Feature

All the power line poles on the road to a seniors' trailer-home community are snapped. Ripped-off roofs lie askew in the streets as residents clear the debris. As American Red Cross volunteer psychologist David Romano, PhD, drives around the area, he tallies the damage, realizing it will take months--maybe longer--to repair. But, he decides, at least he can help give residents a much-needed mental health boost in the meantime by organizing volunteers to hand out food.

This thought process, connecting basic needs to mental health, is fundamental for Romano, the Red Cross mental health chair for central Florida. The state was hit hard by hurricanes Charley, Frances, Ivan and Jeanne this summer and early fall.

"There's nothing I can do about broken power poles, but I get an understanding of what people's needs are," explains Romano, who coordinated relief efforts in the area. "How's that relate to mental health? If I'm helping to meet those basic needs like food and water, I help reduce stress for people who now don't have to worry about what issue will come next."

Indeed, the mental turmoil that back-to-back hurricanes inflicted upon pummeled Floridians--from depression to fear to lingering anxiety--can be just as devastating as a destroyed home, Romano says. That's where psychologists volunteering through APA's Disaster Response Network (DRN) aim to intervene. The DRN--a national network of more than 2,000 volunteer psychologists with disaster-response training--works with the Red Cross to help relief workers, victims and their families cope during disastrous situations.

Launched in 1992, the DRN represents APA and the Red Cross's commitment to adding mental health professionals to the staff of trained volunteer responders. In a disaster, local Red Cross chapters contact DRN members through APA's Practice Directorate or through state psychological association DRN coordinators like Romano, the DRN coordinator for the Florida Psychological Association.

Serving as Red Cross volunteers, DRN members perform a range of aid activities on-site, including offering victims referrals to community mental health resources, listening to people talk about their concerns and even providing for basic physical needs. They also provide support to other relief workers, says Marguerite Schroeder, APA's DRN director.

"DRN volunteers also can help fellow relief workers to manage their own emotions and capabilities while providing aid to enormous numbers of distressed people," Schroeder says.

A call to arms

In August and September, DRN volunteers sprung into action as Charley, Frances, Ivan and Jeanne approached, notes Schroeder.

"Through our active listserv, we were able to rapidly inform state coordinators across the United States about the Red Cross volunteer needs and ways their DRN members could get connected," she says.

Volunteering meant committing to at least 10 workdays under hardship conditions such as minimal electricity, air-conditioning, clean water and housing. Many DRN members from across the country responded, supporting more than 100 Florida Red Cross mental health volunteers.

Romano worked in cooperation with the Red Cross with about 200 DRN volunteers as they aided Floridians before, during and after Category 4 Charley and Category 2 Frances. As the hurricanes drew near, Romano coordinated DRN volunteer efforts from the Disaster Operations Center, a temporary headquarters the Red Cross set up in Orlando. Monitoring the hurricane's expected track, Romano had to gauge expected evacuations and determine how to allocate his volunteers to ensure everyone in shelters could access a psychologist.

When the storm hit, he juggled those duties with assigning DRN volunteers to accompany relief teams to "hot spots"--places from which people with specific needs were unable to evacuate. One team visited an elderly couple who couldn't leave their home yet needed food and flashlights. The team brought the items by while the DRN member helped the couple cope with their concerns about being trapped in their home during the storm. Just providing the flashlights helped ease their worries, Romano says. After the storms passed, Romano oversaw the setup of makeshift kitchens that served 8,000 meals a day to those who couldn't immediately return home. DRN volunteers served food and talked with people as they ate, just to make sure everyone was handling the situation.

"A disaster mental health team provides [Abraham] Maslow's first two levels of hierarchy--food and shelter, then safety and security," Romano explains. "We help people take care of themselves and know where resources are to help them be safe and secure. Then, we might do nothing more than allow them to say what's going on."

Making lasting impressions

Yet recovery is a long-term process. Romano says that small signs of destruction--like fallen tree limbs--can remain for months, providing constant reminders of the disaster. He added that many people in Orlando became so resigned to the destruction that they didn't bother to take down plywood protecting their windows because they anticipated yet another hurricane. DRN volunteers worked with residents to help mitigate that resignation.

Psychologists in Florida also focused on educating the public through media interviews and public service announcements about typical psychological responses to disaster, so people knew what reactions to expect, says Gerard Jacobs, PhD, a manager of disaster mental health in the Red Cross's Disaster Service Human Resources section and director of the Disaster Mental Health Institute at the University of South Dakota.

"A lot of the work we do is education and problem-solving, helping people understand their reactions to the disaster and develop a plan to work through the recovery process," says Jacobs, a 15-year veteran of disaster relief who was involved in the development of the original 1991 partnership between APA and the Red Cross. "Just explaining to people that flashbacks are normal reactions is one of the most powerful interventions I've done in disaster work."

In fact, one lasting benefit emerging from the disaster is a greater appreciation for psychology's importance among both victims and relief workers, says Jacobs, noting that, before the hurricanes, his Red Cross team trained disaster-relief staff in offering basic emotional support to victims and apprising them of community mental health resources.

"We taught people they can to turn to mental health professionals for expertise," he says. "And what strikes me over and over again is the gratitude of people for the support we were able to provide."

Further Reading

To learn more about volunteering with the DRN, visit www.apa.org/practice/drnindex.html.