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Mental Issues Surge, Suicide Rates Flat Post-Katrina

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Mental health problems roughly doubled in the months after Hurricane Katrina, but thoughts of suicide among those with mental health problems actually decreased, according to a new study. The finding of reduced suicide runs counter to many other reports.

The study, published in the Bulletin of the World Health Organization, is the first report of a federally funded tracking survey of the mental health needs of about a thousand adult pre-hurricane residents of Louisiana, Alabama and Mississippi.

It found serious mental health problems among 11.3 percent of respondents compared with 6.1 percent in a similar sample surveyed before the hurricane. Mild to moderate mental illness also nearly doubled, from 9.7 percent to 19.9 percent. The study's author, Professor Ron Kessler of Harvard Medical School, estimates that 400,000 people in the region may have mental health problems as a result of the storm, “about half of them serious enough that they get in the way of people's ability to function on a daily basis.”

The survey, conducted between January and March of 2006, also found an increase in what Kessler calls "post-traumatic growth." Eight out of 10 survey respondents reported that they had discovered new inner strength because of their experiences after Katrina. Almost nine out of 10 said they had found a deeper sense of meaning or purpose in life.

Matt Friedman, the director of VA's National Center for Post Traumatic Stress Disorder, says it is too simplistic to see trauma in purely negative terms.

"A traumatic event is a complicated event. … You can have an adverse effect such as depression or [Post Traumatic Stress Disorder], but on the other hand, you can derive some benefit so you feel this is an important part of your life.”

Psychiatrists usually expect suicide rates to increase in step with depression and other mental illness, but the study finds that thoughts of suicide among people with mental health problems actually decreased. Similar patterns were reported after the Kobe earthquake in Japan and during the civil war in Lebanon, when rates of depression were high, but suicide was uncommon. Dr Kessler says the low prevalence of suicidal thoughts observed in the current study can be explained by personal growth observed among respondents, including those with mental health problems.

Not everyone is convinced by the findings.

In July, Dr Jeffrey Rouse, the deputy psychiatric coroner in Orleans Parish, La., told the Times-Picayune newspaper that suicide rates had tripled in the months after Katrina. And Jim Barbe, a New Orleans psychiatrist, says that in recent months, many of his own patients seem to have lost hope.

"As the months have worn on, there has been a lot more depression and a lot more suicidal ideation in the patients that I am seeing," Barbe says.

The new results are the first from an ongoing study intended to assess mental health in a representative population sample, balanced for demographics and including people who returned home and those who remain dispersed around the country.

Some scientists urge caution when comparing pre- and post-hurricane surveys. Evelyn Bromet, professor of psychiatry at SUNY Stony Brook, says the study's real value may be in the picture of mental health that emerges over time.

Many experts say mental health services in the region have not recovered since Hurricane Katrina. Advocacy groups say many people who need help aren't getting it. Dr Anthony Speier, director of Disaster Mental Health Operations in the Louisiana Office of Mental Health, says his 600 field counselors have made 800,000 contacts with people in the year since the storm. Does he have enough staff to meet demand?

"No," he says.

Allan Coukell is the Health and Science reporter for WBUR in Boston.



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