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Mental stress is challenge in Keys

BY PJ HELLER | BIG PINE KEY, Fla. | October 30, 1998

BIG PINE KEY, Fla. (Oct. 30, 1998) -- The devastation wreaked by

Hurricane Georges when it slammed into the Florida Keys goes far beyond the

visible damage to homes and property.

The storm also shattered people's lives, affecting them so deeply that

mental health and substance abuse counselors are now hard-pressed to keep

up with the demands for service.

"What we're seeing on an outpatient basis are people who are dealing

with depression and frustration," reported David Rice, chief executive

officer of the Guidance Clinic of the Middle Keys. "On an in-patient basis,

we're seeing a substantial increasein domestic violence that's usually

alcohol associated and a tremendous increase in the demand for our

substance abuse/detoxification services."

At an Oct. 22 meeting in Big Pine Key of the de facto unmet needs

committee, Rice warned that his small facility was unable to handle the

number of referrals it was receiving and was being forced to turn patients

away because of a lack of staff.

"We're overwhelmed," he said. "Funding is simply inadequate. There is no

way we can provide the services (to people in need)."

Faith-based organizations are doing what they could to assist affected

residents. Among the programs is a support group that is meeting weekly

with a grief counselor at St. Peter's Catholic Church on Big Pine Key and

"healing worships" that are being held at the Big Pine United Methodist


Rice said the depression, frustration, substance abuse and other

symptoms exhibited by Keys residents was fairly typical of people involved

in a disaster.

"What we're experiencing is fairly classic," he said. "Typically what

happens when you have a disaster is there's a period of time when everybody

rallies and helps everybody and that's when everybody is giving 110


"Then you go through a 'honeymoon' period where everyone believes or

desperately hopes that everyone is going to come in and save you," he said.

"Then you go through a period of long-term recovery. I would say we're

starting to get into that.

But, he warned, "When you get into that area you're dealing with things

that really place a great demand on your substance abuse and mental health

services because you're dealing with depression. You're dealing with

alcohol and the increasing use of alcohol as a result of frustration and


Rice said the frustration and depression is the result of people

realizing that "many of the helping agencies really don't have all the

answers for them."

Coupled with that is the fact that many people have been forced out of

their homes by the storm and forced to find shelter in other communities.

More than 4,300 homes, apartments and mobile homes were damaged or

destroyed in the Keys when Georges ripped into the area on Sept. 25,

according to the American Red Cross.

"What usually happens is that people move in with friends," Rice noted.

"That will last for a couple of weeks. Then life needs to move on for

everybody. Friendships start wearing thin, frustrations increase and that

leads to people not really knowing where to go."

The Rev. Tony Mullane of St. Peter's Catholic Church said that in the

month since the hurricane he has seen people's emotions range from denial,

acceptance, depression, frustration and anger at the system. One of their

greatest frustrations is what seems like a never-ending cleanup effort, he


"One person thought they could clean up the debris in their yard in

three days," Mullane related. "It's been three weeks and it's still not


"The main thing is to try to get people to the stage where they look at

the situation realistically and they can see their way out of the mess," he


But Rice said getting to that point could be a long way off, especially

because of the unique Keys environment.

"Under a normal disaster recovery, you would expect that a year down the

road most people would have their lives back on track with some semblance

of normalcy," he said. "I don't know if that's a good prediction here. It's

a little different here."

Those differences were already exacerbated by a severe housing shortage

and an expensive housing market, along with some of the most restrictive

building codes in the state. Many of the mobile homes destroyed in the

hurricane cannot be replaced under current Monroe County building codes.

Others may have to be elevated to prevent storm damage in the future.

"I think what we mostly fear...is we will lose people from the labor

force, which is already inadequate," Rice said. "Without that labor force

we can't operate. As we drive those people out of the Keys because they

can't find places to live that they can afford, we really create a

tremendous problem. I don't know what the solution is."

He also said that the state is not set up to provide short-term mental

health treatment and substance abuse for victims of a disaster. Although

the state will bring in crisis counseling teams, their function is to refer

people to existing programs in the community, Rice explained.

"Unfortunately, I didn't have counselors sitting around with nothing to

do before the storm," he said. "Logic only tells you that you're going to

need some more help if you're going to meet that need."

In addition, three of 10 substance abuse/detox beds at the clinic

currently cannot be used because there are no funds available for staffing

those beds, he added.

"There appears to be no planning process in place that will come in and

allow for funding to build up your treatment program for a temporary period

to meet needs like this," Rice said.

A spokesman for the Federal Emergency Management Agency said that funds

for such services were available. Rice said he was exploring different

options to obtain money to expand the clinic's services, which he described

as "rather strained right now."

Both he and Mullane said that children in the Keys were not only

affected by the storm but were being impacted by their family's situation.

Typical situations include behavioral problems at home and school, Rice


"What I'm seeing primarily is children who are impacted by what's going

on with the disruption of their living conditions," he said. "I think the

children issue is more in relation to what has happened to their families

since the storm. Parents are boozing it heavily, are into more arguments

and fights around the home, and the children are reacting to that."

"Right after the hurricane there were 800 children out of school, so

you're talking about a lot of displaced children and their lives being

disrupted," Mullane added.

Posted October 30, 1998

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