Treating the trauma caused by natural disasters

If you listened to Andrew Cuomo’s State of the State address a couple of weeks ago, you may have noted that the very first item he mentioned on his list of challenges that Americans are facing in 2020 was the series of earthquakes that hit Puerto Rico in January. “We’ve already sent people to help,” the governor said. “Marcos Crespo, Rubén Diaz, Nydia Velazquez and I were on the first plane that went to Puerto Rico after Hurricane Maria, and we’re going to be going back to Puerto Rico with New Yorkers once again to help them.”

Officially titled the Empire State Relief and Recovery Effort for Puerto Rico and the US Virgin Islands and more colloquially known as New York Stands with Puerto Rico, the state’s recovery assistance program was launched shortly after Hurricane Maria’s landfall in September 2017. Since May 2018, SUNY and CUNY student volunteers have deployed to Puerto Rico on a regular basis to clean, restore and rebuild homes with not-for-profit partners. Last month, Cuomo deployed the National Guard to the island along with additional assets, including building experts and mental health professionals, to help Puerto Ricans respond to the recent earthquakes.

Within the field of mental health, strategies and techniques for coping with the emotional traumas associated with natural disasters, large-scale industrial accidents and the like are a specialized subfield in themselves. And in New York State, the flagship training program for this specialization is housed right here in New Paltz, on the SUNY campus. It’s called the Institute for Disaster Mental Health (IDMH), and its director, Dr. Amy Nitza, has been at the forefront of the state’s efforts to assist Puerto Rico with the psychological aftershocks of first the hurricane, then the earthquakes. The New Paltz Times caught up with her the day before she headed back to the island to conduct a weeklong “train the trainer” program for local professionals who work with trauma-impacted young people.

“I was headed to Puerto Rico two Thursdays ago when the earthquake hit. I was literally at JFK and had checked my bag,” she said. The original plan, she said, was for her to conduct a mental health support training for mental health professionals and faculty at the University of Puerto Rico. The trip had been organized in response to a plea from two professors from the island who attended a November 2019 conference in Albany conducted by Resilience through Innovation in Sustainable Energy (RISE), a University of Minnesota-based consortium focused primarily on restoring the power grid that had been devastated by Hurricane Maria. But after the earthquake forced postponement of the training, other stakeholders came forward wanting assistance in Nitza’s area of expertise. “My phone hasn’t stopped ringing,” she said. So additional training sessions were shoehorned into her schedule. “I’ll be training all day, every day,” with not only psychology students but also first responders, journalists and the staff of NGOs serving children, such as the Boys and Girls Clubs from all the across the island, expected to come away better-equipped to provide “trauma-informed” services.

“It’s not therapy,” Nitza explains. “The goal is to build capacity there – to offer whatever knowledge and resources we have, so they can develop a plan of response.” Whereas traditional psychotherapy is geared toward rooting out deep-seated emotional blocks, typically arising from the patient’s early relationships with his or her parents, disaster situations call for an entirely different, more immediate approach to trauma. “This is not the time for that. ‘Psychological first aid’ is the recommended best practice, and anybody can be trained to provide that.”

Nitza, who took over directorship of the IDMH program in 2016 upon the retirement of its founder, longtime SUNY New Paltz Psychology professor Dr. James Halpern, has already led one contingent of students in her program on a relief mission to Puerto Rico in the wake of the hurricane. “New Paltz first got in during the summer of 2018. There were 30 students in my group total, 15 of them from New Paltz. There were a total of about 500 that summer, coming in two-week waves. The focus was really not on mental health; we were up on roofs fixing cracks. Through the process the students really got to know the homeowners.”

The reconstruction efforts that first summer post-Maria had been partially funded by UNICEF USA. While the most immediate need was to help people make their homes habitable again, Nitza said, “It was pretty clear to us that mental health was an important part of what could be done.” So last summer, while IDMH special programs manager Cassandre Surinon was leading another New York Stands with Puerto Rico student group to fix more storm-torn houses, UNICEF USA gave IDMH a grant “to train teachers to understand the effects of trauma on kids and develop strategies.” The intent of the pilot project was to train students from the University of Puerto Rico to offer group counseling and then send them out to schools in the eastern part of the country, in the communities hardest-hit by Maria.

And now the ravaged island has more devastation to remedy, in the wake of the earthquakes. Federally allocated hurricane aid has already been held up for more than two years by the Trump administration, prompting Governor Cuomo to step into the breach. More student groups will be going back to Puerto Rico this coming summer. A group of eight from SUNY New Paltz was already scheduled to visit the island of Abaco in the Bahamas, to assist with reconstruction following last September’s Hurricane Dorian. “I was there about three weeks afterward. It was just utter devastation – blocks and blocks where every structure was rubble. All the people were relocated to shelters, mostly on other islands.”

For Nitza, who began her training in disaster situations during the HIV crisis in Botswana in 2008-09 on a Fulbright scholarship, and who worked for several years in Haiti after its earthquake, running IDMH is her “dream job.” The program offers an interdisciplinary undergraduate minor in Disaster Studies and a graduate certificate in Trauma and Disaster Mental Health. IDMH deputy director Dr. Karla Vermeulen heads up the certificate program, a specialization sought mainly by students pursuing their Masters in Counseling. The Disaster Studies minor requires a 90-hour practicum in Disaster Response, which students may fulfill by volunteering with the Red Cross, the county Emergency Management Office or other NGOs…or by going to a place like Abaco or Puerto Rico and fixing holes in people’s roofs.

While mixing concrete and pounding nails weren’t what many of these undergrads had in mind when they signed up for the program, Nitza sees such hands-on activities as an effective way of grounding her students in the nitty-gritty work of disaster response. “It was transformative for me, and I know it was for the students. It really expands their worldview,” she said of the Puerto Rico trip in 2018. “I saw the effect on those students and the homeowners. We’ll keep doing it as long as there’s an opportunity to do it.” She smiles with a sense of satisfaction in her work. “We’re helping people get back to pre-disaster.”