Mental health could take a toll, particularly for children, after Boulder County flood

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Stress can particularly affect children.

This story is part of Our Road to Recovery, our coverage of the 2013 Boulder County floods.

As the waters recede and homes are repaired and scrubbed clean, the less visible ripples of the recent floods may begin to appear: the invisible emotional and psychological damage of the stress of having survived a natural disaster.

“Generally after an event like this, there is kind of an immediate phase, after the danger has passed, where communities are good at sort of rallying together and you almost see this sort of phase of collective determination to cope with the event,” says Brian Houston, co-director of the Terrorism and Disaster Center at the University of Missouri. “Then what happens is, after a little bit of time passes, reality sets in. Some of the challenges are still there, particularly with people who have lost homes or loved ones or have some sort of damage to where they live or work. … You may now be in that period where Boulder and the other communities that are affected are very determined to handle this situation, but it may be more difficult in the coming weeks as the cleaning up basements and rebuilding homes, and these sorts of things, the actual work is there and it takes longer and it’s always more difficult than we imagine.”

A disaster mental health study from the Veterans Affairs North Texas Health Care System found that 11 percent to 38 percent of people who arrive at shelters and family assistance centers have stress-related and adjustment disorders.

Just lingering uncertainty can take its toll.

“When we have a situation where we’re uncertain about what’s going on, and uncertain about when we’ll be able to go back, what our lives will be like, what our long-term future is, what the future of our community is, it’s an inherently stressful situation and kind of anxiety-provoking situation just by our nature,” Houston says. “A lot of these situations, there may not be an answer right now about when exactly can we go back, or will the road or the town or the area be rebuilt the way it was — or will the authorities decide we can no longer live there. That lack of being able to visualize what your future is is unsettling for the best of us.”

Obviously, people who were at life-threatening risk or sustained an injury or lost their homes through the disaster are at highest risk, and the people who know them become likely candidates as well. But then there’s a third category — bystanders.

“It can be anyone living in the affected community, and the impact on those people may be from seeing damage to their community, seeing people that they know either very well or just kind of in passing hurt or lose their possessions,” Houston says.

The stress and anxiety — manifested as difficulty sleeping, excessive worry, nightmares and even physical reactions like upset stomachs and headaches — don’t have to proceed to the level of a diagnosable disorder to be worth addressing.

“A lot of people may need just a little bit of something extra to help them navigate a really difficult situation,” Houston says. “Anyone who is uncertain about what they should do or thinks they might need to talk to someone, then they certainly should. There are lots of resources out there that mental health professionals, social workers, religious professionals can connect individuals with that are quite effective and can really provide a lot of help and support.”

For those just navigating waters that feel a bit more rocky, simple breathing exercises to calm the mind and body may help ease the road to recovery.

Turning to social connections may also prove to be helpful, social support being one of the things that seems to really help people cope with a difficult situation. Research compiled by the United States Department on Veterans Affairs indicated that individuals without social networks are at greater risk for developing PTSD in the wake of natural disasters, including hurricanes, tornadoes, earthquakes and floods. Resilience increases with social support, particularly support that provides help solving problems, a sense of being understood or having shared the experience of trauma, reassurance that an individual’s response is normal and tips about coping. Older adults who don’t have great social support or communities are at risk for struggling to recover from the emotional effects of a disaster.

Also at risk are children who have seen their homes and schools evacuated, and their friends and families, including stressed parents affected by the disaster.

“We may assume that our children don’t really understand, or they’re too young to know or we shouldn’t tell them things because it’ll make them more upset, but children are often affected by how parents react and typically know more than we think they know, and where they don’t know things, are quite good at imagining explanations which might actually be worse than the reality in some situations,” Houston says.

Boulder Valley School District has been working to communicate with parents about the disaster, providing articles on how to talk to kids and readying crisis management teams of school psychologists, social workers and staff from Boulder County’s Mental Health Partners.

“You can plan all you want for crises, and then something as widespread as this happens, and everybody has to get on board and work to support students,” says Andrew Tucker, director of counseling services and student engagement for Boulder Valley School District. “We need our teachers to understand what to do, everybody on the staff needs to understand what to do. We want to make sure everybody is ready.”

All Boulder Valley school buildings will have trained staff at the ready for students — and Tucker says they’re well prepared to deal with the emotional needs of kids, including trying to be prepared to anticipate which students — and schools — may have concentrations of students who lost their homes or have been displaced.

“We’ve taken the time to go through our list of students and pull ZIP codes we know were heavily affected and get a good sense of who might really be affected, and we are going to reach out to those students specifically and check in on them,” Tucker says.

As schools prepared to re-open for classes on Thursday — 49 of the 51 buildings re-filling with students — the emphasis was on returning children to a sense of routine.

“When it comes to school and young people, it’s really best if at all possible to get back to business as usual,” Tucker says. “Normalcy and giving students some stability in school is really what research shows is the best way to handle it — as much as possible.”

He reiterated that honesty is the best policy with children.

“Humans have sort of a natural capacity for resilience that I think we under-appreciate often when we’re doing this research and working in this area,” Houston says. “None of us are immune from the possibility of experiencing a situation that would overwhelm us, so no one is completely immune from this, but no one is completely susceptible and powerless either.”

Respond: letters@boulderweekly.com

This story is part of Our Road to Recovery, our coverage of the 2013 Boulder County floods.