Our Guest post today is from Valerie Spear, PMHNP-BC and DNP Class of 2018. Valerie recently graduated from the Psych Mental Health Nurse Practitioner (PMHNP) program at OHSU and is currently in her last year of the Doctor of Nursing Practice program.

I had the great and challenging opportunity to volunteer for the Red Cross in September in response to Hurricane Harvey in Houston, Texas this summer. It was my first involvement with the Red Cross and I was specifically responding as a Psychiatric Mental Health Nurse Practitioner to fill the need for disaster mental health (DMH) workers. This process enabled me to see how health disparities effect people in disaster scenarios and I’m grateful for the experience.

The demand for volunteers and specifically mental health volunteers allowed me to deploy directly without first getting involved with the local chapter. This only occurs in times of great need.

The role of a disaster mental health (DMH) worker can be filled by any master’s or above prepared mental health worker (e.g. licensed social worker, psychiatrist, psychiatric nurse practitioners, psychologist, and RNs/BSN who have worked in psychiatry for at least two years). The position is varied and requires flexibility to the need, community, and disaster. With hurricane Harvey, DMH workers went out in the field, going to areas affected by the disaster and assessing for need while handing out food. They were also in shelters where people who lost their homes were waiting for assistance in getting housing. DMH workers have to be ready to respond to immediate emotional distress and lessen long-term consequences, assume that many people are resilient, augment the community’s mental health resources, rather than replace them, and serve the community in preparedness activities and recovery programs.

My experience volunteering with the Red Cross after Hurricane Harvey can easily be summed up into two words: overwhelming and rewarding. I felt that my nursing education provided a strong foundation in being flexible and building relationships with the people impacted and in need of mental health support.

Here is an excerpt from my journal during my stay:

I get up early and go to the Red Cross headquarters. It’s a bustling joint with everyone in Red Cross vests walking around with a mission. The tension in the air is notable and most people you speak with are stressed or disgruntled with one thing or another. It has been four weeks since the hurricane and still they’re finding new heavily impacted neighborhoods that haven’t yet been reached by either Red Cross or FEMA.

I arrive at the shelter on my second day. It is a huge warehouse with hundreds of cots squeezed in together in order to fit all of the residents. There are tables everywhere with case workers from FEMA, Red Cross, and a local housing organization. Many residents have found housing or have gone to stay with family members. Those who remain have been staying in shelters for nearly a month. The desperation is noticeable in everyone’s eyes—volunteers and residents alike. I round the shelter every 20 minutes to keep tabs on people, create relationships, provide emotional support, and assess for any concerning signs of depression or suicidal thoughts.

Many of the residents who are still in the shelter are those with severe and persistent mental illness (SPMI) and were homeless prior to the hurricane; the shelter is a place where they can be fed and clothed for a few weeks. Once those people that had housing prior to Harvey return to housing, the shelter will close and those that were homeless will most likely go back to being homeless.

In essence, the shelter is a representation of our broken system–a system that the Red Cross will not fix alone in a disaster response. People who are impoverished, people of color, people who are differently abled, and the mentally ill are yet again those that are least supported in our healthcare and support systems and thus most impacted by a disaster. Only by recognizing and addressing these disparities can we begin to create a system that is equitable.

Since volunteering with the Red Cross, it is evident to me that disasters only magnify the broken system that we are currently living and working in. I will not say Red Cross is perfect, it is confusing and sometimes hard to work within. But the truth is, without the Red Cross there is essentially no one else who is able to respond with the numbers and equipment that they do. Nursing leaders and nurse practitioners are well suited to not only respond to disasters but also to improve the system to prepare our patients and ourselves when disasters occur. Nurse leaders can play an integral role to help the Red Cross continue to design systems and models that are adequate and efficient in responding to disasters. I highly encourage getting involved with your local Red Cross chapter to help those near and far when in need.