Disaster Surge Highlights Need For Better Mental Health Support

After a pair of hurricanes tore through the southeast in early October, battered residents are still struggling to pick up the pieces. It’s a process that can take weeks, months, or even years. And they’re often trying to move past these disasters while wrestling with post-traumatic stress disorder (PTSD).

Now, a pair of recent studies offer a fresh look at what this recovery looks like. Together, these reports reinforce the desperate need for better mental health interventions to better support natural disaster survivors.

Prevalence of PTSD Among Flood Survivors

According to the National Oceanic Atmosphere Administration, 2023 marked a historic year – and not in a good way. 

“There were 28 weather and climate disasters in 2023, surpassing the previous record of 22 in 2020, tallying a price tag of at least $92.9 billion,” the agency reported earlier this year. “The [United States] experienced 28 separate weather and climate disasters costing at least $1 billion. That number puts 2023 into first place for the highest number of billion-dollar disasters in a calendar year.”

Floods remain one of the more prevalent disasters. They wreak havoc physically, and can often leave behind lingering psychological damage. The first paper, a meta-analysis of 23 studies, which reviewed data from more than 500 scientific articles, revealed that the prevalence of PTSD among flood survivors is unsettling, haunting nearly 30 percent of survivors. This is much higher than earlier research suggested, including a 2015 meta-analysis that estimated the prevalence to be much lower, at less than 16 percent.

The yawning gap in PTSD rates among flood survivors – which is as low as 9.2 percent in some areas to more than 50 percent in others – is a product of multiple factors. According to the authors, geographic location, flood severity, and available support networks all play a part in dictating mental health outcomes.

The researchers found that women were particularly vulnerable to PTSD, as were individuals with lower socioeconomic status and those already living with a mental health condition.

Evaluating Disasters and PTSD

While the rate of PTSD among flood survivors remains perilously high, another paper, a scoping review of more than a dozen randomized controlled trials (RCTs), exposed the gaps in effective interventions. The review spanned a wide range of therapeutic approaches, such as pharmaceuticals, nutraceuticals, cognitive-behavioral therapy (CBT), yoga, acupuncture, and multimodal programs. But the results showed notable inconsistencies. In fact, the review uncovered a dearth of reliable clinical evidence to support most of these interventions.

The authors found CBT appeared to be the most dependable treatment approach. Four RCTs centered on CBT, and included both group and online therapy formats. And the trials consistently demonstrated significant improvements in PTSD symptoms. As the standard of care for PTSD, the review found that CBT proved to be equally effective in disaster-related cases.

Other interventions, such as pharmaceuticals (including hydrocortisone and herbal supplements), produced less consistent results. The efficacy of nutraceuticals – such as fish oil – also remained unclear. While these treatments hold potential, the lack of conclusive evidence calls for more data to better evaluate their effectiveness.

The review also looked at increasingly popular alternative treatments – such as yoga and acupuncture – and narrative exposure therapy. Still, the authors found no conclusive clinical evidence to support their growing acceptance.

Survivors of the 2008 Bihar Flood in India embraced yoga as they sought help[ with their recovery. Meanwhile, Chinese survivors of the 2008 Sichuan Earthquake leaned on acupuncture. And while these therapies certainly hold cultural relevance, their effectiveness remains unproven in the absence of reliable research data.

The authors found that cultural sensitivity and resource availability remain critical in disaster-stricken regions. Many of the studies the team examined focused on populations in Asia, where earthquakes and floods are more frequent. In these areas, access to trained mental health professionals and culturally appropriate treatments could be limited. And that makes it that much harder to implement effective interventions.

The authors emphasized the necessity for future research to account for cultural preferences. They also highlighted the unique challenges faced by survivors from various regions.

Future Directions

Both studies underscore the need for comprehensive, evidence-based mental health interventions for natural disaster survivors. While CBT remains a proven PTSD treatment, survivors would benefit from more high-quality RCTs to evaluate the effectiveness of other treatment options. Expanding research to include diverse populations across different geographic regions would also help establish help build a better understanding of which interventions work best in a given cultural context.

As climate change continues to drive the frequency and severity of extreme weather events, policymakers must make it a priority to tackle the mental health needs of a growing population. Immediate screening, long-term psychological support, and culturally sensitive interventions would be an ideal starting point.

Further Reading

Research Reveals Mental Health Effects of Community Disasters, Highlighting PTSD

US Suicide Rates and Impact of Major Disasters 

The Extent and Impact of Mental Health Problems After Disaster