In the aftermath of Hurricane Katrina, there’s been sporadic media coverage of traumatized survivors struggling with mental health problems. Years later, the children who experienced the disaster are still drowning in the emotional fallout. In a mostly Black community, whose health system was already broken pre-deluge, the Government Accountability Office reports that youth with mental health issues still face various obstacles in getting the support they need—from hard barriers of cost to softer walls of social stigma:

Stakeholder organizations most frequently identified a lack of mental health providers and sustainability of funding as barriers to providing mental health services to children in the greater New Orleans area; they most frequently identified a lack of transportation, competing family priorities, and concern regarding stigma as barriers to families’ obtaining services for children.

Sadly, the problem that left people unable to escape the disaster in the first place—a lack of transportation—also impedes many from getting to a care provider. The general inaccessibility of care was highlighted recently in the community response to a controversial proposal to close a youth mental health hospital. The subsurface issue is the scarcity of culturally competent care for people of color. A federally supported study on post-Katrina mental health service use in New Orleans identified several groups especially prone to “undertreatment” the very young and elderly, poorer people, and people of color. Citing "[s]tructural, financial, and attitudinal barriers" to care, the researchers concluded that several months following the disaster, “Few Katrina survivors with mental disorders received adequate care." In general, they wrote, “Although people with lesser means and those from minority groups are at higher risks of psychological sequelae from disasters, they are underserved when it comes to their mental health care needs." The quiet crisis is playing out on a national scale as well: American Indians, Blacks and Latinos report feelings of distress and despair at higher rates than whites. Yet those problems often fly under the radar of the white-dominated mental health infrastructure. For youth of color, mental health care disparities overlap with intervention by the juvenile justice and child welfare systems, two institutions plagued with racial disproportionality. In New Orleans, despite numerous reports over the years and some sputtering streams of federal funding, poor children of color are still growing up in communities where counseling and treatment are invisible or nonexistent. The best hope in the short term may be found in grassroots initiatives like the Common Ground Health Clinic or the REACH NOLA Mental Health Infrastructure & Training project, which aim to strengthen mental health services through partnerships between community-based organizations and healthcare providers. The government has run into criticism for inadequately funding post-Katrina reconstruction efforts. But physical rebuilding means nothing when the next generation is condemned to live in a crumbling psychological interior. Image: New Orleans Adolescent Hospital (via flickr)