The call went out, “Are you ready to roll?” This was the question that my director at the Nassau County Office of Mental Health, Chemical Dependency and Developmental Disabilities Services (the Office) asked me the day before Hurricane Sandy hit Nassau County as we prepared to make our rounds to the Office of Emergency Management and the shelters that would be opened to accommodate evacuees. I replied “Yes,” and, although mildly anxious, I reassured myself that I had fulfilled all of the disaster mental health planning activities, that I was calm in emergencies, and that I love to work hard.
And hard work it was. First, being in the role of both disaster victim and responder was stressful. Like my fellow responders, I was separated from loved ones who sheltered in place in homes that were without power and vulnerable to falling trees. Traffic lights were inoperable, and driving was perilous; and due to the lack of access to gas because of the shortage, I was preoccupied with running out of gas. Communicating with loved ones was inconsistent and unpredictable; land lines were not working, and cell phones could not be charged due to prolonged power outages.
Second, working in and sleeping in shelters was physically taxing. Shelters are after all, usually gymnasiums and there should be no expectation for comfort. The temperature was usually cold, the lights bright and intrusive, and the noise level high. Mental health responders were always on the move and the most available seating was on the floor, sitting next to an evacuee’s cot while speaking with them. And sleep was restless to say the least.
Third, the work itself is challenging. I was trained in Psychological First Aid and after thirty-two years as a social worker I felt confident in my clinical abilities. However, I learned that after a few days in a shelter, “information” trumps empathy and emotional intelligence is the most valuable asset. “Do you know where my mail is being forwarded to?” “Are the buses running south of Sunrise Highway?” “Is my house still standing?” “Where am I going to live?” “How do I get my medication?” “When is the psychiatrist coming?” “How am I going to get to my methadone clinic?” “Do you know if there is power at my house?” “How long will the shelter be open?” Evacuees were very appreciative of mental health responders’ kindness; and I know that our efforts served to give comfort and hope to those we served, however, the lack of access to information caused many evacuees to feel frustrated. As a remedy, we dedicated much of our time to gathering as much credible, real time, information as we could. If they could articulate it as such, I think the consensus statement of evacuees might be, “We appreciate that you are kind and supportive and good listeners, but what we still need is concrete, specific, information.”
Another challenging aspect of working in shelters came in assuring that the evacuees received the needed “commodities” or “amenities.” “I am cold, can I have another blanket?” “My baby is one week old; can you get me a bottle warmer?” “Could I borrow a pair of reading glasses?” “I would like to take a shower – do they have towels?” “My back hurts from sleeping on the cot – do they have pillows here?” “I have been wearing these clothes for ten days. Can you bring in some clothes for me?”
In the event of a disaster, the number one goal of a shelter is to provide safety, food and water, and in the event of supply shortages items may be rationed. But the limitations and restrictions on procuring items such as the aforementioned caused many us responders to feel limited in their ability to respond in the desired manner. As for me, it exacerbated the survivor guilt I felt every evening when I left the shelter. In response to these “commodity challenges,” mental health responders engaged in traditional community organizing and advocacy work.
Sound stressful? It was, but it was not all bad. The Office and its provider agencies have a culture of responsiveness among practitioners and respond they did. Over 100 mental health responders deployed to ten shelters, for as long as fifty days; and at the largest shelters covered overnight shifts. The camaraderie, cohesion and dedication of responders was inspiring and made me feel proud to be a part of our treatment provider system. There was a tremendous sense of home town spirit and desire to do the best for “our people” and the work they did was selfless and impressive.
Providing information and assisting with concrete tasks were critical activities and evacuees were extremely grateful for anything that responders were able to do for them. Responders accompanied evacuees to FEMA and the bus stop; helped evacuees to locate missing relatives, we contacted school principals, employers and landlords; and used our personal cell phones to call long distance to notify relatives of evacuee whereabouts. Responders helped evacuees get food, clothing, METRO Cards; medication and psychiatric assessments; and arranged for their case managers to come to the shelters. We mediated disputes about space within the shelter, about personal belongings and supplies; and arranged for children’s activities and Halloween candy. And sometimes we simply sat and had a cup of coffee with an evacuee and listened.
Observing evacuees was as inspiring as observing fellow responders. And their coping skills and adaptive behavior was enlightening. Moms were like bears protecting their cubs, arranging their family’s cots with a perimeter, “their area” to create a sense of safety and security and perhaps an illusion of privacy. “Good Samaritans” were helpful and altruistic, keeping an eye out for fellow evacuees who were in need, perhaps getting their meals for them, helping them to the rest room, or advocating for their needs with personnel.
Hurricane season started on June 1st in Nassau County and the news media predicted an “active” season with some hurricanes expected to make landfall in the northeast. I must confess that this news caused what I would like to call “forecast anxiety.” During the days following Hurricane Sandy, after power was restored in my neighborhood, if I saw a power company truck nearby my anxiety level increased. “Oh no, don’t tell me my power is out again.” Likewise, for forecasts about hurricanes, my anxiety level increases, and a sense of dread overcomes me – “Oh, no, not another one.” Hopefully there will be no future hurricanes, not even a nor’easter, but our Office and treatment provider system responders deployed for Irene in 2011, Sandy in 2012, will be on the ready again, if needed.