When four back-to-back natural disasters hit southwest Louisiana three years ago, residents lost their homes, community and livelihood. And their struggles didn’t end there.
Federal aid took nearly two years to be approved and even longer to arrive. Fraudulent contractors robbed survivors of the little they had left. Battles between homeowners and their insurance companies continue to this day.
And as the region and its residents clawed their way out of the unprecedented destruction, the scars have become visible, said Tanya McGee, director of the Imperial Calcasieu Human Services Authority.
“When a trauma happens, and we had back-to-back traumas for almost a year and a half, people go into survival mode,” McGee said. “When they get out of that survival mode is when the actual trauma starts affecting their lives.”
McGee has the numbers to show it. In the year after the storms and flood, her agency provided mental health services to 3,900 residents. Over the last year, that number shot up to 4,440.
Some of this increase may be attributed to people returning. The providers to serve them, however, have not.
Psychiatrists, whose ability to prescribe medication makes them a crucial part of the mental health system, are in particularly short supply. “There’s a major shortage of psychiatrists in the Lake Area,” said Ellen Fontenot, central intake director for Oceans Behavioral Health, after rattling off a list of psychiatrists who evacuated and didn’t return, or retired after the storms.
“We’re not getting an influx of more providers to fill their shoes,” she added.
Oceans, one of the main providers of behavioral health services in the region, with clinics in Lake Charles and DeRidder, also suffered significant losses.
One of its two facilities in Lake Charles, a former state mental health hospital, was destroyed by the storms. The owner of the property decided not to rebuild. Where the 40-bed facility once stood is now an empty lot, reducing Oceans’ local capacity from 60 to 20 beds.
An initiative by the Louisiana Department of Health to create a statewide mental health crisis response system, compelled by a lawsuit from the U.S. Department of Justice, hasn’t borne fruit in the region either.
Department staff point to a lack of providers as the reason. Region 5, which covers Cameron, Calcasieu, Beauregard, Allen and Jefferson Davis parishes, is the only region in the state where no providers for crisis services have been identified by the program.
Between a shortage of local resources and little interest from outside providers to move into the area, it’s been difficult to find a crisis services partner for the region, Stephen Phillippi, director of LSU’s Center for Evidence to Practice, said during a recent presentation to mental health professionals. The center trains the staff of providers selected to participate in the state’s program.
“It’s been hard to find providers to move into that area and provide services,” Phillippi told attendees, which ranged from individual mental health professionals to representatives of local health authorities, like McGee.
For now, “there is no crisis response system,” the local health authority director said. “When people are in crisis, they go to the emergency department.”
Emergency departments across the state are overrun by patients whose primary need is mental health crisis support, prompting an array of programs to emerge, with varying degrees of success.
In Lafayette, mental health issues were identified as the primary diagnosis in 4,695 emergency department visits by Medicaid recipients between April 2022 and March 2023, according to data collected by LDH. The state did find a partner to provide crisis services in the Acadiana region, but after months of struggles, The Ness Center recently closed its doors, starting the search for a crisis provider anew.
McGee said her agency didn’t apply to become a provider for the state-coordinated system in the Lake Charles area. “I don’t have the staff to do it,” McGee said.
Funding would have been a challenge too, she acknowledged. The state’s program focuses on Medicaid patients, whose reimbursement rates are lower than those for patients carrying private health insurance.
“Medicaid is the cheapest and the hardest dollar to get,” McGee said.
Instead, McGee and other local providers have focused on investing in creating a feeder system for mental health professionals in the region.
In partnership with the McNeese University Foundation, the health authority was just awarded a $315,000 Community Impact Grant by the Blue Cross and Blue Shield of Louisiana Foundation to provide stipends to students who are completing their graduate counseling program at one of the partnered counseling agencies.
Disclosure: Blue Cross Blue Shield of Louisiana provides financial support for The Current and the Advocate’s health reporting partnership.
Oceans staff has partnered with other providers in the region to create a local coalition and hold monthly seminars to inform residents about local resources, and promote communication between the few remaining mental health resources.
People in the area need all the help they can get, McGee said. “We’re still very mentally fragile.”