The psychology of a disaster: new studies consider unseen effects and access to care.

MATERIAL DEVASTATION IS OBVIOUS. Hurricanes Katrina and Rita and the subsequent breaking of the levees in New Orleans left us with haunting images of destroyed neighborhoods. Indeed, three years later, the imploded homes and deserted streets continue to provide a physical measure of how little we have done to rebuild. What is more difficult to measure, however, is the psychological impact the disaster has been having since day one.

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"I wasn't traumatized by the hurricane per se. I was traumatized by everything I had to deal with after the hurricane," said Christine Gavin-Latham, who is 55 years old and fled with her daughter from their home in Gulfport, Mississippi. She now lives in New York City, where she is a part of the New York Solidarity Coalition for Katrina/Rita Survivors.

Contrary to the conventional wisdom that the passage of time is all most people need to recover, mental illness rates of Katrina survivors have intensified over time rather than abated. A group of roughly 800 survivors (including people still living in the region and those who were displaced) was surveyed five to eight months after the initial disaster and again a year later. In an article in the April issue of Molecular Psychiatry, researchers found that the rates for post-traumatic stress disorder (PTSD) increased to 20.9 percent from 14.9 percent, serious mental illness increased to 14 percent from 10.9 percent, and thoughts of suicide ...