When severe weather strikes and residents are advised to seek shelter either out of state or at a local evacuation shelter, some of those evacuees will undoubtedly include people battling mental health issues. For some, being confined to a crowded shelter is enough to be triggering. For others, the storm itself is stressful.

Right now, many areas across South Carolina are still dealing with property damage inflicted earlier this hurricane season. But when it comes to mental health issues caused by storms, the unseen damage may take much longer to clean up. 

The S.C. Department of Mental Health recently received a $415,000 grant to address immediate mental health concerns in the state following the recent flooding and severe weather. The grant, provided from a partnership between the Federal Emergency Management Agency and the Substance Abuse and Mental Health Services Administration, will support a 60-90 day crisis counseling program catered toward the assessment of trauma after disasters.

“It gives us time to figure out the extent of the need,” said William Wells, South Carolina's Department of Mental Health disaster coordinator.

According to Wells, the program will involve counselors visiting South Carolina residents to educate them on trauma while also doing a very brief, low-level assessment to refer people to expert resources if necessary. The ultimate goal is to examine the overall level of trauma.

Though Wells said that most people are going to be fine, the department wants to make sure that people know where they can find resources for those individuals that may not be.

“Most people are resilient,” he said. “But there are other people who aren’t doing as well.”

In a recent study published in the Journal of Emergency Management on the relationship between people who were displaced during Hurricane Sandy and mental health needs, experts found that those individuals who were displaced during the 2012 storm were more likely to have increased symptoms of post-traumatic stress disorder, depression and anxiety. In the same study, they also found that when those displaced individuals stayed with family and friends versus at a shelter, it decreased their odds of having PTSD symptoms by almost 50 percent.

The study concluded that disaster preparedness efforts should include an increased amount of mental health resources, specifically for those who are displaced.

Tosha Connors, CEO of My Sister’s House, a South Carolina domestic violence shelter and resource center, said that a lot of the women that come through the organization struggle with PTSD. When severe weather passes, she said that the organization does see a slight uptick in women coming to them in the aftermath.

But during the storm, when those women have to be evacuated to shelters, Connors says they have noticed that it does have an impact on the women’s mental health.

“That will definitely increase their symptoms,” she said.

One example she gave involves differing work schedules. If one woman works a traditional 9-to-5 job and sleeps near a woman who works nigh- time hours, the movement made by the woman who works nights could possibly trigger symptoms from the woman who is sleeping.

“Those are things we have to take into consideration,” she said.

Another correlation between home displacement and increased PTSD symptoms is stress, according to Dr. Julianne Flanagan, a psychiatry professor at the Medical University of South Carolina.

Flanagan says when external challenges are introduced, it’s much more challenging for people to manage their emotions. So when natural disasters hit, the damage, of course, lingers long after the storm has passed, she said.

In their research, Connors said she and her colleagues have also found that this often leads to an increase in domestic violence. Two of the most common correlations with family violence are PTSD and substance abuse, she said. During times of stress, like home displacement, drinking alcohol is also known to increase.

In South Carolina, when people are directed to evacuation shelters, Wells said that they try to send clinicians and even sometimes physicians to serve as mental health counselors for shelter evacuees. While the state recovers from the effects of Hurricane Florence, he said that assessing the level of trauma is even more important. It is especially important for those who have been in back-to-back traumatic events, he said.

“It’s not that you build a resistance to it, it’s that you become more vulnerable to it,” he said.