In September 2022, Puerto Rico, Cuba, and Florida are experiencing devastation from hurricanes. Extreme weather events — floods, hurricanes, and natural disasters like wildfires — are linked to a broad range of adverse mental health outcomes. The most reported mental health conditions in the aftermath of extreme weather events and natural disasters are post-traumatic stress disorder (PTSD) along with depression, anxiety, suicide, and substance abuse disorders (Cianconi et al., 2020).

Mental Health Systems Are Strained After Wide-Scale Disasters

Those impacted by the recent climate events are just beginning their journey. Emergency response mental health workers will be present in the initial days. However, the lasting impact for a community devastated by natural disasters lingers for weeks, months, or years. There is a strain on mental health systems as the number of people needing assistance exceeds a community's capacity.

Suggestions for Helpers

For those assisting individuals during and after a disaster, the following suggestions reflect lessons learned by the Trauma Resource Institute as we have been invited to help communities after human-made and natural disasters:

1. Be careful not to interrupt the work of emergency response workers. Rescuing survivors and stabilizing infrastructure, such as restoring electricity, are priorities.

2. Help identify where survivors can acquire concrete services: water, food, shelter, hygiene products, and bathrooms. Direct survivors to where governmental groups like FEMA have established temporary locations. The elderly may need assistance with completing documents to receive benefits. As a result of the destruction, people with disabilities may have difficulty maneuvering to sites to receive services. Organizations like the Red Cross, local disaster response units, FEMA, Save the Children, and faith-based groups can help network support for community members.

3. Communication systems may be down because of power outages. There can be increased anxiety in not knowing the well-being of family members, friends, and pets and whether homes are still standing. Try to provide as much information about when providers may restore communication systems.

4. You may assume that people need to talk about what happened during the disaster to heal. We have found that this is not necessarily true for every person. Inviting choices to share or not to share about what happened is essential. Questions like, "I am here to provide support. If you would like, we can talk about what happened if that would be helpful. You can share with me as little or as much of what happened to you as you would like."

Ask Strength-Based Questions to Remind Survivors of Encouraging Elements of Their Experience

5. Questions highlighting strengths can help survivors remember what else may be true now. Often when asking questions in this way, it broadens the perspective of the trauma to include other elements of the experience that were more positive. Questions can include:

• "When did help first arrive?'
• "When did you know you and your family were going to get to a safer place?"
• "What or who is helping you the most right now?
• If a person is agitated or sad, ask respectfully, "When challenging events have happened to you in the past, and what or who helped you get through?

Help Now! Strategies Can Be Simple and Effective Ways to Help

6. Another way to help calm a person who is distressed are the "Help Now!" strategies from the Community Resiliency Model set of wellness skills. They may appear simple, yet they can help people calm down and feel more like themselves. The following invitations can help children and adults experience a greater sense of well-being:

• Would it be helpful to go for a walk together?
• Sometimes, it helps to get the energy of anxiousness out by pushing against the wall with our hands or our back against it. Do you want to do it with me?
• Can I get you a drink of water?
• If I am anxious, sometimes it helps me to count down from 20. Would you like to try it with me?
• If I am feeling a lot of tension in a part of my body, I try to find a part of my body that is less tense. Then, I bring my attention to the parts that feel better. Do you want to try doing this?
• I found this app called iChill, and I listen to it when I am down or too anxious. You might want to consider using it when you are stressed or down.