Mental health concerns in a rural community post-disaster

Post-traumatic stress disorders, anxiety, and other psychological stressors have been observed in the immediate aftermath of disasters, yet less is known about the long-term effects of a disaster on the mental health of persons in an already vulnerable and stressed community. In 2005, residents of Graniteville, SC were ravaged by a train derailment that killed several residents and leaked approximately 60 tons of chlorine gas into the small community. We present data collected from community residents, healthcare providers (HCPs), and hospital discharge records regarding the mental health impacts on the community seven years post-disaster. Data were triangulated using results collected from three methods: photovoice conducted with community residents in 2012, semi-structured interviews conducted with area HCPs (2012-2013), and secondary data analysis of hospital discharge data from area healthcare facilities. Qualitative data were analyzed using NVivo 10 software. Quantitative data were analyzed using SPSS v20. Community members reported anxiety from the sound of train whistles or the scent of chlorine, depression from the loss of quality of life and resultant physical ailments, and desire to suppress memories of the train disaster. Similar reports were noted from HCPs. Analysis of hospital data comparing pre-disaster and post-disaster discharges resulted in a significant increase in the reports of mental health conditions since the disaster. Mental health concerns should be anticipated both immediately following and in the longer term secondary surge period after disasters. Improving access to mental healthcare services, particularly in communities with limited resources, is an essential element in disaster response efforts.