According to a new study conducted at Princeton University, many survivors of 2005’s Hurricane Katrina are still struggling with poor mental health even today, years after the storm.

Lead researcher Christina Paxson and her team began this project in 2003 as a study of low-income adults enrolled in community college. They used sites around the country for their research, three of those sites were located in New Orleans. Their original questionnaire asked participants for their opinions on topics related to education, income, families, and health.

After Hurricane Katrina hit in August 2005, the researchers decided to continue to track the New Orleans-based participants because the type of information they had was very rare in disaster studies, as they already knew much about the individual’s mental and physical health. In most disaster studies, researchers are never able to determine if the participants are suffering because of the disaster or because they already had underlying conditions that would have led to poor mental health even before the disaster hit.

With data collected one year before, 7-19 months after, and 43-54 months post-Katrina, they found that although symptoms of posttraumatic stress and psychological distress declined over time, these symptoms were still high 43-54 months after the storm. They also found that damage to the home was an especially important predictor of chronic posttraumatic stress symptoms, with and without symptoms of psychological distress. Those individuals with higher earnings and better social support reported better outcomes in the long run, but results indicate that mental health issues still remain a concern for hurricane survivors.

Even four years after the storm, researchers found that about a third of participants still reported high levels of posttraumatic stress and about 30 percent reported suffering from psychological distress.

According to Paxson, “I think the lesson for treatment of mental health conditions is don’t think it’s over after a year. It isn’t.”

To read more about the study, see January’s issue of Social Science & Medicine.

What do you find most beneficial in working with survivors of traumatic events?

The National Defense Authorization Act recently passed by Congress omitted a key requirement, possibly making it easier for active-duty military personnel and veterans to receive mental health care.

Previously, mental health practitioners were required to be licensed in the state in which care was being administered. The removal of this provision means that military personnel and vets located anywhere in the US may be able to receive counseling through video teleconference technology from a mental health professional  located elsewhere.

A previous exemption allowed cross-state counseling only if both practitioner and patient were located on federal property, but the new law permits care to be provided at any location, including from a civilian location or even inside a patient’s home.

Limitations still exist, however. The delivery of care via telehealth into service members’ homes is not currently authorized under Tricare policy.

Nearly 20% of service members returning from Iraq and Afghanistan report symptoms of PTSD or major depression, according to a Rand Corporation study. And telehealth is a hot topic within the military—last year, the Department of Defense National Center for Telehealth and Technology launched an online educational tool that enables combat veterans to learn more about PTSD within a “second life”-type environment.

How do you feel about using telehealth technology to deliver PTSD therapy? What other changes must be made to make this type of counseling more accessible? Weigh in—we’d love to hear what you think.