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This paper uses Behavioral Risk Factor Surveillance System data to study life satisfaction and mental health across the geography of the United States. The analysis draws on a sample of 1.3 million citizens. Initially we control for people's personal characteristics (though not income). There is no correlation between states' regression-adjusted well-being and their GDP per capita. States like Louisiana, plus Washington, D.C., have high psychological well-being levels; California and West Virginia have low well-being. When we control for incomes, satisfaction with life is lower in richer states, just as compensating-differentials theory would predict. Nevertheless, some puzzles remain. [ABSTRACT FROM AUTHOR]

Background: Substance abuse treatment following a natural disaster is often met with challenges. If treatment is available, facilities may be unequipped to service an influx of patients or provide specialized care for unique populations. Objectives: This paper seeks to evaluate trends in substance abuse treatment over time and assess changes pre- and post-Hurricane Katrina. Methods: Substance abuse treatment admission data (N = 42,678) from New Orleans, Louisiana, for years 2000 through 2012 were obtained from the Treatment Episode Data Set. Admissions were examined to evaluate demographic, socioeconomic, psychiatric, and criminality trends in substance abuse treatment and assess changes following Hurricane Katrina. Results: Treatment admissions have decreased from 2000 to 2012. About one in five admissions had a psychiatric illness in addition to a substance abuse problem. A staggering 76% of admissions with a psychiatric illness were referred by the criminal justice system post-Katrina as compared to pre-Katrina. Rates of alcohol and marijuana admissions have remained stable from 2000 to 2012. Cocaine/crack admissions have declined and admissions who abused heroin have increased over time. Conclusions: Treatment admissions stabilized following Hurricane Katrina; however, since 2009, they have begun to decline. Targeted exploration of factors affecting admission to treatment in New Orleans with populations such as the homeless, those with a psychiatric illness in addition to a substance abuse problem, and those referred by the criminal justice system is essential. The results of this study assist in identifying variations in substance abuse treatment characteristics for those admitted to treatment in New Orleans. [ABSTRACT FROM AUTHOR]

Background: Families exposed to disasters such as Hurricane Katrina are at risk for numerous adverse outcomes. While previous literature suggests that the degree of disaster exposure corresponds with experiencing negative outcomes, it is unclear if parents and children report similar levels of disaster exposure. Objective: The purpose of this paper was to examine levels of disaster stressor agreement among mother-child dyads affected by Hurricane Katrina, and to examine whether discrepancies in disaster stressor reports are associated with higher levels of posttraumatic stress (PTS) symptoms. Methods: Participants in this study consisted of 353 dyads of mothers (age M = 38.79 years, SD = 7.52; 68 % African American) and children (52 % girls; age M = 11.61 years, SD = 1.57) exposed to Hurricane Katrina. Parents and children were assessed at two timepoints, 3-7 months and 14-17 months postdisaster. Parent and child responses to items regarding hurricane related stressor exposure and PTS symptoms were analyzed. Results: Agreement on hurricane related exposures was predominately slight to moderate, with kappas ranging from κ = 0.19 to κ = 0.83. Polynomial regression analyses revealed that when mothers reported low levels of Immediate Loss/Disruption stressors and children reported high levels of these stressors, children reported higher levels of Time 2 PTS symptoms, b = −0.72 (0.33), p = .03. Conclusions: Overall, levels of mother-child response agreement were low. Discrepancies in mother and child reports predicted higher levels of child PTS symptoms. Clinicians may want to query both parents and children about their disaster experiences when working with families postdisaster. [ABSTRACT FROM AUTHOR]

Literature suggests that survivors of catastrophic loss may suffer long-term emotional damage. This paper presents a secondary data analysis from the ABC News Hurricane Katrina Poll conducted in August, 2006. Following analyses, a significantly higher percentage of women (44%) and those who experienced residential damage (66.7%) reported long-term negative impact on emotional well-being. Overall, 70.3% of Katrina survivors reported a strengthening in fellow man following the disaster. These results may serve as beginning evidence for appropriate identification and implementation of mental health support for those most in need following disaster.

Limited research has evaluated the mental health effects during compounding disasters (e.g., a hurricane occurring during a pandemic), and few studies have examined post‐disaster mental health with alternative data sources like crisis text lines. This study examined changes in crisis help‐seeking for individuals in Louisiana, USA, before and after Hurricane Ida (2021), a storm that co‐occurred during the COVID‐19 pandemic. An interrupted time series analysis and difference‐in‐difference analysis for single and multiple group comparisons were used to examine pre‐and post‐changes in crisis text volume (i.e., any crisis text, substance use, thoughts of suicide, stress/anxiety, and bereavement) among help‐seeking individuals in communities that received US Federal Emergency Management Agency individual and public assistance following a presidential disaster declaration. Results showed a significant increase in crisis texts for any reason, thoughts of suicide, stress/anxiety, and bereavement in the four‐week, three‐month, and four‐month post‐impact period. Findings highlight the need for more mental health support for residents directly impacted by disasters like Hurricane Ida. Plain Language Summary: There is limited research evaluating the mental health effects of disasters happening within a short time of each other or at the same time and few studies have used crisis lines for post‐disaster mental health information. This study examined the change in crisis help‐seeking for individuals in Louisiana, USA, before and after Hurricane Ida (2021), which occurred in the same time period as the COVID‐19 pandemic. Our analyses looked at the change in crisis help‐seeking behavior before and after Hurricane Ida for any crisis text, substance use, thoughts of suicide, stress/anxiety, and bereavement in communities that received assistance following the hurricane. Results showed a significant increase in crisis texts for any reason, thoughts of suicide, stress/anxiety, and bereavement in the 4 weeks post‐impact. In multiple post‐impact periods, there was an increase in crisis texts for any crisis event, substance use, thoughts of suicide, stress/anxiety, and bereavement. These findings highlight the need for more mental health support for residents directly impacted by co‐occurring disasters. Key Points: This study examines changes in crisis help‐seeking among those exposed to Hurricane Ida in Louisiana, USAIda led to a sustained increase in stress/anxiety, thoughts of suicide, and bereavementFindings support the need for crisis text lines in post‐disaster mental health support and surveillance efforts [ABSTRACT FROM AUTHOR]

Globally, the rate of incarceration among women is rising, and in the U.S., women's incarceration has grown at twice the rate for men over the last four decades. Louisiana has the second highest rate of incarceration in the U.S. There is evidence that men in Louisiana prisons do not receive adequate healthcare, but little is known about their women counterparts. We aimed to document formerly incarcerated women's experiences with receiving healthcare during incarceration in Louisiana to inform policy and practice change. In partnership with two community‐based organisations in New Orleans, Louisiana, between August 2016 and April 2018, we conducted semi‐structured 1‐hr interviews with 22 formerly incarcerated women who had been incarcerated in the state for at least one consecutive year. A convenience sample of participants was recruited through community‐based organisations' re‐entry and health programmes. Our interview guide included questions about experiences with accessing care, reproductive health needs, interactions with providers and preventive care during incarceration. We used applied thematic analysis techniques to interpret data. Over 90% of interviewees identified as Black. Their mean age was 50.7. The average length of incarceration was 8.4 years. Participants reported multiple barriers to accessing care including punishment for seeking care, long wait times, costs, lack of respect from providers and health concerns being dismissed. Participants reported limited mental health, preventive and dental services; an insufficient number of providers; and poor health outcomes as a result of delayed care. Overall, women did not have access to adequate, timely care during incarceration. Findings suggest a need for policy changes related to the provision of carceral healthcare services and external oversight of prison conditions and healthcare delivery. Further research into women's experiences of ageing during incarceration and tailored transitional health models is needed. [ABSTRACT FROM AUTHOR]

Introduction: Physical, psychological, and emotional trauma experienced while incarcerated influences subsequent mental health outcomes. Upon release, there is a fragmented landscape of mental health services and many of the existing services do not account for the root causes of challenges faced by formerly incarcerated people (FIP). To address the unmet social, psychological, behavioral, and emotional needs of FIP in Louisiana, the Formerly Incarcerated Peer Support (FIPS) Group developed a twelve-unit curriculum in 2019. Methods: We detail the evolution, development, and evaluation of the FIPS Group program. Additionally, we describe the community-driven process for developing the curriculum. Results: The FIPS Group has grown from informal meetings of a handful of FIP in New Orleans, Louisiana, into a multi-state, interdisciplinary network of more than 150 stakeholders. FIPS Group has developed the only peer support curriculum we are aware of that is designed by FIP, for FIP, and uses the shared experience of incarceration and reentry as its organizing principle. Limitations of the model include the lack of pending evaluation data and challenges with technological proficiency among FIP. Conclusions: The FIPS Group model may be generalized in a number of settings. Similar approaches may benefit the mental health of the millions of Americans involved in the criminal-legal system. [ABSTRACT FROM AUTHOR]

HIV researchers use short messaging service (SMS)-based surveys to monitor health behaviors more closely than what would be possible with in-person assessment. Benefits are tempered by nonresponse to completing surveys. Understanding response patterns and their associated study participant characteristics would guide more tailored use of SMS-based surveys for HIV studies. We examined response to weekly 7-item SMS surveys administered as part of an HIV prevention trial. Using Mixture hidden Markov models (MHMM), we identified the underlying response patterns shared by subgroups of participants over time and quantified the association between these response patterns and participant characteristics. Three underlying response patterns were identified; responders, responders with phone-related errors, and non-responders. Non-responders versus responders were more likely to be younger, male, cis-gender, Black and Latinx participants with histories of homelessness, incarceration, and social support service utilization. Responders with phone-related errors compared to non-responders were more likely to be Black, Latinx, female, students, and have a history of incarceration and social support service utilization. More nuanced results from MHMM analyses better inform what strategies to use for increasing SMS response rates, including assisting in securing phone ownership/service for responders with phone-related errors and identifying alternative strategies for non-responders. Actively collecting and monitoring non-delivery notification data available from SMS gateway service companies offers another opportunity to identify and connect with participants when they are willing but unable to respond during follow-up. [ABSTRACT FROM AUTHOR]

Health care organizations are increasingly assessing patients' social needs (eg, food, utilities, transportation) using various measures and methods. Prior studies have assessed social needs at the point of care and many studies have focused on correlates of 1 specific need (eg, food). This comprehensive study examined multiple social needs and medical and pharmacy claims data. Medicaid beneficiaries in Louisiana (n = 10,275) completed a self-report assessment of 10 social needs during July 2018 to June 2019. Chronic health conditions, unique medications, and health care utilization were coded from claims data. The sample was predominantly female (72%), Black (45%) or White (32%), had a mean age of 42 years, and at least 1 social need (55%). In bivariate analyses, having greater social needs was associated with greater comorbidity across conditions, and each social need was consistently associated with mental health and substance use disorders. In multivariable logistic analyses, having ≥2 social needs was positively associated with emergency department (ED) visits (OR = 1.39, CI = 1.23 – 1.57) and negatively associated with wellness visits (OR = 0.87, CI = 0.77 – 0.98), inpatient visits (OR = 0.87, CI = 0.76 – 0.99), and 30-day rehospitalization (OR = 0.66, CI = 0.50 – 0.87). Findings highlight the greater concomitant risk of social needs, mental health, and substance use. Admission policies may reduce the impact of social needs on hospitalization. Chronic disease management programs offered by health plans may benefit from systematically assessing and addressing social needs outside point-of-care interactions to impact health outcomes and ED utilization. Behavioral health care management programs would benefit from integrating interventions for multiple social needs. [ABSTRACT FROM AUTHOR]

The floods and devastation of Hurricanes Katrina and Rita contributed to socioeconomic instability and psychosocial trauma for the affected communities and populations, significantly for people of limited economic means and persons of color. Though more than 1/3 of the adult population from impacted areas experienced significant psychological distress, few people had access to or received appropriate health or mental health services in the months and years that followed. Community health workers (CHWs)-defined as lay community members whose backgrounds are similar to those for whom they provide such services as culturally relevant health education, individual- and community-level advocacy, and links to the health care system- may represent a particularly promising workforce strategy to increase access to quality mental health services and overcome racial and ethnic disparities in care. In this paper, we briefly review a post-disaster mental health training program for CHWs from the greater New Orleans area. We present preliminary evidence that CHWs remain engaged in addressing post-disaster concerns, and that there is community support for further CHW education. We discuss implications for CHW participation in recovery from future disasters and we highlight the work of Cynthia Carriere, a CHW from the Lower 9th Ward in New Orleans. [ABSTRACT FROM AUTHOR]

Objective: To describe a disaster recovery model focused on developing mental health services and capacity-building within a disparities-focused, community-academic participatory partnership framework. Design: Community-based participatory, partnered training and services delivery intervention in a post-disaster setting. Setting: Post-Katrina Greater New Orleans community. Participants: More than 400 community providers from more than 70 health and social services agencies participated in the trainings. Intervention: Partnered development of a training and services delivery program involving physicians, therapists, community health workers, and other clinical and non-clinical personnel to improve access and quality of care for mental health services in a post-disaster setting. Main outcome measure: Services delivery (outreach, education, screening, referral, direct treatment); training delivery; satisfaction and feedback related to training; partnered development of training products. Results: Clinical services in the form of outreach, education, screening, referral and treatment were provided in excess of 110,000 service units. More than 400 trainees participated in training, and provided feedback that led to evolution of training curricular and training products, to meet evolving community needs over time. Participant satisfaction with training generally scored very highly. Conclusion: This paper describes a participatory, health-focused model of community recovery that began with addressing emerging, unmet mental health needs using a disparities-conscious partnership framework as one of the principle mechanisms for intervention. Population mental health needs were addressed by investment in infrastructure and services capacity among small and medium sized non-profit organizations working in disaster-impacted, low resource settings. [ABSTRACT FROM AUTHOR]

Over the course of 16 d in the fall of 1998, Hurricane Georges made landfall on five Caribbean Island nations, two U.S. states, and two territories. Along its path, it impacted nearly every type of built environment and terrestrial and marine ecosystem found in the Caribbean and the southeastern United States. We reviewed ecological and sociological research related to Georges in order to demonstrate the potential power of regional synoptic networks despite notable gaps that existed at the time. Most studies examined various effects and responses within four years of the storm, though a few reported longer‐term results. Reduction in forest stem density was the most reported ecological effect and ranged from 7% to 51% among sites in different forest types. Forests previously impacted by Hurricane Hugo in 1989 showed lower mortality from Georges than forests with longer hurricane‐free intervals. Rivers in the storm's path exported heavy loads of sediment to marine systems. For example, 5–10 million tons of sediment was transported to marine systems from Puerto Rico, and suspended sediments increased tenfold in coastal Louisiana. Economic costs directly related to Hurricane Georges ranged from 5% to 200% of annual GDP in the year after the storm. Sociological research indicated that children and college students exposed to Hurricane Georges experienced elevated effects on mental health such as anxiety and depression for up to 2.5 yr. Established research areas and longitudinal studies were valuable in understanding hurricane effects in the context of long‐term trends but fragmented research capacity reduced both local and regional synthetic efforts. Georges provides a template of how future integrated research programs could provide a deeper understanding of how nature, urbanization, human culture, and societal norms interact, respond, and recover from a major hurricane. However, future studies should avoid using the Saffir‐Simpson scale as a shorthand indicator or predictor of storm effects because topographic, historical, ecological, political, infrastructural, and societal factors interact to alter storm effects. The breadth of topics addressed in the research produced after Georges shows the potential for transformative, regionally synthetic research that spans whole watersheds and nearshore areas while integrating ecological and social sciences. [ABSTRACT FROM AUTHOR]

Background: In 2016, the Patient-Centered Outcomes Research Institute funded the National Patient Centered Clinical Research Network (PCORnet) Bariatric Study (PBS). Understanding the experience of postoperative patients was a key component of this study. Methods: Nine focus groups were conducted in Southern California, Louisiana, Pennsylvania, and Ohio and in a national advocacy conference for patients with obesity. Participants were identified and recruited in both clinical and community settings. Focus group transcripts were analyzed using an iterative inductive-deductive approach to identify global overarching themes. Results: There were 76 focus group participants. Participants were mostly women (81.4%), had primarily undergone gastric sleeve (47.0%), were non-Hispanic white (51.4%), had some college education (44.3%), and made $100,000 annual income or less (65.7%). Qualitative findings included negative reactions patients received from friends, family, and co-workers once they disclosed that they had bariatric surgery to lose weight; and barriers to follow-up care included insurance coverage, emotional and situational challenges, and physical pain limiting mobility. Conclusions: These findings confirm the other qualitative findings in this area. The approach to bariatric surgery should be expanded to provide long-term comprehensive care that includes in-depth postoperative lifetime monitoring of emotional and physical health. [ABSTRACT FROM AUTHOR]

The health and well-being of pregnant women during and after natural disasters remains an international concern. In this mixed methods study we described pregnant women's mental health, psychosocial concerns and sources of stress living in New Orleans during long term recovery from Hurricane Katrina. Our survey of 402 pregnant women indicated poor social support was associated with higher levels of depression symptomology, post-traumatic stress disorder, anxiety, and stress. Women were interviewed and described seven common areas of worry. We concluded that pregnant women living in post-disaster communities have stressful lives years after the event, needing innovative models of care to build resilience. [ABSTRACT FROM AUTHOR]

Generations of nurses to come, now called heroes in the media, will have challenges in providing care for persons during this global pandemic. COVID-19 has impacted all demographics, regardless of race, gender, or socioeconomic class globally. African Americans have experienced a disproportionate number of deaths related to COVID-19 in the New Orleans and surrounding Metropolitan areas. According to the Louisiana Department of Health (2020), fifty-seven percent (57.40%) of the deaths in Louisiana related to COVID-19 have been African American (Black) and fifty-five percent (55.2%) have been males as of May 11, 2020. Social determinants of health are the conditions in which people age and the conditions they are born, grow, age and work. These conditions include neighborhoods, schools, and places of employment. These circumstances are shaped by the distribution of money, power, and resources at global, national, and local levels (World Health Organization, 2020). Years later the same community that comprised "pre-and post-Katrina" are now facing this pandemic. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to determine if complementary and alternative medicine therapies are associated with mental health in postdisaster environments. Design: Pregnant women (N = 402) were interviewed between 2010 and 2012 as part of a larger cross-sectional study on hurricane recovery and models of prenatal care. Methods: Symptoms of depression (Edinburgh Postnatal Depression Screen), prenatal anxiety (Revised Prenatal Distress Questionnaire), posttraumatic stress (PCL-S), and perceived stress (PSS) were examined. Logistic regression was used to adjust for income, race, education, parity, and age. The most commonly reported therapies were prayer, music, multivitamins, massage, and aromatherapy. Findings: Mental illness symptoms were common (30.7% had likely depression, 17.4% had anxiety, and 9.0% had posttraumatic stress). Massage was protective for depression (Edinburgh Postnatal Depression Index [EDSI] >8; adjusted odds ratio [aOR] = 0.6, 95% confidence interval [CI] = 0.3-0.9), while use of aromatherapy (aOR = 1.9, 95% CI = 1.1-3.2) and keeping a journal (aOR = 1.9, 95% CI = 1.1-3.2) were associated with increased odds of depression. Aromatherapy was associated with symptoms of pregnancy-related anxiety (aOR = 2.0, 95% CI = 1.1-3.8). Conclusions: Symptoms of mental illness persist after disaster, when untreated. Nurses should consider assessing for complementary and alternative medicine utilization in pregnancy as a potentially protective factor for mental health symptoms. [ABSTRACT FROM AUTHOR]

This study assessed the psychosocial needs of Hurricane Katrina evacuees temporarily residing in Dallas, TX, after sheltering but prior to their permanent resettlement. Common trauma exposures were physical exposure to flood water, seeing corpses, witnessing death, and loss of family, friends, or home. Fewer than 10 % met symptom criteria for disaster-related posttraumatic stress disorder (PTSD). More than one-fourth met major depressive disorder (MDD) symptom criteria post-disaster but only 15 % had a new (incident) MDD episode after the disaster. Specific trauma exposures and some hurricane-related stressors contributed to risk for both Katrina-related PTSD symptom criteria and incident MDD, but other hurricane-related stressors were uniquely associated with incident MDD. Referral to mental health services was associated with meeting symptom criteria for PTSD and with incident MDD, but only about one-third of these individuals received a referral. Understanding the needs of disaster-exposed population requires assessing trauma exposures and identifying pre-disaster and post-disaster psychopathology. [ABSTRACT FROM AUTHOR]

Background: High impact experiences following a natural disaster have been shown to influence later psychopathology. Individual-level factors such as age may also contribute to a disaster's impact on mental health, though it is unclear whether young age confers a protective effect or represents a period of increased risk as compared to adulthood. Objective: The present study evaluated the influence of adolescent age and hurricane experiences on mental health in the years following multiple hurricanes in the New Orleans region. Methods: 794 women, currently aged 18-45, participating in a cohort study of lifetime adversity and reproductive health completed a survey about hurricane experience and current mental health. Joint associations between disaster experience and age at the time of disaster on depression and post-traumatic stress disorder (PTSD) were evaluated. Results: Compared to women who were adults at the time of the disaster, being in early adolescence resulted in reduced depression and PTSD up to 9-years post-disaster, controlling for hurricane experiences, time since disaster, and income. A similar effect was not observed among older adolescents. Increased endorsement of feeling one's life was in danger and experiencing illness or injury resulted in increased odds of depression, while danger was associated with increased odds of PTSD. Conclusions: Younger age at the time of a natural disaster may confer a protective effect on mental health outcomes post-disaster, even when disaster experiences are considered, potentially representing the importance of parental support and cognitive development on disaster effects. [ABSTRACT FROM AUTHOR]

Background: Post disaster psychosocial surveillance procedures are important for guiding effective and efficient recovery. The Louisiana State University Health Sciences Center Katrina Inspired Disaster Screenings (KIDS) is a model designed with the goal of assisting recovering communities in understanding the needs of and targeting services toward children and adolescents. Objective: As a critical, yet understudied, component to the KIDS model, the objective of this study is to test the psychometric properties of the National Child Traumatic Stress Network Hurricane Assessment and Referral Tool for Children and Adolescents. Methods: Exploratory factor analysis (EFA) was used to investigate the factor structure of the NCTSN Hurricane Assessment and Referral Tool. The convenience sample included 7530, 9-18 years old students who completed the school initiated screener in Southeastern Louisiana schools from December 2005 to December 2006. On a small treatment seeking population ( N = 62), associations among the referral tool and the PTSD Reaction Index were also explored. Results: EFA of the referral tool revealed a two factor solution, anxious and depressive reactions, that accounted for 45.8 % of model variance. Internal consistency was high and symptom scores were moderately associated with the PTSD Reaction Index. The cutoff score was also confirmed with scores ≥4 suggesting the need for referral. Conclusion: This study allows for the recommendation of the NCTSN Hurricane Assessment and Referral Tool as a reliable and valid part of the KIDS model; together they provide an initial step toward addressing the needs of child and adolescent disaster survivors. [ABSTRACT FROM AUTHOR]

This manuscript outlines the multiple methods utilized in a long-term follow-up of a non-traditional population: Homeless substance abusers in New Orleans. This article addresses qualitative mental health research by outlining steps taken to explore both qualitative and quantitative data sources. By way of qualitative and quantitative methods, this research examines the life course of a sample of New Orleans homeless substance abusers from the time they entered into treatment (1991) until the present and observes the quality of their social bonds and their long-term outcomes. By making use of mixed methods, this research gives a more thorough understanding of mental health, specifically examined through homelessness and substance abuse. [ABSTRACT FROM AUTHOR]

The recent scandal involving Bishop Eddie Long of New Birth Missionary Baptist Church has led millions of individuals to evaluate the guilt or innocence of Bishop Long as well the significance of the black mega-church. This study examined the possible effects of a well-publicised scandal involving a black mega-church pastor on the mental health of African Americans within and outside of the church. To address this paucity in the research, over 3000 comments made by anonymous contributors on CNN's public website were analysed using a grounded theory methodology. The following five themes were identified: (1) Keep an Open Mind: “Most People Thrive on Negativity;” (2) Hypocrisy as Part of Religion: “They aren’t real Christians;” (3) Greed as Part of Religion: “Just in it for the money;” (4) Religion and/or Christianity as Problematic: “Christians scare the Jesus out of me;” and (5) Religious Leaders Actions are separate from Individuals’ Personal Faith and Their Relationship with God: “You don’t put your faith in a man.” Narratives will be offered to support and illustrate each of these themes, and the implications for the mental health of African Americans will be discussed. [ABSTRACT FROM PUBLISHER]

This study advances research on the mental health impacts of disasters by examining how a mainstay of the sociological literature, community attachment, influences negative affective states such as anxiety and fear stimulated by a technological disaster. Survey data were collected in three coastal Louisiana parishes (counties) geographically proximate to the BP oil spill of 2010 while the oil was still flowing. The data reveal that community attachment is associated with higher levels of negative affect. This finding holds for those tied to the fishing and seafood industry, those tied to the oil industry, and those having no immediate links to either industry. These results highlight that although community attachment is essential for community resilience, it can also be disruptive to individual well-being when technological disasters occur in communities dependent on renewable and natural resources. [ABSTRACT FROM PUBLISHER]

Few studies have assessed the results of multiple exposures to disaster. Our objective was to examine the effect of experiencing Hurricane Gustav on mental health of women previously exposed to Hurricane Katrina. A total of 102 women from Southern Louisiana were interviewed by telephone. Experience of the hurricanes was assessed with questions about injury, danger and damage, while depression was assessed with the Edinburgh Depression Scale and post-traumatic stress disorder using the Post- Traumatic Checklist. Minor stressors, social support, trait resilience and perceived benefit had been measured previously. Mental health was examined with linear and log-linear models. Women who had a severe experience of both Gustav and Katrina scored higher on the mental health scales, but finding new ways to cope after Katrina or feeling more prepared was not protective. About half the population had better mental health scores after Gustav than at previous measures. Improvement was more likely among those who reported high social support or low levels of minor stressors, or were younger. Trait resilience mitigated the effect of hurricane exposure. Multiple disaster experiences are associated with worse mental health overall, although many women are resilient. Perceiving benefit after the first disaster was not protective. [ABSTRACT FROM AUTHOR]

The devastating effects of Hurricane Katrina have contributed to a dynamic demographic shift in the Latino composition of New Orleans. This article focuses on a particularly deleterious pattern of crack cocaine smoking associated with numerous social and health consequences. Utilizing a rapid assessment methodology, in-depth qualitative interviews were conducted with 52 Latino immigrant day laborers in New Orleans. Findings reveal that the presence of a flourishing drug market has facilitated and maintained patterns of crack use including initiation and periods of daily use. Moreover, feelings of isolation and constant exposure to victimization due to day laborers’ marginal status are described as contributing to this use. This qualitative analysis reveals how social processes and contextual factors contribute to crack use among Latino day laborers in a post-disaster context. This study has important public health implications in the spread of HIV and other blood borne pathogens. [ABSTRACT FROM AUTHOR]

This pilot study examined the effects of a manualized meditation intervention (called Inner Resources) for posttraumatic stress disorder (PTSD), depression, and anxiety symptoms among 20 African American and Caucasian mental health workers in New Orleans beginning 10 weeks after Hurricane Katrina. They participated in a 4-hour workshop followed by an 8-week home study program. Complete follow-up data were available for 15 participants. Results of intention-to-treat analyses indicated that participants' PTSD and anxiety symptoms significantly decreased over the 8 weeks of the intervention; these improvements were significantly correlated with the total number of minutes of daily meditation practice. The majority of participants reported good treatment adherence and improvements in well-being. These findings suggest that meditation may be a feasible, acceptable, and effective postdisaster intervention. [ABSTRACT FROM AUTHOR]

Hurricanes and tropical storms served as natural experiments for investigating whether autism is associated with exposure to stressful events during sensitive periods of gestation. Weather service data identified severe storms in Louisiana from 1980 to 1995 and parishes hit by storm centers during this period. Autism prevalences in different cohorts were calculated using anonymous data on birth dates and parishes of children diagnosed with autism in the state mental health system, together with corresponding census data on all live births in Louisiana. Prevalence increased in dose-response fashion with severity of prenatal storm exposure, especially for cohorts exposed near the middle or end of gestation ( p < 0.001). Results complement other evidence that factors disrupting development during sensitive gestational periods may contribute to autism. [ABSTRACT FROM AUTHOR]

Background: Addiction treatment systems and services are increasingly challenged to provide effective treatments for persons with co-occurring disorders. Evidence-based practices are still being developed, and practice benchmarks remain vague in guiding treatment providers in enhancing services, or in delineating standards with which to evaluate the quality of existing care for persons with dual disorders. The American Society of Addiction Medicine (ASAM) proposed a taxonomy of addiction treatment program dual-diagnosis capability, and provided a conceptual model of services for persons with co-occurring substance use and psychiatric disorders. Method: This article describes the development and application of the Dual Diagnosis Capability in Addiction Treatment (DDCAT) Index, which is designed to assess the dual diagnosis capability of addiction treatments services, and is based upon the ASAM taxonomy: Addiction Only Services (AOS), Dual Diagnosis Capable (DDC) or Dual Diagnosis Enhanced (DDE). Results: The DDCAT has been found to have acceptable psychometric properties (internal consistency, inter-rater agreement, kappa) and is sensitive to change. Three case examples illustrate its use in assessing the dual diagnosis capacity of treatment services, and in measuring the targets and impact of change strategies. Conclusions: The DDCAT has demonstrated practical value for addiction treatment systems and treatment service providers. Validity studies are in progress testing the relationship between the index and patient level outcomes. [ABSTRACT FROM AUTHOR]

The article reports on the impact of memories of the devastation caused by Hurricane Katrina on mental health recovery in New Orleans, Louisiana five years after the deluge. According to experts, an elevated rate of stress-related mental health disorders, such as depression and mental health disorders, continue to affect survivors. Harvard Medical School professor of health care policy Ronald Kessler claims that severe stress can be found in people who lost a loved one or a home. Mental health recovery trends are collated and published by the Kaiser Family Foundation.