After Hurricane, Signs of a Mental Health Crisis Haunt Puerto Rico


Puerto Rico was already combating a rise in psychological sickness amid a 10-year recession that introduced hovering unemployment, poverty and household separation attributable to emigration. Public well being officers and caregivers say that Maria has exacerbated the issue.


A photograph of Ms. Serrano Ortiz together with her two oldest kids. Her residence flooded as much as the ceiling throughout the hurricane.

Erika P. Rodriguez for The New York Times

Many Puerto Ricans are reporting intense emotions of tension and despair for the primary time of their lives. Some are paranoid catastrophe will strike once more. And individuals who had psychological sicknesses earlier than the storm, and who’ve been reduce off from remedy and medicine, have seen their circumstances deteriorate.

“When it starts raining, they have episodes of anxiety because they think their house is going to flood again,” stated Dr. Carlos del Toro Ortiz, the medical psychologist who handled Ms. Serrano Ortiz. “They have heart palpitations, sweating, catastrophic thoughts. They think ‘I’m going to drown,’ ‘I’m going to die,’ ‘I’m going to lose everything.’ ”

With hurricane practically two months previously, the island continues to be in shock. Its residents are haunted by dozens of deaths attributable to the storm, and plenty of extra life-threatening close to misses. The reminders are inescapable. They lie in piles of rotting particles as tall as properties that also line many streets and in cellphones which might be ineffective for checking on relations.

Returning to a routine is crucial step towards overcoming trauma, in keeping with physicians and public well being officers. But for many Puerto Ricans, logistical obstacles like scarce water and electrical energy, in addition to closed faculties and companies, make that not possible.

Since Sept. 20, when the storm got here ashore at 6:15 a.m., greater than 2,00zero calls have overwhelmed an emergency hotline for psychiatric crises maintained by the Puerto Rican well being division — double the traditional quantity for that time period, despite the fact that most residents nonetheless wouldn’t have working telephones. Puerto Rican officers stated that suicides had elevated — 32 have been reported because the storm — and plenty of extra folks than regular have been hospitalized after being deemed harmful to themselves or others.

At the emergency well being clinic in Toa Baja, the place Ms. Serrano Ortiz lives, Dr. Toro stated that he had been frantically calling for badist from colleagues in different cities as a result of the power was overrun with folks in want of psychological well being care.

Continue studying the primary story

Because it’s in a flood zone, Toa Baja was one of many worst affected areas in Puerto Rico. At least 4 folks died there and water ranges peaked at greater than 12 ft. The metropolis of 80,00zero west of San Juan flooded a number of occasions, every time that it rained after Maria handed.


Dr. Carlos del Toro Ortiz met with a affected person on the emergency clinic in Toa Baja. Mental well being specialists worry that Puerto Rico is approaching a disaster.

Erika P. Rodriguez for The New York Times

In his practically 20 years of training drugs, Dr. Toro stated he had by no means earlier than hospitalized as many individuals with suicidal or homicidal ideas in such a short while interval. Of about 2,500 individuals who had been to the clinic because it opened two weeks earlier, greater than 90 % had been referred for psychological well being screenings, Dr. Toro stated. He and different practitioners on the clinic had already referred at the very least 20 folks to psychiatric wards elsewhere on the island.

“This is an emergency situation,” he stated. “It’s still affecting us. There are people that we haven’t seen.”

Health staff are bracing for results just like these seen in New Orleans after Hurricane Katrina and in Haiti after the 2010 earthquake, the place instances of each reasonable and extreme psychiatric sicknesses spiked. In New Orleans, many individuals skilled insomnia, cognitive impairment and short-term reminiscence loss, which grew to become recognized colloquially and amongst researchers as “Katrina Brain.”

Prolonged losses of electrical energy, water communications or infrastructure have been linked to the onset of psychological well being crises, stated Dr. Domingo Marqués, the director of medical psychology at Albizu University, a distinguished graduate faculty of psychology on the island with clinics in two main cities. All of these components have been relentlessly current in Puerto Rico.

“And this is all happening at once,” he stated. “What we have lost is the foundation that holds a society together.”

He stated that Puerto Ricans must regulate their definition of normalcy in an effort to operate: “It’s ‘I survived. My family didn’t die.’ That’s the new definition of O.K.”

This hurricane season has prompted psychological misery, and strained badets for treating it, all through the Caribbean, in keeping with reviews from the United States Virgin Islands, Dominica and Antigua.


Laura Rodriguez relied on a strict each day routine to handle her borderline character dysfunction, a routine upended by Hurricane Maria.

Erika P. Rodriguez for The New York Times

The psychological well being division of the Puerto Rican well being division acquired $three million from the Federal Emergency Management Agency to coordinate a response to Maria, stated Suzanne Roig, the administrator of the Puerto Rican company.

Continue studying the primary story

Its medical doctors have been knocking on doorways within the worst-hit components of the island and visiting emergency shelters the place individuals who misplaced their properties have been residing.

“We are trying to reach people to tell them that this crisis will pbad,” she stated, “and that they should not make permanent decisions.”

The company additionally began an initiative to watch social media, and staged interventions in a handful of properties of people that posted what gave the impression to be suicide notes.

During high-volume hours, its employees members have been taking up further shifts and dealing extra time to answer the rise in cellphone calls to the 24-hour emergency disaster hotline.

In addition to combating their very own feelings, Ms. Roig stated that distressed callers had reported kids who had not spoken because the storm or cried inconsolably when it rained. And folks with critical psychological sicknesses who had skilled psychotic episodes had been locked inside rooms by relations who didn’t know what else to do.

“People who have a prescription can’t get to a pharmacy,” Ms. Roig stated. “If they can get to the pharmacy it might not be open. If it’s open, they might not have the medicine.”

Before the storm, Laura Rodriguez, 39, managed her borderline character dysfunction with out remedy by counting on a strict routine: Early morning CrossFit exercises, lengthy hours at work as an inside designer, going to mattress early and by no means having friends at her residence in Río Piedras.

Continue studying the primary story

But since Maria hit, her health club had been closed and her therapist had not been working. Neither had she.

“I’m constantly anxious,” she stated. “I get these urges to be violent and I can’t control it.”

Memories of the storm had been additionally tormenting her. She had been trapped inside her condominium for 2 days together with her boyfriend, her mom and her mom’s cat. They used plastic tarps, towels, bedsheets and items of wooden to attempt to plug the home windows the place rain water was surging via.

Without entry to any of the balms that she sometimes relied on to stabilize her temper, she was apprehensive about resorting to self-harm, an impulse that she had struggled to manage since she was eight years previous. “What if it’s like three months, four months?” she stated. “I cannot do this for so long.”

For Ms. Serrano Ortiz, one other risk to her psychological and bodily well being loomed.

Before the storm, a scan of her throat had indicated that she might have most cancers for the second time. But she has not been capable of get any extra details about her prognosis as a result of her physician’s workplaces have been closed.

At the emergency clinic, she informed Dr. Toro that she won’t have the power to battle the illness once more. When she seemed within the mirror, she stated, she noticed in herself a mirrored image of her residence — one thing soiled, smelly and tainted.

“I don’t feel like myself anymore,” she stated.

Continue studying the primary story

Source hyperlink

Leave a Reply

Your email address will not be published.