After Hurricane, Signs of a Mental Health Crisis Haunt Puerto Rico

 In U.S.

Puerto Rico was already struggling with an increase in mental illness amid a 10-year recession that brought soaring unemployment, poverty and family separation caused by migration. Public health officials and caregivers say that Maria has exacerbated the problem.

Photo

A photo of Ms. Serrano Ortiz with her two oldest children. Her home flooded up to the ceiling during the hurricane.

Credit
Erika P. Rodriguez for The New York Times

Many Puerto Ricans are reporting intense feelings of anxiety and depression for the first time in their lives. Some are paranoid that a disaster will strike again. And people who had mental illnesses before the storm, and who have been cut off from therapy and medication, have seen their conditions deteriorate.

“When it starts raining, they have episodes of anxiety because they think their house is going to flood again,” said Dr. Carlos del Toro Ortiz, the clinical psychologist who treated Ms. Serrano Ortiz. “They have heart palpitations, sweating, catastrophic thoughts. They think ‘I’m going to drown,’ ‘I’m going to die,’ ‘I’m going to lose everything.’ ”

With hurricane nearly two months in the past, the island is still in shock. Its residents are haunted by dozens of deaths caused by the storm, and many more life-threatening near misses. The reminders are inescapable. They lie in piles of rotting debris as tall as homes that still line many streets and in cellphones that are useless for checking on family members.

Returning to a routine is the most important step toward overcoming trauma, according to physicians and public health officials. But for most Puerto Ricans, logistical barriers like scarce water and electricity, as well as closed schools and businesses, make that impossible.

Since Sept. 20, when the storm came ashore at 6:15 a.m., more than 2,000 calls have overwhelmed an emergency hotline for psychiatric crises maintained by the Puerto Rican health department — double the normal number for that period, even though most residents still do not have working phones. Puerto Rican officials said that suicides had increased — 32 have been reported since the storm — and many more people than normal have been hospitalized after being deemed dangerous to themselves or others.

At the emergency health clinic in Toa Baja, where Ms. Serrano Ortiz lives, Dr. Toro said that he had been frantically calling for help from colleagues in other cities because the facility was overrun with people in need of mental health care.

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