A mental health crisis unfolds

The most visible damage from the Gulf of Mexico oil spill might be to the Gulf’s beaches and its wildlife populations, but damage is also occurring to the psyche of many who live in the Gulf, as they lose trust in public officials to handle disasters effectively and become withdrawn from their neighbors, say psychologists who’ve studied the effects of other environmental and community disasters.

University of California, San Francisco, psychologist Nancy Adler, PhD, who chaired an Institute of Medicine workshop on health effects of the Gulf oil spill, sees similarities in people’s frustration with official responses to the cleanup and with post-Katrina problems. “A lot of the issues around Katrina were about mistrust, and we’re also seeing a lot of mistrust of government now,” she says.

People who’ve lost their jobs don’t know if they can trust BP to reimburse them properly. The halting nature of the cleanup and capping efforts, as well as the government’s perceived mismanaging of its oversight of the spill, may also have eroded confidence in public officials.

“There’s a lack of trust but there’s also this sense of helplessness, of hopelessness,” adds Nadine Kaslow, PhD, a clinical and family psychologist at Emory University in Atlanta. That’s led to cynicism surrounding just how effective and well planned the government’s and BP’s relief efforts really are, she says.

Now that the gusher itself seems to be contained, many are wondering about potential health risks posed by the oil — and whether they should trust government scientists who’ve so far claimed that there’s no evidence the oil is hazardous to one’s health.

“But people realize that ‘no evidence of harm’ isn’t the same thing as ‘evidence of no harm,’” Adler says. To convince people to trust in their findings, “scientists have to be willing to step down from a totally objective standpoint and speak straight,” she adds.

Compounding mistrust are media reports that hype health threats because it makes for better headlines. Kaslow says the media should also focus on positive things occurring in the Gulf, such as efforts to use the spill as an opportunity to strengthen environmental protection laws and pump funding into more eco-friendly technology.

So how to regain the public’s trust? For one, when a report on health effects comes from the federal government, it may be trusted more if it comes from someone viewed as nonpolitical, like the surgeon general, Adler says. But more important, people tend to place more trust in local sources than they do people who fly in and tell them what to do, she says. Local scientists, politicians and community leaders can help people sift through official responses and figure out how that applies to their lives — how much they can expect to be reimbursed, where they can go for help, whether they should worry about their health, psychologists say.

“Research shows that people trust those who treat them like adults and give them accurate information and don’t make promises they can’t keep,” says cognitive psychologist and decision expert Baruch Fischhoff, PhD, of Carnegie Mellon University in Pittsburgh.

As with other disasters and health risks, officials should tell people in simple language what they need to know and how to prepare themselves, he says. When people don’t get that information, you see breakdowns in trust and empathy, says Lawrence Palinkas, PhD, a medical anthropologist at the University of Southern California who studied the effects of the 1989 Exxon Valdez oil spill.

After that disaster, Alaskans who lost jobs to the spill, as well as those who helped with the cleanup, were three times more likely to experience post-traumatic stress disorder, twice as likely to experience symptoms of depression and three-and-a-half times more likely to have generalized anxiety disorder than unaffected Alaskans.

“It turned out to be just as traumatic as someone putting a gun to their heads,” Palinkas says.

Social disruption in the communities was the most profound effect of increased depression and anxiety. It was a bit like a gold rush, he says. Relief workers and volunteers descended on coastal towns, and efforts to clean up the oil created a miniature economic boom, leading some to profit from the disaster while their neighbors grew poorer. The long hours spent cleaning up the coast also took a toll on families, he says.

“People became frustrated and angry with themselves and with each other,” Palinkas says.

He says the Gulf situation may play out differently. The fact that BP has set aside $20 billion to fund relief efforts and reimburse people has given people some hope, and he says communities have been more proactive in providing resources to those going through especially hard times. Still, uncertainty looms for people in the fishing and oil industries who may not be able to return to their jobs for years, Palinkas says.

The best way to head off depression and anxiety and to protect against communities turning on each other is to build community support systems now, he says. Psychologists and social workers can work together to train community leaders and design programs to teach people about resilience. Also, because trauma is isolating, people in these communities should ask their neighbors if they need help, even knock on doors to reach people who wouldn’t otherwise seek help, says Palinkas.

“Let them know what’s available to them,” Adler says. “Let them know where they can go and who they can talk to for help.”