Presidential Column

Every Cloud has a Silver Lining: Disasters and Prevention

By Annette M. La Greca, Ph.D., ABPP

Every cloud has a silver lining. That adage certainly applies to disasters. Growing up in the Northeast, I don’t recall being exposed to any major disasters as a child. Sure, there were school closings due to winter storms and occasional hurricanes that traveled up the coast. It wasn’t until I was an adult living in Miami that I first experienced a disaster – and it was a doozy – Hurricane Andrew.

Before Andrew, my hurricane preparation included stocking up on nonperishable food – such as cans of baked beans and Spam – which I was certain I would never eat. I also “protected” the windows of my home by covering them with duct tape, which was impossible to remove days later when the heat and humidity melted the adhesive onto the window. Oy!

Andrew was a game-changer. It was terrifying to think that a Category 5 hurricane, packing winds exceeding 165 mph, was about to strike Miami. Fortunately, my preparation for that storm far exceeded prior attempts. Amazingly, I slept through most of the storm, awaking at times to hear a very loud whistle – like the sound of a railroad train running through the safe place I was staying. 

By morning, the storm had passed, and my world changed overnight. It was as if a bomb had dropped! Outside, all the leaves had been stripped from the usual lush Florida landscape. No traffic lights or road signs were anywhere in sight. There was debris everywhere. And, of course, no electricity (for weeks). Needless to say, life did not return to “normal” for a long while, at least for anyone residing in Miami-Dade County. Although it took two years to have the damage to my home repaired, I considered myself lucky. 

So, what is the silver lining here? Despite the distress, there were many. For one, I learned to appreciate that one’s life can “turn on a dime,” and not to take things for granted. And, consequently, to treasure and be grateful for the positive things we have on a regular basis.

As a psychologist, I also learned the importance of prevention.

Mental Health Needs Increase During and After Disasters

At that time, we did not fully appreciate the mental health fallout of disasters. We now know that hurricanes such as Andrew, but also other natural disasters (e.g., fires, tornadoes, floods), acts of violence, and major accidents, often result in increased symptoms of anxiety, depression, and traumatic stress, as well as increased alcohol consumption and suicide ideation (among other effects) for many youth and adults directly affected. We also know that up to 20-30% of affected youth and adults do not fully recovered even one to two years after the disaster event.

How can mental health providers deal with such burgeoning mental health needs, especially when disasters strike a large population? Under “normal” circumstances, there is already a dearth of mental health professionals. There simply are not enough providers to address the increased mental health needs of those affected by disasters. And individuals most at risk for adverse outcomes often have limited access to evidence-based mental health care. As practitioners and scientists, we need to think about what we can do to minimize the collateral damage of disasters on youth and adult mental health.

Prevention Context for the COVID-19 Pandemic and Other Disasters

This brings me to the summer of 2021, as we are all in a disaster mode! The COVID-19 pandemic is still a huge concern (especially with the rise of the Delta variant), and the annual Atlantic Hurricane and North American Wildfire Seasons are in full swing (and expected to be active!). With respect to COVID-19, for example, all evidence points to increased mental health needs for youth and adults. In fact, mental health providers report that they are overwhelmed and cannot keep up with demand for services. 

As psychologists, we need to do what we can to “flatten the cure” in terms of the mental health fallout of disasters. This may mean adopting a prevention perspective to support youth and adults at risk, so that fewer reach the level of needing intensive clinical care. We all should be thinking of ways we can work in a prevention mode, while trying to meet the needs of those already experiencing problems.

Psychologists already know about evidence-based strategies for managing stress and for preventing symptoms of anxiety and depression in youth and adults. Psychoeducation can also be an effective tool for reducing psychological distress. Wide-scale use of preventive interventions in schools and community settings, or via telehealth, could go a long way to promote resilience and reduce the psychological fallout of disasters. Special attention to vulnerable populations, such as children, parents, and caregivers, as well as the elderly and those from disadvantaged backgrounds, will also be important.

Prevention requires a new mindset and some challenges. As psychologists, we must address prevention in multiple contexts – practice, research, education, and advocacy – if we wish to make significant inroads in improving youth and adult mental health and well-being. Embracing a prevention perspective could be one of your silver linings from disasters. 

Annette M. La Greca, PhD, ABPP