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Context Concerns about mental health recovery persist after the 2005 Gulf storms. We propose a recovery model and estimate costs and outcomes. Objective To estimate the costs and outcomes of enhanced mental health response to large-scale disasters, using the 2005 Gulf storms as a case study. Design Decision analysis using state-transition Markov models, for 6-month periods from 7-30 months post-disaster. Simulated movements between health states were based on probabilities drawn from the clinical literature and expert input. Participants Hypothetical cohort, based on the size and characteristics of the population affected by the Gulf storms. Intervention Enhanced mental health care consisting of evidence-based screening, assessment, treatment, and care coordination. Main Outcome Measures We report morbidity, in 6-month episodes of mid/moderate or severe mental health problems through 30 months post-disaster; units of service (e.g., office visits, prescriptions, hospital nights); intervention costs; human resources Results Full implementation would cost $1,133 per capita, or over $12.5 billion for the affected population; yield 94.8-96.1% recovered by 30 months; but exceed available provider capacity. Partial implementation would lower costs and recovery proportionately. Conclusions Evidence-based mental health response is feasible, but requires targeted resources, increased provider capacity and advance planning.

This study describes a videovoice project implemented in post-Katrina New Orleans during a pivotal time in city rebuilding and revitalization. Videovoice is a health advocacy, promotion, and research method through which people get behind video cameras to research issues of concern, communicate their knowledge, and advocate for change. Using videovoice method, a community-academic-filmmaker partnership engaged 10 Central City neighbors, who took part in an 18-week training and community assessment. The resulting 22-min film premiered before more than 200 city leaders and residents, reached more than 4,000 YouTube viewers during its first 2 months online, and was shared through the distribution of 1,000 DVDs. Viewing further helped mobilize the community for action on three priority issues: affordable housing, education, and economic development. Challenges in using videovoice, including privacy issues and cost considerations in a resource-poor community, are discussed. Despite such challenges, this method may provide community-academic partnerships with the opportunity to equitably engage in research, produce independent media, and mobilize for action.

ClinicalTrials.gov Identifier NCT02561221.