By Taylor Knopf
After weathering the storm at home in the town of Marion, A.C. was without power and water and decided to make the 30 mile-trip to Asheville to get supplies. A.C. is the manager of a local restaurant and also wanted to check on her business and make sure her employees were okay. (NC Health News is using initials to shield this woman’s identity because of the online bullying and threats she received after posting and sharing video about her experience on social media.)
Similar to many western North Carolina residents, A.C. had been cut off from the world by Hurricane Helene — not knowing the full extent of the damage until she ventured out four days after the storm. Driving the back roads to Asheville, she came across upended cars lodged in mounds of mud and trees. She spotted what she initially thought were Halloween decorations washed away by the floods, but she soon realized they were likely victims of Helene. As she made what she later described as unwise choices to drive through floodwaters, she questioned whether she’d return home to see her child again.
A.C. said she reported the bodies to 911 and received a follow-up call from emergency responders asking more about location so they could go out and recover any victims. A.C. didn’t hear anything more after that. She said she would likely need mental health therapy to help her process the storm’s devastation.
A.C. is not alone. Other mountain residents have taken to online platforms to describe the mental stress induced by the catastrophic loss of life and property. They report feeling traumatized, shocked, overwhelmed and alone. Several have posted about being unable to sleep, some say they wake to imaginary sounds of trees breaking or to nightmares. Others have said they’re struggling to do simple tasks, such as drive down familiar roads.
Those who’ve evacuated the area express varying levels of survivor guilt — some say they feel as though they abandoned their communities, while others worry about the fate of friends and family they haven’t heard from yet.
While surrounding communities, nonprofits and local and federal emergency responders rush to rescue people and meet their basic daily needs, mental health providers in and outside of North Carolina want to help too.
There’s a growing list of more than 200 mental health providers from North Carolina and other states who are offering various levels of free mental health services and therapy to those affected by the storm. There’s also a growing Facebook group of local mental health providers that formed after the storm to share resources and help connect folks trying to meet people’s different needs.
Many health care providers from outside North Carolina who have offered to provide support via telehealth now can, thanks to an executive order signed by Gov. Roy Cooper over the weekend. However, there is still some red tape that needs to come down in order for North Carolina providers to keep supporting their patients who have left the state. That’s something leaders of the state’s mental health professional organizations have asked and will continue to ask state lawmakers to address.
Meanwhile, the North Carolina General Assembly unanimously passed a $273 million disaster relief bill on Wednesday to begin addressing the damage caused by Hurricane Helene. State lawmakers are expected to reconvene and allocate more funding once the various state and local agencies have a chance to better assess what the needs are.
Preparing to help
There’s been a flurry of activity across the state as donation and volunteer lists have been filling up in response to Helene. Everyone wants to do what they can, including mental health providers who are signing up to offer free counseling.
“We’re a helping profession, so everybody wants to hurry up and help,” said Valerie Arendt, executive director of National Association of Social Workers North Carolina Chapter.
“There’s still search and rescue going on, and it’s important for folks not to self deploy,” she said. “Then try to go through the appropriate channels, because if people just show up and they don’t have that crisis response and disaster response training, they sometimes do more harm than more good.”
Food, water and supplies are limited, and without a plan, people who show up wanting to help could unintentionally end up taking resources from those in need, Arendt warned.
For mental health providers who want to go in person to help in Western North Carolina, Arendt said they should go through the American Red Cross’s health care volunteer portal or the governor’s office, which has set up a form, to be appropriately deployed. The American Red Cross also provides disaster training, which is a good first step for volunteers to prepare themselves to help.
For those already part of a health system in North Carolina, there are ways to provide relief to health providers in western North Carolina, said Katy Kranze, executive director of the N.C. Psychiatric Association.
“You can do system-to-system credentialing, and you can provide relief for services,” Kranze explained. “I know that Duke and UNC are building up their resources that way to provide relief for the people who live in Asheville that have been sleeping at the hospital and working nonstop. So that’s another official type of avenue that we’re trying to push our folks in.”
Long-term impact
Arendt is reminding providers who want to help immediately that the mental health needs following Hurricane Helene will be long-term. She said some willing providers may need to be patient right now and prepare themselves to help WNC residents process this tragedy in the coming months when they’re ready and more accessible. Cellular and internet services are still spotty for many.
Studies have shown that the long-term mental health impact of natural disasters can last years. Research shows catastrophes can worsen symptoms of mental illness and lead to new diagnoses of depression, anxiety and post-traumatic stress disorder.
Experts who have assisted communities in eastern North Carolina after multiple hurricanes have observed that mental health needs typically surge three to six months after a storm. This is the period when the initial adrenaline rush subsides, search and rescue operations conclude, media coverage diminishes and the daunting challenge of rebuilding begins to set in.
North Carolinians outside of the affected counties may also be feeling some stress as they see the images of the devastation caused by Hurricane Helene, which shattered our previous expectations of these storms, explained Martha Turner-Quest, executive director of the North Carolina Psychological Association.
Turner-Quest has family members who live in houses on 12-foot stilts on the Louisiana coast where hurricane preparedness is a way of life, she said. Eastern North Carolina residents can relate to this as well. She argued that Hurricane Helene should make all residents of coastal states prepare for storms differently.
“For me, what clicked this time is that none of us are safe in these coastal states,” she said, adding that the idea that because someone lives in the Triangle area or the mountains they won’t be affected too severely by these storms is gone.
Out of state licensure issues
While the governor’s executive order allows health providers from other states to help North Carolinians, it does not allow providers licensed in North Carolina to continue treating their patients once they have crossed state lines. Kranze said she’s heard from psychiatrists in the Asheville area who are unable to provide care to their patients who have temporarily evacuated to other states due to this licensure limitation.
Kranze explained that they have been working with other states to determine which ones have licensure waivers in place to allow out-of-state providers to continue treating evacuated patients. Tennessee has an executive order similar to North Carolina’s, however, not all surrounding states do right now. This is where professional licensure compacts come into play.
North Carolina lawmakers have passed legislation to allow several professional licensure compacts, which allow those providers that hold active licenses to treat patients in other states who have entered into the compact as well. For example, North Carolina entered into one for counselors and psychologists, but not for social workers or psychiatrists.
Arendt has been pursuing a compact for social workers. A bill was introduced in the Senate last legislative session with bipartisan support, but it never made it out of the committee to a floor vote. With an inter-state compact, North Carolinians wouldn’t have to wait for an executive order to receive out-of-state help from social workers, Arendt said, and North Carolina licensed social workers would be able to treat their patients when they cross state lines.
She said her organization will continue to advocate for this compact, adding that maybe health needs caused by Helene will motivate lawmakers to “do the right thing.”
Grassroots groups form
Carolyn Miller is a social worker with a private practice called The Healing Point in coastal Wilmington, and she is all too familiar with the short-and long-term mental health repercussions of a natural disaster.
“The impacts of Florence were not just in the days and months after, they were years later,” she said of the 2018 hurricane. “I see children and adults right now who just a simple thunderstorm can create a lot of panic and anxiety because their body and their brain remembers Florence.”
During Hurricane Florence, Miller herself evacuated and couldn’t go home for two weeks.
“I felt so helpless,” she said. “I wanted to help. I wanted to check on my clients, I wanted to see my friends and my neighbors, and I couldn’t get back home. I feel the same way now about western North Carolina.”
Miller was on the receiving end of help and support in 2018, and now she wants to pay it forward to those in the mountains. She banded together with Allie Barker, a social worker and Owner of Nurture Within Counseling PLLC, to create a list of mental health providers in and out of state who are offering varying levels of individual and group therapy sessions to those affected by Helene. Some on the list have included their specialties, including experience working with first responders, children or Spanish speakers.
The initiative took off rapidly with more than 200 providers signing up to offer free support in less than a week after the storm. Miller said there are even more on a backup list that they will add to the master list as the available slots fill up.
While a handful of the volunteer mental health providers live in western North Carolina and can see people in person, the majority are offering telehealth sessions or in-person sessions to evacuees if they happen to be in their area. Miller added that telehealth advancements since the COVID-19 pandemic have made the response to Helene markedly different from what she remembers during Florence.
Barker said the list has been given to community leaders, community members and officials at the state health department to help get it into the hands of people on the ground.
“The response from providers all across the state have been incredible, and I’m hopeful that we can all start healing soon,” she added.
Mental health providers are also converging in a Facebook group — NC Mental Health Emergency & Disaster responders — that’s grown to almost 1,000 members in one week. The group was started by Adriana Scott-Wolf, a licensed counselor in Wake Forest. Overwhelmed by all the information shared on different non-health care pages and groups, she decided to try to condense it all and funnel mental health providers to one closed Facebook group.
“I was getting too much information from too many different places, and it was very hard for me to reference back where I saw something that was helpful,” she said. “We’re all trying to do something to help that is within our control.”
Crisis numbers and support groups
The Disaster Distress Helpline is a national multilingual hotline that offers crisis counseling 24/7. Call or text: 800-985-5990. Para Español: Llama o envía un mensaje de texto 1-800-985-5990 presiona “2.”
National suicide and crisis lifeline: call or text 9-8-8 anywhere in the United States 24/7 for help and local resources.
Vaya Behavioral Health is the organization that manages public behavioral health dollars for the N.C.’s western counties and has many resources, including county-by-county up-to-date information on walk-in behavioral health clinics that are open. Vaya’s Behavioral Health Crisis Line (1-800-849-6127) is available 24/7, and the Vaya’s member and recipient service line (1-800-962-9003) is available Monday through Saturday from 7 a.m. to 6 p.m.
North Carolina-based Warmline 1-855-PEERS-NC (1-855-733-7762): This peer-run mental health support line is staffed 24/7 by people with lived experience of mental illness with Promise Resource Network in Charlotte. Other warm lines based in the United States can be found here.
The list of mental health providers offering free individual and group therapy to Helene victims in North Carolina.
The resource list Coping with the impact of Helene was put together by Kathleen Turner, the social and emotional learning specialist at Claxton Elementary with Asheville City Schools. It includes resources to help children through a crisis.
Resources for Resilience is holding daily virtual listening circles from noon to 1 p.m. ET for those affected by Helene now through Oct. 18.
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