According to the American Psychological Association, “schools are the main source of support where families and communities seek help,” says Maria Rolon, PhD, school psychologist and director of student services at Puerto Rico’s Department of Education. Puerto Rico’s Department of Education has begun training teachers in psychological first aid, offering social-emotional training and TF-CBT to students, and offering resiliency training to teachers and school principals. The department has also helped 857 public schools establish centers where parents can access resources like clothing and advice on topics like caring for children with autism during and in the aftermath of disasters like Hurricane Maria and Irma. However, mental health professionals have begun reporting that they themselves are suffering from high levels of anxiety, fatigue, and burnout after caring for survivors of Hurricane Maria and Hurricane Irma after more than two years. |
According to the American Psychological Association, by February 2018, El Nuevo Día reported that suicide rates increased by 29% after Hurricane Maria and Hurricane Irma due to an inability to obtain necessary and an interrruption in access to medical health professionals. In response, the Puerto Rico Psychology Association (“APPR”) created a disaster response schedule. The first 30 days after the storms, association members visited displaced persons and provided emotional support; 60 days later food, clothing and supply distributions began; and 90 days later the association members began documenting their discoveries to refine future emergency mental health protocols. However, local psychologists and volunteers that have been working since the aftermath of Hurricane Maria in 2017 are now suffering from burnout, combating both the heavy workload and their own traumas. In an attempt to help, the American Psychological Association (APA) designated $20,000 to APPR for post-disaster mental health recovery services. |
According to the Miami Herald, just months before Hurricane Maria, 7.3 percent of the population was already suffering from a “serious mental illness,” nearly double the 4 percent national average. Just months before Hurricane Maria, 43.5 percent of Puerto Rico’s residents were already under the federal poverty line. When Hurricane Maria finally hit, suicide rates spiked by 28 percent since 2016 for a total of 254 cases in 2017 alone. |
According to a study conducted by The Washington Post one year after Hurricane Maria, “more than one-fifth of the island’s residents reported needing or receiving mental health services and 13% said they started new or higher-dose prescription medications to treat emotional problems.” |
According to a study published by the Journal of the American Medical Association examining 96,108 school students in Puerto Rico, 7% of school students in Puerto Rico were found to meet the clinical standards for PTSD—about twice the national average. The study also found that more than 57% of children had a friend or family member leave Puerto Rico, 45% reported damage to their homes and 32% experienced shortages of water or food. One-third of the surveyed children, moreover, felt that their lives were at risk during or after the storm. According to Rosaura Orengo-Aguayo, PhD, lead author of the study and assistant professor at the Medical University of South Carolina’s (MUSC) Department of Psychiatry and Behavioral Sciences, this statistics demonstrate that nearly every child in Puerto Rico was affected by the disaster in ways that are also predictors of post-traumatic stress, depression, and anxiety in the future. The new evidence also helped the department secure competitive grants from the U.S. Department of Education and the Substance Abuse and Mental Health Services Administration, which will be used to hire 360 nurses and 107 psychologists and to provide training in trauma-focused cognitive-behavioral therapy (TF-CBT). |
According to The Guardian, from November 2017 to January 2018, Puerto Rico’s suicide hotline Linea PAS reported a 246% increase in calls from people who had attempted suicide, and a 83% increase in calls from people who were considering suicide. In a preliminary study of thirty-four families in Yabucoa, the site of Hurricane Maria’s landfall, 74% participants shared that they would like psychological help. The Federal Emergency Management Agency (FEMA) awarded $6.7 million to Puerto Rico for its emergency mental health services assistance and training program, as well as $12.6 million for a similar mental health program including services for long-term counseling for children and the elderly. The U.S. Substance Abuse and Mental Health Services Administration also offered technical assistance, provided materials—among which are 300 disaster kits and 5,000 suicide prevention wallet cards—and loosened restrictions of existing block grants. |
According to The New York Times, the Puerto Rico Health department’s emergency hotline for psychiatric crises reported that their workload has doubled the normal numbers despite the fact that most residents still do not have normal. Officials in Puerto Rico also reported that people have been hospitalized after they were deemed dangerous to themselves or others. Suzanne Roig, the administrator of Puerto Rico’s mental health division of the health department has reported that people who suffer from psychotic episodes because of mental illness have been locked inside rooms by family members who do not know what else to do. Roig has also reported that distressed callers have been reporting that their children have not spoken since the storm or that their children cry inconsolably anytime it rains. Dr. Domingo Marqués, the director of clinical psychology at Albizu University, said that the new definition of O.K. has become, “It’s ‘I survived. My family didn’t die.” |
According to USA Today, crisis managers at a suicide prevention hotline in Bayamon, near San Juan, receive 500 to 600 calls a day from people around the island in varying stages of desperation. The number of suicide-related calls to the hotline more than doubled from 2,046 in August to 4,548 in January, according to department statistics. Suicide attempts also have climbed 782 in August to 1,075 in January. The mental health center at Ponce Health Sciences University in the southern part of the island receives about 4,000 to 4,500 patients a month. Besides manning the suicide hotline, public health officials have dispatched more than 400 counselors and mental health professionals across the island to meet the growing need. |