for FEMA. He said people who can't function well with medications are now running out of them, and without those drugs, many have a hard time coping with the extreme stress of the hurricane and now evacuation.

Dr. LARSON: They come into a scene of mass chaos in which they're put into lines and they're put on a plane to some city which they really don't have much choice but at least there's some shelter at the end. They have freaked out in that type of situation.

SHAPIRO: Another doctor working here is Lawrence Hipshman. He's a psychiatrist.

Dr. LAWRENCE HIPSHMAN (Psychiatrist): Most people in a disaster setting are tremendously resilient. I've been always amazed. The resilience is absolutely remarkable what people can survive.

SHAPIRO: But Hipshman says mental health providers can expect to treat many people dealing with loss from this disaster.

Dr. HIPSHMAN: Imagine yourself in a similar situation. Your house is gone. Your job is gone. You have a family still. You are then transported to a new city. There you are and let yourself think about how you will look at yourself, your family, your place in society, how you might feel about society. Would you feel abandoned? Would you feel marginalized? What would you do? And then you might have a sense of why long-term care is important.

SHAPIRO: Often disaster relief is something offered right after a hurricane, but many mental health problems won't show up for weeks or months or even longer.

Joseph Shapiro, NPR News, New Orleans.

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