The Disaster Mental Health Responses to the BP Oil Crisis

Wendell Cathcart

Disaster Mental Health• DMH intervention is a

relatively recent addition to disaster health treatment

• People at risk from a disaster: Pre-existing condition, People who are affected, Children, Underserved populations

• Interventions are largely dependent on ability to access at-risk and underserved communities

• Different interventions are needed for different disasters

Exxon Valdez and Hurricane Katrina

Looking at Technological disasters (such as an oil spill) and at Natural Disasters (such as a hurricane)

The Exxon Valdez SpillMarch 24, 1989 – Prince William Sound,

AlaskaSurface-spill: between 260-750,000

barrels◦BP Spill, estimate at 4.9 million barrels

between April 20 and July 15, 2010Oil spill “Technological” DisasterMore stressful than Natural DisastersThose most at risk: People who feel their

livelihood and lifestyles are at riskExxon cleanup dollars – “money pollution”

The Gulf Coastal States

Hurricane KatrinaMental Health

infrastructure and behavioral health problems left over from Katrina

Gulf economy already recovering from Katrina

April 20, 2010 – July 15, 2010

Estimated Oil Coverage by August 7, 2010

ProjectComparing the Mental Health responses in

the five Gulf Coast statesBased on interview data from the five

Disaster Mental Health Coordinators (DHMCs)

Examined four variables as they related to the disaster mental health responses of each state ◦the physical proximity to spill ◦ the economic threat from the disaster◦the state’s funding of disaster mental health ◦ the state’s mental health support system

Example QuestionsFigure 1. Interview Questions

1. How is your state fairing through this disaster? What were your departments or state’s priorities when you realized the severity of this disaster?

2. Who was considered most at risk for mental health problems/stress from this spill?

3. What are some of the specific difficulties in terms of mental health for your state?

4. Did your department start any new mental health programs following the spill?

5. How were new programs funded or resourced?

6. What would you do differently in another, similar disaster?

7. What role is the nonprofit sector playing in your state’s mental health response effort?

At-Risk Populations by StateTexas – Refinery workers, support

industry: Community stigmaLouisiana – Fishermen, Oil workers,

support industry, Disaster respondersMississippi – Fishermen, Vietnamese

shrimpers, Support industry, tourismAlabama – Fishermen, Tourism,

Family-owned businessesFlorida – Shrimpers, Oystermen,

General economy (coastal state)

Mental Health Indicators on CoastIncreased demand for

Community Mental Health resources

Increased use of state support resources

Suicides and domestic violenceAlcohol and drug abuse“Acting out” and misbehavior in

schools

DMH Responses by StateTexas

◦ Continued as normal◦ Did not request resources from BP

Louisiana◦ Governor supplied $1million to fund “Louisiana Spirit”

program Hired 50 early responders in “diad” pairs to target at-risk

populations for 60-day recovery fund◦ Requested $138 million for 5 year program from BP,

received $15 million installation payment Contributed $6 million to Catholic Charities

◦ BP/Transocean took care of many employees “in house”◦ Huge volunteer effort by Catholic Charities and other

nonprofits

DMH Responses by State cont. Mississippi

◦ Community Mental Health resources operated without any additional funds until the state legislature accept BPs funds in late October

◦ Requested $125 million for 5 year program from BP, received $12 million installation Money delayed until late November

◦ Money used to bolster existing health, mental health, and economic aid programs

◦ Grant program began late November Alabama

◦ Chartered boat captain suicide in June Alabama advanced its own funds to hire 20 responders following the

suicide and 70 in all by November◦ Received $12 million installation payment from BP

Spent money on psychological counseling programs as well as programs for economic aid

DMH Responses by State cont.Florida

◦Requested $6 million from BP for a 90-day program, eventually received $3 million Bolstered existing mental health and outreach

programs Gave grant to Blakeview Baptist Behav. Health

(hurricane experience)◦Natural disaster responders were heavily used◦Bi-monthly surveys for a year to assess MH

and response◦Nonprofits, faith-based, and volunteer

organizations have a large presence

General Information  Texas Louisiana Mississippi Alabama FloridaAt-Risk Refinery

Workers, Support workers

Fishermen,Oil workers,Disaster Responders

Fishermen, Vietnamese Shrimpers,Support Industry,Tourism

Fishermen,Tourism,Family businesses

Shrimpers/Oystermen,General economy

MH Care System

CMH (?) CMH (?) CMH (top-down) CMH (top-down) CMH (run regionally)

BP Funding Requested

NA $138mil/5 years

$125mil/5 years

? $6 mil

BP Funded NA $15mil $12 mil $12 mil $3 milBP Funds Available

NA September October (avail. late November)

August September

Disaster (State) Funding

NA $1mil (Louisiana Spirit)

No ($?) Early Staff Hirings

No

Add’l State Employees (B4 BP Funds)

Normal Lvl Normal lvl+ 10-50

Normal Lvl Normal lvl+ 70+

Normal Lvl

Federal Surveillance

NA CASPERSAMHSA

CASPERSAMHSA

CASPERSAMHSA

SAMHSA

# Counties Touching Gulf

17 11 3 2 23 (+/–)

Gulf County Pops.

Millions 1,528,567 355,145 591,599 Millions

Policy SuggestionsInvest early in behavioral health

response efforts to target at-risk individuals (Louisiana and Alabama)

States should share information and work with SAMHSA

  Texas Louisiana

Mississippi

Alabama Florida

Proximity Far Closest 2nd Closest

Close Medium

Econ. Threat

Low High High High Medium

Add. State Disaster Fund.

NA High No additional

High No additional

MH Support System Use

Normal High Medium High Normal

Risk Low High High High MediumResponse Low High Medium High Medium

Conclusion

My hypothesis was correct, the physical proximity to spill, the economic threat from the disaster, the state’s funding of disaster mental health, and the state’s mental health support system could determine a state’s response.