As manager of disaster mental health for the American Red Cross, Valerie Cole, PhD, has seen her share of hurricanes, tornados and other disasters. But the contaminated-water debacle in Flint, Michigan, is a tragedy of a different sort, says the Washington, D.C.-based psychologist.
"With most disasters — even big ones that take a while to come back from — once they're over, they're over, and people can start recovering," Cole says. In Flint, though, "people are experiencing a lot of frustration and sadness and a feeling that you can't depend on anyone else."
Citizens are experiencing extreme parental worry over children's long-term health and behavior; ongoing feelings of angst, anger and mistrust of government; and escalating rates of distress, both among people with long-standing mental health issues and those who were healthy before the crisis, says Lauren Tompkins, PhD, chief clinical officer at Genesee Health System, the lead agency in Flint working to address mental health needs there.
"People are mostly expressing worry about what is going to happen — the fact there is no end in sight — and also about the many ways [the crisis] impacts their day," she says. Because people don't trust the filtered water and because it isn't recommended for children and pregnant women anyway, many continue to live on bottled water, a daily challenge that involves lifting and carrying heavy water containers, sometimes without adequate transportation. Since bathrooms and laundry rooms lack filtered water entirely, bathing is also a source of anxiety, with regular reports of skin rashes, welts and thinning hair among locals. People are also reporting the premature deaths of pets exposed to contaminated water at the start of the crisis.
"One family had four of their relatively young dogs die within less than a year," Tompkins says.
Another ongoing psychological issue is burnout among temporary aid workers, says Susan Silk, PhD, APA's Disaster Resource Network (DRN) coordinator for Michigan. Because the work is long-term, and because volunteers don't have the satisfaction of seeing people's lives truly getting back on track, "it's a situation where supporting our workers is more important than ever," she says.
Seeking to address these mental health concerns is a combined effort of local, state and federal forces. There is widespread training on psychological first aid, an evidence-based set of tools that includes active listening, practical assistance such as delivering water to those who can't travel, connection with supports and other ways of helping people cope in a crisis. To deploy these techniques, the U.S. Public Health Service tapped Red Cross workers to train community members including professionals like social workers, students and regular citizens in the techniques. Dozens of classes are underway so people can take part.
In addition, Genesee Health System, with support from the Public Health Service, Red Cross, United Way and others, is overseeing a large number of community-based work groups that are addressing Flint's mental health needs through public communication, crisis outreach, workforce stress management, mental health needs assessment and more.
Flint residents also have access to well-publicized crisis services that include a crisis call line, intensive outreach by Genesee Health System workers and community-based counseling opportunities. Public assistance also is helping to ease matters: All crisis-affected residents under age 21, as well as pregnant and postpartum women, have access to free case-management services, including mental health services, through Medicaid.
While the long-term impact of the population's lead exposure remains unclear, there are hopeful signs.
One is an influx of resources that weren't available before the crisis, says Helen Ostien, a social worker and Red Cross disaster mental health volunteer who participated with the Public Health Service in developing the training for Flint aid workers on psychological first aid concepts like communication skills and relating to people in distress.
"The community is learning some ways of relating and helping each other that they might not have had in the past," she says. "I'm so impressed by the spirit of the people in the area who have come forward to help, and who want to be part of the solution. And they haven't stopped — they're still coming."
