NEW ORLEANS — Dispersed across the nation, survivors of Hurricane Katrina are suffering such severe psychological distress that the federal government has launched the broadest -- and probably the most costly -- counseling program in the nation's history.
An estimated 500,000 people need some form of mental health service, which could include treatment for post-traumatic stress, substance abuse counseling, anti-anxiety medication, even art therapy for children too young to talk out their grief.
The federal government has allocated $141 million to serve evacuees scattered among at least two dozen states, said Seth Hassett, who directs the emergency response unit of the federal Substance Abuse and Mental Health Services Administration.
Officials are negotiating a separate grant for the state of Louisiana; it could be as high as $70 million. That would bump the total cost of hurricane counseling well above the $178 million appropriated for the mental health needs of victims of the Sept. 11 terrorist attacks.
Cost aside, the Katrina response is proving the agency's toughest challenge ever, Hassett said.
In New Orleans, even those trained to offer solace break down easily and often: A hospital nurse, a school psychologist, a paramedic, a counselor all lose composure as they talk about Katrina.
"The truth is, we are not OK. We are so definitely not OK," said Burke Beyer, 31, who leads a federally funded team of counselors in New Orleans.
Experts knew from the start that Katrina would be traumatic. The storm killed more than 1,300 people, submerged 80% of New Orleans, flattened neighborhoods and forced friends and relatives apart. But the scope of the mental health crisis is only now emerging.
The half-year mark should be a milestone; many locals expected recovery to be well underway. Instead, their lives are still a mess, their city is still in ruins, and they can see no end to the chaos.
"You try to adjust but you can't," said Walter L. Collins Jr., 30, a truck driver.
Federal officials estimate that 25% to 30% of hurricane survivors in hard-hit cities such as New Orleans will suffer "clinically significant" mental health problems. Another 10% to 20% need psychological help, but aren't classified as clinically ill.
Lyn Shraberg, who directs the nonprofit Cope Line in New Orleans, hears the strain in call after call. Before the storm, her counselors handled at most three suicidal or severely depressed callers a day. Now, they get 12 to 14 a day.
