Race and Mental Health in Katrina's Aftermath

In the wake of Hurricane Katrina, almost half the residents of New Orleans are in need of mental health services. Health experts say African Americans experiencing emotional problems are not likely to seek care. This is the final of four reports in a series on mental health after the storm.

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Race can influence whether someone seeks help, especially if the problem is emotional turmoil. In a special study done in October, the Centers for Disease Control and Prevention determined that 45 percent of the residents in the New Orleans area were in need of some form of psychological counseling. Research also shows that African-Americans, one of the groups hardest hit by the storm, are less likely to seek mental health care. NPR's Alix Spiegel has this final report in our series on Mental Health After the Storm.

ALIX SPIEGEL reporting:

Kasandra Scott(ph) spent the week that Katrina hit on the fifth floor of Charity Hospital. She's a registered nurse who's been with Charity for 13 years. During the storm and the days that followed, Scott worked 14-hour days in near darkness, worked through heat and chaos and uncertainty. But Scott says that for most of the crisis, she was too focused on what she had to do next to think about her own situation. She didn't even realize she was in physical pain. Three months before Katrina, she'd had surgery on her knees, but her adrenalin high obscured the fact that constant stair climbing was taking a toll.

Ms. KASANDRA SCOTT (Registered Nurse): We just worked, you know, and I didn't realize until after I got home that my knees were swollen, I mean, to like half their size. But I never realized that, you know, because, like, we were just working and we did what we have to do.

SPIEGEL: When Scott got back home, she assumed life would just be business as usual. Her house was fine. Her family lived in another state. As time went on, however, she felt an overwhelming sadness, but somehow couldn't bring herself to talk about her time at Charity.

Ms. SCOTT: I hadn't talked to my family about it, and I said, `Oh, I'm OK, you know, let's go do this, let's go do that.' And kind of like pushing it farther and farther back until about two weeks ago I decided I needed to talk to somebody.

SPIEGEL: This was a first for Scott, who had never seen a mental health counselor before.

Ms. SCOTT: `Oh, no. No.' You know, and I'd think that's a thing with African-Americans; we don't believe in psychiatrists. That's just a thing.

SPIEGEL: If you ask Kasandra Scott to explain why there's such resistance to psychiatry in her community, she says she doesn't know.

Ms. SCOTT: I have no idea. I guess they just feel like you're crazy if you have to go and talk to someone, and I guess nobody wants to be labeled crazy. I don't know. You know how a lot of things start and you don't actually know where it came from, but you just go with it? I don't know where it started, but there is a strong belief in the African-American community that we just don't talk to psychiatrists.

SPIEGEL: Dr. Harold Neighbors is an African-American professor in the School of Public Health at the University of Michigan. Neighbors has studied why black Americans are uncomfortable with psychiatry, and he says that the hesitation is grounded, at least in part, in experience.

Dr. HAROLD NEIGHBORS (School of Public Health, University of Michigan): It seems that everybody has a story about an acquaintance, an aunt or an uncle or a cousin, who was either taken away involuntarily, committed; typically it might be a story about an interaction with the police. And those stories tend to circulate and contribute to a lot of reluctance to seek help for mental health problems.

SPIEGEL: There are also relatively few African-American psychiatrists and psychologists, and it's sometimes difficult to reach out across racial boundaries. But part of the problem, Neighbors says, is simply cultural unfamiliarity with one of the basic premises of mental health. Neighbors recalls a recent focus group with black men in Detroit.

Dr. NEIGHBORS: There was one individual who I can paraphrase, and his attitude was, `Why in the world would I go and tell the most intimate details of my life to someone that not only does not know me at all, but someone I do not know as well?'

SPIEGEL: Instead of reaching out to strangers, African-Americans tend to rely on the church, family and friends. But, Neighbors says, this attitude doesn't serve his community. When you don't turn to services early, problems can get worse. For her part, Kasandra Scott, the Charity nurse, continues to struggle. She says there are a couple of issues in particular that trouble her.

Ms. SCOTT: Starting over, I guess, 'cause it's going to be awhile before they can get Charity back up and running. And they can't hire everybody back. And I think just to have to accept help, the pride part of me, that's kind of bothering me ...(unintelligible).

SPIEGEL: Despite these issues, she says she's not sure she wants to see a mental health counselor again.

Ms. SCOTT: It depends.

SPIEGEL: Yeah.

Ms. SCOTT: I mean, if every time I have to talk about it, I start crying, then, of course, I do need help. But like I said, it is--just depends.

SPIEGEL: For NPR News, this is Alix Spiegel in Washington.

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