Hurricane Katrina and 9/11 terrorist attack are one of the most tragic disasters in American history. Enormous damages were caused to the country and thousands of people became victims of these events. Hurricane Katrina became the deadliest hurricane in the United States in seven decades and the most expensive natural disaster in American history (Silke, 2003). When analyzing September 11 attack, it is clear that the disaster was thoroughly planned, significantly financed and carefully orchestrated. Instead of common terrorist method of blowing the airplane, they used aircraft as weapons, in such a way increasing the number of victims from hundreds to thousands. They had a clear purpose to elaborate organization that should be taken into account when taking measures to prevent similar attacks in future. Analysing the nature of victims’ psychological trauma, caused by hurricane Katrina and World Trade Center attacks, helps to better treat people who experienced similar traumas.

On September 11, 2001, terrorists turned passenger airplanes into weapons of mass destruction, crashing the World Trade Center in New York, a symbol of the world's financial markets, and crippling the Pentagon in Washington, DC. The damage caused by these events spreads beyond the extent of property damage or the number of dead and injured people. The lives of numerous rescue workers, police officers, family members, friends and bystanders were “shattered by the psychological, emotional, physical, spiritual and financial toll of these tragedies” (Silke, 2003, p. 134). Citizens of about 80 countries were among the tragedy victims.

On the morning of August 29, 2005, Hurricane Katrina made landfall on the Gulf Coast between the major cities of New Orleans, Louisiana, to the west, and Mobile, Alabama, to the east (Gabe, Falk, & McCarty, 2005). Fortunately, the majority of those areas’ inhabitants rode out the storm safely. More than 500 000 people were evacuated, but more than 1600 died. Nearly 90 000 square miles were declared a disaster area, that is roughly equal to the land mass of the United Kingdom (Kessler, Galea, Jones, & Parker, 2006). The main damage, such as loss of life, property destruction and sizeable displacement of the population was largely concentrated along the Gulf Coast within a 100-mile radius of the storm’s landfall. This area suffered great devastation due to high winds and storm surge. In addition, due to breached levees and flood walls, there was a flooding that affected the huge amount of people - much of New Orleans was flooded (Gabe, Falk, & McCarty, 2005).

Nearly all victims of hurricane Katrina disaster (95%) waited multiple days to be evacuated from the New Orleans area, which resulted in high levels of traumatic exposure and loss. Moreover, the majority reported sustaining minor-to-severe injuries and mild-to-severe illness in the hurricane or evacuation process (Gabe, Falk, & McCarty, 2005, p.19). More than 63% reported being directly exposed to corpses during the disaster, 14% of participants suffered the death of a relative or loved one, and the vast majority was separated from at least 1 family member for several days or more. Property loss was also prevalent and severe: majority of participants lost their home or vehicle. Moreover, 66% of participants who lost property lacked any form of property insurance (Mills, Edmondson, & Park, 2007).

Similar stress was faced by victims of 9/11 terrorist attack. Injured and alarmed, people were even killing themselves, jumping from the highest floors of the World Trade Center. Before dying in the aircraft that crashed into the Pentagon lots of victims managed to contact their family members (Silke, 2003, p.175). All these factors made victims dramatically transformed and lead to the development of post-traumatic stress disorder (PTSD) among them.

PTSD may be called the main psychological symptom of hurricane Katrina and 9/11 attacks’ victims. It is an anxiety disorder that usually develops after an individual has experienced a situation that causes severe physical harm (Mills, Edmondson, & Park, 2007). As a result of PTSD, a person may feel frightened and uneasy in a situation that presents no danger. People suffering from this disorder can often re-experience the traumatic situation in the form of flashbacks (Mills, Edmondson, & Park, 2007).

The New York University study (2007) found that the direct experience of September 11 atacks  resulted in a “flashbulb type of memory, the exceptionally vivid, confident and multisensory recollecting of a shocking public event” (Frenkel, 2007). Those in vicinity to the World Trade Center who saw and heard the final results of the attacks “showed depressed activity in the parahippocampal cortex, which encodes neutral peripheral details” (Frenkel, 2007). This modified brain activity could help to understand how flashbulb memories are shaped and why they are often more durable than other memory types(Frenkel, 2007).

Individuals with little financial resources or certain health problems are some of the most assailable in disaster situations, both in terms of initial exposure and ability to recoup (Mills, Edmondson, & Park, 2007). For example, while 54.4% of individuals without any previous psychiatric history met criteria for acute stress disorder (ASD), “the prevalence was 77.8% for individuals with a history of an anxiety disorder and 71.4% for those with a history of depression” (Mills, Edmondson, & Park, 2007). Thus, the regulation of complex disasters like hurricane Katrina becomes a substantial challenge to the current United States health care system and to mental health care specialists in particular. The absence of a qualified mental health care structure, as it was obvious in New York after 9/11, remains to be a national matter. Easy access of existing services to displaced individuals, who are often economically and socially disadvantaged and have different ethnic or socioeconomic background than service providers, is also a concern (Mills, Edmondson, & Park, 2007).

The destruction caused by Hurricane Katrina has lasted much longer than those after previously occurring hurricanes (Kessler, Galea, Jones, & Parker, 2006). The exact death toll may never be known but thousands were injured, killed or missing. The government scrambled to establish security, both on the ground and in the air. The two major categories of assistance were provided after the hurricane: public assistance, which encompasses various forms of aid to state and local governments and some nonprofit organizations, and federal assistance to individuals and households.

Federal assistance was provided to individuals and households who were uninsured to pay for necessary expenses, as a result of the disaster that could not be met otherwise, and included financial help to occupy alternative housing, provision of temporary housing units, home repair, and aid for other expenses (Gabe, Falk, & McCarty, 2005, p.10). In order to assist displaced residents in finding housing urgently, government was calling all property providers, such as state rental agencies, to list available rental housing on the free, statewide housing location services (Mills, Edmondson, & Park, 2007). The process of listing and searching was fast, easy, available online 24 hours and free. All individuals and organisations were encouraged to list the available housing.

Psychology plays a major role in terrorism consequence management. Public officials and mental health leaders took a proactive approach to providing mental health services after the September 11 terrorist attacks. Within an hour of the attacks on September 11, the American Psychological Association's Disaster Response Network (DRN) was in contact with the American Red Cross organization (Silke, 2003, p. 258). By noon, the DRN members met by conference call and within hours the Association had sent DRN co-ordinators to the disaster sites (Silke, 2003, p. 258).

FEMA awarded a Crisis Counseling Program grant of $ 132 million to New York State Office of Mental Health to provide immediate and intermediate-range services up to 1 year (Myers & Wee, 2005, p.256). The New York State Crime Victims Board provided nearly $6.5 million for the reimbursement of medical bills, personal property, or mental health counseling for injury victims of the 9/11 attack. In Washington DC, anyone who worked at the Pentagon was eligible for free counseling through Operation Solace. In New Jersey Project Phoenix, funded by FEMA, and Virginia's FEMA Crisis Counseling Project also provided free services. At the 1-year anniversary after the attacks, American Red Cross Disaster Mental Health Services had provided free mental health sessions to 238,280 victims of the attacks. In New York, the Red Cross also provided teams of disaster mental health workers 24 hours a day to help firefighters, police, emergency medical service, and other recovery workers at respite centers (Myers & Wee, 2005, p.256).

Long after incident sites are cleared and buildings restored, there will still be psychological wounds, many of which will never heal. The need for psychological intervention within this component continues for years. Studies held at New York–Presbyterian Hospital and New York University presented long-term neurological and psychological impacts on adults who were close witnesses of the World Trade Center terrorist attack and also impacts it had on children who lost a parent in this tragical event (Frenkel, 2007).

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The New York State Office of Mental Health estimated that as many as 1.5 million New Yorkers could need some kind of mental health help in the aftermath of September 11 (Frenkel, 2007). The American Red Cross trained approximately 1,000 mental health professionals in the private and nonprofit sectors on addressing the long-term mental health effects of the terrorism disaster (Frenkel, 2007). In the first 5 months after the September 11 attacks, the toll of stress on emergency personnel in New York was clearly evident. The New York police department ordered all of their 40,000+ employees “to attend half-day stress management educational sessions about the psychological distress they might experience” (Frenkel, 2007). The New York fire department required “mandatory physical examinations for firefighters that included psychological assessments” (Frenkel, 2007). Nearly 2,000 firefighters, fire officers, and workers saw a counselor through the department's counseling services unit in the first 5 months after the attacks, tripling the number usually seen in one year (Frenkel, 2007). Of those in counseling, 100% were diagnosed with PTSD or ASD (Frenkel, 2007). Additionally 650 fire workers were on light duty or medical leave at the 5-month anniversary due to “physical injuries-from respiratory ailments to broken bones” (Frenkel, 2007). Some of those personnel also had symptoms of extreme stress. 

Because of the wide geographical spread of the displaced population, a comprehensive assessment of hurricane Katrina survivors’ mental health does not exist. The Department of Public Health in Louisiana documented significant psychopathology among nearly 50 000 of the survived, who were cared for in evacuation centres soon after the disaster (Mills, Edmondson, & Park, 2007).

The most shocking finding is the lower conditional likeliness of suicidality among people considered to have mental disorders after hurricane Katrina compared with people interviewed before (Kessler, Galea, Jones, & Parker, 2006). A more credible explanation is that the impact of increased mental illness after hurricane Katrina on suicidality “were offset by protective factors activated by the hurricane” (Kessler, Galea, Jones, & Parker, 2006).

However, worse results were received from the interviews conducted with adults who evacuated to Kentucky, and were living in the state at the one-year anniversary of the event or had recently returned to the Gulf Coast (Kessler, Galea, Jones, & Parker, 2006). The psychological health of respondents was evaluated using several validated measures. More than a half met the criteria for PTSD and a majority had symptoms of depression and anxiety. The mean quality of life score was “0.6 on a scale from 0–1, suggesting that adaptation and return to pre-hurricane well-being had not occurred 12 months after the storm” (Kessler, Galea, Jones, & Parker, 2006). The potential for long-term psychological well-being damage exists in this group of disaster’s survivors. Results suggest that other evacuees may also be subjected to a heightened risk of psychological and neurological repercussions.

About one-fourth of the people who lived in areas damaged or flooded by hurricane Katrina were children under age 18 (Gabe, Falk, & McCarty, 2005, p. 23). Hurricane Katrina struck at the beginning of the school year, potentially displacing an estimated 183,000 children (Gabe, Falk, & McCarty, 2005, p.24). One more tragic consequence of both Katrina and 9/11 disasters is the number of children who lost their parents. The study that was conducted at Cornell (2007), dealt with children who tragically lost a parent in the World Trade Center disaster. Regardless of the fact that most were receiving intensive therapy during the two years, since the experienced loss, the prevalence of psychiatric disorders in these children “doubled from 32 percent before 9/11 to nearly 73 percent afterward” (Frenkel, 2007). The stress and separation anxiety after the loss were the most prevelent symptoms.

Children seemed to have chronic increase of the stress hormone cortisol in the saliva, which suggests that their acute stress response mechanisms remained switched on (Frenkel, 2007). According to the researchers, “long-term cortisol elevation may lead to hypersensitivity to stress later in life, which in turn could cause cognitive impairment, weak bones, and insulin resistance” (Frenkel, 2007).Understanding the nature of these vulnera­bilities may help to assist people who experienced similar traumas (Frenkel, 2007).

Serious emotional disturbance (SED) among children was the result of severe stress generated from traumatizing events as with Hurricane Katrina and September 11 attack.  There were lots of children with serious SED disorders, who exhibited distorted thinking abilities, high anxiety, and mood change. These actions are usually prevalent for a long period of time, which suggests that children with SED are not able to cope with their coevals or their surrounding environment (Seawell, 2010). A survey was held 18 to 27 months since hurricane Katrina to assess the prevalence of SED among children who had been exposed to the disaster.  This survey resulted in data that “9.3% of youths who ranged from 4 to 17 years of age were estimated to have SED that was directly caused by the events of hurricane Katrina” (Seawell, 2010).  It also found that stress exposure was compellingly correlated with SED, and that “20.3% of youths surveyed with high stress exposure had SED that was accredited by Hurricane Katrina” (Seawell, 2010). This finding suggests that even after 2 years SED is still widespread among youth that survived hurricane Katrina disaster, which means that there is still  a tremendous demand for psychological health treatment resources in areas where people are affected by this storm (Seawell, 2010).

Among the secondary effects of a terrorist attack that children faced were disruption of normal schooling, restrictions on travel, etc. (Silke, 2003, p. 158). Secondary effects were more severe in situation of hurricane Katrina disaster, i.e. poor availability of food and medical supplies, which had more severe health implications for the children involved.

Mass destruction events invite media coverage because the effects are dramatic and terrifying. News about hurricane Katrina disaster and its political, social, economic, and humanitarian influence have dominated global headlines since the natural disaster struck the Gulf Coast (Powers, 2005). The positive encouraging effect had the coverage that emphasized that both lesser-developed and impoverished countries, as well as typical adversaries of the United States, have offered humanitarian aid in the wake of the crisis (Powers, 2005).

Any resolve not to cover or dramatise terrorist action could not have withstood the magnitude and surprise of the September 11 attacks, which simply could not be ignored. Traditionally, terrorists have relied on the old saying, 'Kill one and frighten ten thousand'. Today's terrorists understand that with the impact of the media they can kill thousands and frighten millions (Silke, 2003, p. 260). This is what happened on September 11, 2001. While media coverage is essential in achieving the terrorist goal, measuring its impact is not easy. Since, media coverage is so integral to the process, it may be impossible to separate the impact of the media from the impact of the event itself. After all, indirect victims of terrorism do not exist until they know about the event. This is also true for other disaster situations.

While the public appetite for information and visual confirmation of incidents such as September 11 is extensive, it is clear that exposing children and young people increases the stressful impacts of the event. The Pfefferbaum study (2003) showed that PTSD scores were greater when the proportion of television viewing was higher at the time of the incident. While some effects from such catastrophes are inevitable, the impact on children and young people could definitely be reduced, if their television exposure to the event was limited (Silke, 2003, p. 192).

Most of individuals were not physically on-site or in immediate danger and were not related to direct victims – they instinctively turned to television, radio and the Internet to learn what had occurred. The media, so essential in providing information, became the vector of fear—a powerful weapon of the terrorists. For these direct and indirect victims, it may never be possible to tease apart the impact of the event from the impact of media coverage of it (Silke, 2003, p. 181). There is a clear dependence of stress levels from television exposure, but still television coverage that day and the following days constituted a major source of information and may have been a means of coping for individuals interested in obtaining information about the situation or what to do (Silke, 2003, p. 181).

Hurricane Katrina and September 11 events caused not only physical devastation, but they caused destruction within the psyches of the people who experienced its destructive forces first hand and survived. Individuals and communities must find a balance between anxiety and preparedness, and resiliency and optimism, in order to go on with productive and fulfilling lives (Myers & Wee, 2005, p. 246). The knowledge we’ve acquired when analyzing and assessing the disasters’ effects should be used to contribute significantly to the prevention of future catastrophes’ negative impact. By researching and understanding the character and origin of mental health disorders of people affected by hurricane Katrina and 9/11 attacks, it is possible to avoid or better treat similar symptoms in future.

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