COMMENTARIES Mental Health and Recovery in the Gulf Coast After Hurricanes Katrina and Rita

HURRICANE KATRINA WAS THE MOST DEVASTATINGnatural disaster in US history. Large parts ofNew Orleans and nearby Louisiana parisheswere destroyed. About 90 000 square miles of the Gulf Coast, an area roughly the size of Great Britain, was declared a federal disaster area. The often contami-nated flood waters covering much of New Orleans for almost 2 months contained a mix of raw sewage, bacteria, millions of gallons of oil, heavy metals, pesticides, and toxic chemicals, raising health concerns for residents and cleanup workers. As recently as June 19, 2006, Federal Emergency Man-agement Agency (FEMA) officials estimated that as many as 2.5 million Gulf Coast residents may have been dis-placed from their homes by hurricanes Katrina and Rita; this number is based on FEMA applicants whose mailing ad-dresses were outside of their home ZIP code and the as-sumption that each applicant represents an average of 2.5 people.1 Although more than 1.5 million residents fled the storm, hundreds of thousands remained behind, many of whom died or were injured during or in the immediate af-termath of the storm. As of July 2006,more than 1800 deaths were reported, including 1577 in Louisiana, and 231 inMis-sissippi.2,3 The number of fatalities would undoubtedly have been higher without prestorm evacuation and the efforts of many government and military personnel, first respond-ers, area citizens, and volunteers