The call for psychologist Priscilla P. Dass-Brailsford, EdD, came from Washington, D.C., on Labor Day last year. It was the Red Cross, deploying her to a disaster mental health team serving the Cajundome in Lafayette, La. Her charge: To help more than 2,000 men, women and children whose lives had been shattered by Hurricane Katrina.
The assignment was overwhelming. And Dass-Brailsford, a professor of counseling psychology at Lesley University in Cambridge, Mass., soon discovered that her fellow disaster responders were ill-prepared for it. The main problem, she said, was a lack of cultural understanding of Katrina's mostly indigent, African-American survivors. They accounted for 95 percent of the Cajundome's evacuees, yet, at least initially, Dass-Brailsford was the sole responder of color on the mental health team.
Flying to the scene, she read a newspaper headline that, to her, seemed to summarize the cultural gap: "Ignore the dead," it read. "We want the living."
The comment struck Dass-Brailsford as deeply insensitive to the strong kinship ties and religious values among African Americans in the Deep South.
"They were not prepared to ignore their dead," she said. "In fact, they could not continue living until their dead had been accounted for and respectfully put to rest."
In Dass-Brailsford's view, many dominant-culture responders to Katrina meant well, but were culturally myopic about the importance of religion and extended family to evacuees. That cultural disconnect made it hard for many responders to help a desperate population, she said.
"The most important lesson that Hurricane Katrina has taught us is that strategies for helping should always centrally locate culturally specific needs for interventions to be effective," said Dass-Brailsford in an APA 2006 Annual Convention session sponsored by APA's Board for the Advancement of Psychology in the Public Interest and six other APA committees and divisions.
Disparity laid bare
A native of South Africa who works with trauma victims in inner-city Boston and South African townships, Dass-Brailsford has seen considerable racial injustice and economic disparity. Yet the prevalence of both in the Cajundome still shocked her, as one evacuee after another implored her for word of economic assistance or lost family members.
One thing was clear: The poverty among evacuees had been building for years, as whites fled New Orleans for better-paying jobs and safer neighborhoods. Before Katrina, the city was home to the country's largest working-poor population. After Katrina, that population was worse off than ever.
"The hurricane did not sweep away the social ills and other problems that many survivors faced before the storm," said Dass-Brailsford, chair of APA's Committee on Ethnic Minority Affairs. "Instead, new losses heightened pre-existing issues. Substance dependence, psychiatric disorders, child molestation, domestic violence and other relational difficulties increased under the stressful conditions of living. These issues would keep survivors and me up until the late hours of the night and into the early hours of the morning."
Dass-Brailsford was writing a chapter on trauma response to natural disasters for her forthcoming book, "A Practical Approach to Trauma: Empowering Interventions" when Katrina hit. Now she's added firsthand lessons on what to do when helping minorities, especially African Americans. Briefly summarized, she suggested that mental health responders:
Be willing to openly discuss the effects of institutionalized racism and the role of power and oppression.
Understand African Americans' worldview, language, communication style and values regarding community and interpersonal relationships.
Acknowledge the role that religion and spirituality may play in healing.
Finally, Dass-Brailsford advised that relief-effort coordinators strive to include responders that reflect the survivors' ethnic, racial and social backgrounds.
For more on psychologists' experiences with and views of Katrina's effects on minorities, see the March Communiqué.
- Hays, P.A., & Iwasama, G.Y. (2006). Culturally Responsive Cognitive-Behavioral Therapy: Assessment, Practice, and Supervision. Washington, DC: American Psychological Association.