By Dinah Miller, MD
[Winter 2006; Vol. 32, No. 2; Pg 1-2]
Cheryl Person wants to know what happens to
people when disaster strikes, and how psychiatric interventions alter the
outcomes. As Chair of the MPS
Disaster Psychiatry Committee and a fellow at Johns Hopkins Bloomberg School of
Public Health in psychiatric epidemiology, Dr. Person (pronounced Peer·son) was
among the first Maryland psychiatrists--maybe the very first--to be deployed to
Baton Rouge after Hurricane Katrina struck.
Full of energy, and eager to both help and
learn, Dr. Person registered with three organizations: the Board of Physicians,
the Department of Health and Mental Hygiene Disaster Mental Health Volunteer
Corps, and the American Red Cross. On
September 4th,
she heard from the Board of Physicians and they wanted to send her immediately.
“I told them, ‘You do realize I’m a
psychiatrist.’ Initially, they
were interested, then they decided to hold off on sending me,” Dr. Person
said. On September 6th,
she was notified by the Red Cross to report to Baton Rouge, and she caught the
next flight to Lafayette, Louisiana two days later.
In the Lafayette airport, she rented the last available car and drove
with several other Red Cross workers to Baton Rouge.
“We were all first-time volunteers,” Dr.
Person said, “I found them when I approached a woman in the airport who was
wearing a t-shirt with a teddy bear and a red cross on it and asked if she knew
if anyone from the Red Cross was there.”
The group found the Red Cross Headquarters in
Baton Rouge in a huge abandoned Wal-Mart. Dr.
Person began the process of registering, then found her way to the Mental Health
area.
‘“I’m a psychiatrist, what can I do?’
I asked. There was a psychologist
standing there and he wanted me to come to the shelters, but the woman doing the
assignments said I couldn’t prescribe. The
psychologist was really
upset. He made some calls and I was eventually referred to the Medical and
Mental Health Needs Survey where I was hooked up with three U.S. Public Health
Officers—a nurse, an epidemiologist, and an engineer.”
Along with the Public Health officers, Dr.
Person spent the next three days visiting nine mostly-makeshift shelters in
rural areas surrounding Baton Rouge. These
shelters were not pre-designated Red Cross sites, and had sprung up in the
churches and towns. They housed
anywhere from five to 100 evacuees.
“We met with the shelter managers and asked
just two mental health questions,” Dr. Person said. “Is any one here
experiencing symptoms of post-traumatic stress disorder, and does anyone here
have pre-existing psychological problems?”
She didn’t meet directly with the evacuees,
but when they approached her they asked where the Red Cross was. The high level
of frustration was obvious.
In Ferriday, the shelter was next to the
sheriff’s office. They didn’t
have the safety issues they were having in Baton Rouge, but the sheriff was
feeding the people. Even there, the
Red Cross didn’t provide food.
“What was striking,” Dr. Person continued,
“was the burnout among the workers. One
woman, a shelter manager, just broke down and cried.
In other places, the staff looked less overwhelmed and more resilient.
And the shelter workers might not know about mental health needs; the
evacuees were screened for their medical, but not their mental health,
histories.”
During this leg of the trip, Dr. Person spent
her first night sleeping in a Red Cross shelter in conditions she described as
“atrocious”. She slept on a
floor with three other snoring people and there was one shower for over 100
people. In the outlying parishes she
shared a hotel room with the Public Health nurse.
Later in the trip, Dr. Person stayed in the home of someone she met, and
spent one more night sleeping in a shelter.
Dr. Person’s next stop was Camp Mosquito in
Port Allen, LA—the U.S. Public Health Service headquarters which she described
as a big portable army base, “Think big tents, portable showers, potties, and
a mess hall.” She was planning to
return to the Red Cross in Baton Rouge for a new assignment but, learning that
she was a psychiatrist, the U.S. Public Health Service asked her to work at the
First Responders Clinic and she was sent to the Belmont Hotel where she and
seven other mental health workers provided psychological first aid for the New
Orleans Police, Fire, and EMS departments.
“These were people who’d been working
non-stop for two weeks, sleeping anywhere they could find (including on the
floor of an office building). They
had two days off and their families were scattered, and then they were headed
back to New Orleans to work another two weeks.
Sleep was a big issue, I ended up getting samples of Ambien to give
them.”
There were many stories of distress.
One that stands out—a veteran policeman was guarding a warehouse and a
rookie officer pulled a gun on him and threatened his life.
His partner then drew his revolver and kept the situation from
escalating, but when the veteran officer reported this to his superiors, he was
told to keep quiet about it.
“There was a huge breakdown in the command
structure and it left many policemen wondering how they could continue to
work.”
There has never been a disaster in the United
States that has destroyed so much of the infrastructure of so vast an area.
In the aftermath of Hurricane Katrina, Dr. Person describes scenes of
pandemonium, frustration, and desperation.
“I
hope to go back,” she said, “but this time to do research.”