Factors Influencing Mental Health Deterioration and Recovery after Hurricane Harvey

Overview: Postdisaster research indicates up to 75% of natural disasters experience PTSD. Scant research exists on factors influencing mental health (MH) sequalae. This study discusses psychosocial, demographic, and clinical factors which impact MH and how to translate these factors into disaster recovery settings, to increase the probability of resilience for survivors.Proposal text:

Background/Purpose: Postdisaster research indicates up to 75% of natural disasters experience PTSD. Scant research exists on specific factors influencing mental health mental health sequalae after hurricanes and other natural disasters. Prior research has demonstrated that persons with prior mental health conditions are more likely to have an increase in symptomatology after a hurricane and that people with no mental health issues can experience problems due to their experiences in a natural disaster. It has also indicated those who experience symptoms in the short-term recovery period are significantly more likely to continue to experience mental health issues. Given that 43% of the natural disasters in the USA are floods, and that climate scientists project that future floods will become more frequent and severe, mental health issues as a response to natural disasters are only expected to increase. This study discusses psychosocial, demographic, and clinical factors which impact post-hurricane mental health and how to translate these factors into disaster recovery settings, to increase the probability of resilience for survivors.

Methods: Data from the Roper Institute for Public Opinion Research random cross-sectional surveys (#311647 and #311688) at 3 months and 1 year after Hurricane Harvey were compiled into one dataset. The subsection (n = 2,114) of participants (n = 3,286) impacted by Harvey were asked further questions on mental health. A dichotomous composite variable “Mental Health Recovery” was created from 3 questions: (1) Worsening of self-reported mental health (SMRF) since Harvey, (2) New prescription for mental health issues, and (3) Unmet needs for mental health. Using the enter regression method, mental health recovery was regressed with demographic (age, gender, race/ethnicity), psychosocial (federal income poverty level (FIPL) below 200%) and clinical proxy measures (general assessment of self-reported mental health (SRMH), inability to control temper, increased alcohol usage), and flood experience variables, including exposure to prior flooding. Multiple imputation was utilized for missing data. Bivariate associations were evaluated with independent t-tests and chi-square tests.

Results: Of the 2,114 respondents, 25% percent were classified as poor mental health recovery. Regression models accounted for 28% to 42% of the variance in mental health. The resulting salient factors can be utilized to create a basic risk assessment for survivors of natural disasters, to help responding professionals evaluate the possibility of worsening mental health.
Conclusions/Implications: Even though a substantial portion of respondents reported poor post disaster mental health outcomes, there is not yet a standardized, validated post-hurricane mental health assessment tool to assist disaster responders in appropriately evaluating flood and hurricane survivors in the immediate aftermath of a disaster. This research shows factors associated with a greater risk of mental health sequalae post disaster, which can allow practitioners and disaster responders to better assess survivors and focus their efforts on those who need mental health intervention and supports. Findings from this study may inform current evaluation practice until such rigorous tools have been developed.