Anxiety and depression are easy to spot at Utah's Camp Williams, where Katrina evacuees are just beginning to settle in. Eventually, some may exhibit signs of post-traumatic stress.
But the experts counseling evacuees say they are not seeing more acute mental health problems than they would at any mental health clinic, according to Janina Chilton, spokeswoman for the state's Division of Substance Abuse and Mental Health.
And human resilience is evident everywhere, says Victoria Delheimer, a program manager for the division who is helping coordinate mental health services for the evacuees. As she talks with teens who were separated from their mom and dad, adults who are wondering whether their siblings survived, evacuees of all ages mourning the known deaths of loved ones, "I am amazed by people's optimism and resilience," she said.
Indeed, national experts say most people, over time, will recover their equilibrium.
Chilton said there have been surprises. For instance, a lot of the people who were homeless even before the tragedy seem to be coping better than many of the others. "That's their reality," said Chilton. "Now they will have help and maybe be able to regroup and actually start over."
While it's impossible to gauge the horrors all the evacuees have seen, Chilton said, this subpopulation of affected people are "used to fending for themselves and protecting themselves," and while some expected them to lack coping skills, they're doing quite well.
Delheimer was part of the crisis teams at the airports comforting families after terrorists crashed the planes on 9/11. She sees similarities and contrasts between Katrina and 9/11.
The human loss is in many ways the same, she said, with people mourning and wondering about loved ones. In 9/11, the wondering part was relatively brief. These evacuees may not know for a long, long time who lived and died, with people scattered across the country, communication disrupted and the daunting task of identifying the dead. She's even concerned about the many different lists that have been set up to reunite loved ones, which may actually increase stress, she said.
In 9/11 when you walked eight blocks, everything was intact. Katrina cut a much larger geographic swath of destruction — the extent of which evacuees are just beginning to recognize.
"People have been thinking that in a couple of weeks they're going home. Now, as they see televisions and newspapers, the reality is setting in that many have nothing to go back to," Delheimer said.
And to the loss of human life the two events share, Katrina heaps on the loss of jobs, of pets, of homes, of old photos and neighbors and beloved landmarks and basic possessions. Even personal identification is a gargantuan problem, she said. One evacuee told her he has places to go and the money to get there — if he could access his bank account.
She expects that about one-third of those now at Camp Williams will be reunited with family elsewhere. The population left behind will face different challenges.
The gratitude to be alive and cared for will wear off, she said, as long-term realities set in. "I'm safe, but I've got nothing. How do I build my life back? I think we'll see a lot of post-traumatic stress."
Counselors at Camp Williams are meeting folks who are having trouble sleeping, who feel agitated and frustrated and sad. Chilton said so far perhaps 5 percent of the evacuees are demonstrating signs of acute distress, even mild dementia. A couple of people were hospitalized with psychiatric issues.
One thing everyone seems to have in common, Delheimer said, is a need to talk. And that is the form most "counseling" takes right now.
"If you put up a sign that says 'counseling,' people don't want to go," she said. "Right now it's more a matter of just starting a conversation. Our work is very informal."
A brief initial screening helped those who take medications replace them. Before long, Delheimer predicted, there will be some support groups set up, both at the camp and in the community. In the meantime, people are being encouraged to talk about what they've endured and seen and anything else they want to discuss.
The evacuees are also helping each other over the emotional hurdles, instinctively following the advice Delheimer also offers for those who didn't endure the storm but are nonetheless traumatized.
"If you're losing sleep and worry is interfering with day-to-day functioning, find somebody and talk to them. A bishop or priest or minister or local mental health person or just a friend." She also recommends that someone who has become obsessed or can't sleep see a doctor.