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How to Help Survivors of Extreme Climate Events (


Screen Shot 2022-09-30 at 8.46.25 PMBy Elaine Miller-Karas MSW, LCSW Building Resiliency to Trauma Psychology Today, September 30, 2022 Mental health can suffer after extreme climate events.


  • Mental health conditions exacerbated by natural disasters include post-traumatic stress disorder, depression, and anxiety.
  • After a disaster, the number of people needing assistance from the mental health systems strains or exceeds community capacity.
  • There are simple strategies helpers can use to help survivors restore well-being after climate events.

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.

Identify Community Mental Health Clinics and Alcohol and Drug Treatment Programs

7. It is a complex process to lose one's home, livelihood, and surrounding community. The journey of recovering and rebuilding can exacerbate mental health conditions and also lead to increases in alcohol and drug use. Helping survivors identify community mental health clinics and drug and alcohol treatment programs can lead them to essential safety nets.

How to Learn More

To help to gain more information about how to build more resilient communities to prepare your community for climate events, contact the International Transformational Resilience Coalition (ITRC), inspired by the work of climate change advocate Bob Doppelt. The ITRC elaborates upon how society can invest in effective responses that can address the mental health challenges that invariably will result from climate events. The coalition has a wide range of experienced professionals working on a dynamic steering committee to guide its projects, policies, and advocacy, including representatives from the National Association of Social Workers, the American Psychiatric Association, the American Psychological Association, the American Public Health Association, the Alliance of Nurses for Healthy Environments, and more. As a founding member, my organization, the Trauma Resource Institute, has worked in collaboration with the ITRC to help communities prepare and respond to climate events.


Cianconi, P., Betro, S., & Janiri, L. (2020), The Impact of Climate Change on Mental Health: A Systematic Descriptive Review, Frontiers in Psychiatry, March 6, 2020, |

Elaine Miller-Karas, LCSW, is an author, lecturer, consultant, radio show host, trauma therapist, and social entrepreneur. She is a co-founder and the Director of Innovation of the Trauma Resource Institute and a founding member of the International Transformational Resilience Coalition. She is the author of Building Resiliency to Trauma: The Trauma and Community Resiliency Models® (2015). Her models have been introduced in over 75 countries. She has presented at the Skoll World Forum, Resiliency 2020 and 2021, and the United Nations. Her book was selected by the United Nations and Taylor and Francis’ curated online library as one of the innovations helping to meet the United Nations' Sustainable Development Goals. She is also a Senior Consultant to Emory University’s SEE Learning program, inspired, and launched by His Holiness the Dalai Lama, and she is consulting with the Medgar and Myrlie Evers Foundation to help create a virtual curriculum of the U.S. Civil Rights Movement. Her radio talk show, Resiliency Within: Building Resiliency during Unprecedented Times, is on VoiceAmerica.


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