Kerala Floods’ Hidden Cost: How to Cope With Mental Health Woes?

Mental health issues like post-traumatic stress disorder (PTSD), depression and anxiety come with natural disasters

A boy cries as he sits in a boat after being rescued by volunteers in Kerala. 

(Photo: AP)

A 19-year-old student in Kerala ended his life after flood waters destroyed his documents. Another 54-year-old went back from the relief camp to find his house in ruins and hanged himself. A similar third suicide was reported from Kerala as well.

As the floodwater recedes and the state takes stock of the losses its incurred, survivors pick up the pieces of a life swept away. With teams of doctors deployed to the state looking to curb disease outbreaks, an equally important aspect to address is the mental health of the affected people.

Post-traumatic stress disorder (PTSD), depression and anxiety are all realities that a natural disaster brings with itself. The 2001 Gujarat earthquake, 2004 tsunami, 2005 Mumbai floods and the 2010 Chennai floods are all testament to that.

A man row away from his flooded house with his dog in a boat in Kerala.(Photo: AP)

(Photo: AP)

Kerala Health Minister, KK Shailja, made it a point to remind flood survivors that they’re not alone. Chief Minister Pinarayi Vijayan has assured that the government will stand by them. The authorities have also stated that mental health is important to them, with counsellors and psychologists helping out people in the state.

Psycho-social teams from the National Institute of Mental Health & Neuro Sciences will be deployed as and when requested by the state government, Union Health Minister JP Nadda has assured.

But how does a natural disaster impact the survivors psychologically and why is it important to tackle it right now?

The Impact of Suffering Losses In a Natural Disaster

Dr CJ John, Chief Psychiatrist, Medical Trust Hospital in Kochi, says that an unforeseen event which disrupts the lives of people to such an extreme can have a lasting impact on mental health.

A study conducted in a village in Cuddalore district, Tamil Nadu, two months after tsunami found that 12.7 percent of the adults suffered from PTSD symptoms of irritability and emotional numbness. Other studies confirmed the incidence of PTSD among victims of 1993 Latur earthquake and 2005 Mumbai floods.

An elderly man wades through flood water in Kerala.(Photo: AP)

First, a disaster like this induces a fear for life. Then comes the grief of losing valuables, their homes and property damaged, and disruption in lives. This is acute stress which can trigger depression and anxiety. When this passes, they may then be haunted by the memory of it and undergo PTSD.

Dr CJ John, Chief Psychiatrist, Medical Trust Hospital, Kochi

The thought of being inflicted by the disaster again and the imagery of the disaster may stay with the survivors. Some may start avoiding anything which can induce that imagery. Others may take to substance abuse as a coping mechanism or withdraw themselves from social life. These are all signs of PTSD. Dr John explains that for example, even when they just look at rain, they may feel anxious and get startled by small things.

A girl who has left her flood-affected home rests on her baggage at a relief camp in Kochi.(Photo: AP)

A mother of two went through exactly what Dr John describes. Her house got submerged in knee-deep water back in 2010. The water had reached till her baby’s crib. Thankfully, her baby that day was with her in the bed instead of the crib but she wondered “what if”. They didn’t incur any losses and they emptied the water after hours of work. But she dealt with the anxiety and panic attacks for almost five years before she could find closure. She used to start packing up valuables and shifting them to upper shelves at just the sight of dark clouds.

80 percent of people may have psychological symptoms and 15-25 percent may suffer psychiatric disorders.

Dr John adds that nearly 80 percent of the people in situations like these have psychological symptoms, not psychiatric disorders but symptoms like fear and anxiety, which may wane off in due course. But 15-25 percent people may suffer a lasting impact. If it goes beyond say, three and a half weeks, then its a psychiatric issue. Rehabilitation and counselling efforts, however, should start right away.

A boy cries as he sits in a boat after being rescued by volunteers in Kerala. (Photo: AP)

What Should Be Done?

There is already help that has been mobilised, even psycho-social teams, but there has to be a direction to all those things now. They can set up self-help groups in the relief camps and start counselling there and then.

Dr CJ John, Chief Psychiatrist, Medical Trust Hospital, Kochi

In the camp, all the people are going through the same type of stress and its easier to nip it in the bud. As the three suicides show, the problem is going to creep in when they go back to their homes and there needs to be a plan to address this issue.

After the Tsunami hit Tamil Nadu in 2004, psychiatrists from Chennai’s Institute of Mental Health visited the affected areas and its director Dr M Murugappan had then narrated the way in which they dealt with the survivors.

We first allow people to vent their feelings. Even if we hear them for 10 or 15 minutes, that itself is therapy. Then we ask pointed questions about any complaints that may be mistaken for physical illnesses but are manifestations of mental ill-health.

Flood-affected children at a relief camp site in Kochi.(Photo: AP)

Children play next to relief material packed for distribution at a relief camp in Kochi.(Photo: AP)

In Kerala, a group of experts and volunteers are reportedly making efforts to take care of the mental health of the kids affected by the deluge through storytelling, games and art. Through such sessions they’re trying to make the children overcome the stress in a positive way.

Dr John lays down some rehabilitation steps.

• For the people’s loss, first, there should be social and economic rehabilitation – to increase their confidence and support them.
• Support from people around and companionship will help to recover.
• People should be encouraged to share their distress, talk to people and not keep things within themselves. It is this connectivity that keeps people positive in these situations
• They need to relieve their tension, indulge in activities like listening to music, and be part of social life through the rehabilitation.

No one should shy away from seeking all sort of help that’s available in rehabilitation, small or big, rather than feel alone under the huge burden of doing it all by themselves.