Storm Impact and Depression Among Older Adults Living in Hurricane Sandy–Affected Areas

Abstract

Objective: Research on the impact of natural disasters on the mental health of older adults finds both vulnerabilities and resilience. We report on the rates of clinically significant depression among older adults (aged ≥60 years) living in areas affected by Hurricane Sandy in 2012 and the factors associated with mental health need. Methods: The Sandy Mobilization, Assessment, Referral and Treatment for Mental Health (SMART-MH) program integrates community outreach and needs assessments to identify older adults with mental health and aging service needs. Older adults with significant anxiety or depressive symptoms were offered short-term psychotherapy. Social service referrals were made directly to community agencies. All SMART-MH activities were offered in Spanish, Russian, Mandarin/Cantonese, and English. Results: Across the full sample, 14% of participants screened positive for depression. Hurricane Sandy stressors predicted increased odds of depression, including storm injury, post-storm crime, and the total count of stressors. Outcomes varied significantly by age group, such that all Sandy-related variables remained significant for younger-old adults (aged 60-74 years), whereas only the loss of access to medical care was significant for older-old adults (aged ≥75 years). Conclusions: Storm-affected communities show higher rates of depressive symptoms than seen in the general population, with storm stressors affecting mental health needs differentially by age group. (Disaster Med Public Health Preparedness. 2017;11:97-109)

Health Impact of Climate Change in Older People: An Integrative Review and Implications for Nursing

“…Three of the four studies were qualitative and examined the resilience experienced after a flood. In contrast to the stereotypes of frailty, older people were reported to be resilient or demonstrate characteristics of resilience after a flooding experience (Brockie & Miller, ; Cohen et al., ; Hrostowski & Rehner, ; Nitschke et al., ; Sirey et al., ). They reported “a new sense of commitment and belonging to their communities, interest and appreciation of life, and a rediscovery of their abilities to make valuable contributions” (Hrostowski & Rehner, , p. 343).…”

“…They were 4.49 times more likely to have an emergency evacuation plan and have a 3‐day supply of medications compared to their younger counterparts (Kang, ). Older people reported changes in their quality of life after a flooding experience (Sirey et al., ; Wu et al., ).…”

“…At the individual level, this includes personal disaster preparedness (Kang, ), coping strategies (Bei et al., ), personal strength (Hrostowski & Rehner, ), perceived positive impact after flood (Sirey et al., ), and (personal heat) protective behaviors (Abrahamson et al, ; Loughnan et al., ; Nitschke et al., ). At the family and community level, social support (Brockie & Miller, ; Sirey et al., ) and connectedness (Nitschke et al., ) were reported. Those with two or more family members are 2.92 times most likely to have a 3‐day supply of medications compared to those living alone (Kang et al., ).…”

“…Morbidity and mortality related to typhoons and flooding are predominantly related to injuries, drowning, and mental health problems such as depression, posttraumatic stress disorder (PTSD), and anxiety (Bei et al, 2013;Myung & Jang, 2011;Sirey et al, 2017). Older people are at a higher risk for drowning compared to their younger counterparts (Ching, de los Reyes, Sucaldito, & Tayag, 2015;Myung & Jang, 2011).…”

Advances in Psychotherapy for Depressed Older Adults

“…SMART-MH is a novel service delivery model embedding clinicians into senior centers where they provide outreach services, mental health screening, referral, and the provision of psychotherapy. Preliminary findings highlight the increased mental health needs of this population, with 14% of participants screening positive for depression and hurricane-related stressors predicting increased odds of depression [85]. Among a subsample of diverse elders who received a brief six-session version of ENGAGE psychotherapy (described below), most participants (74.2%) who were offered therapy completed the full 6 sessions.…”