Katrina Task Force
Cultural Committee
Report
12/14/2005
Joe Powell, LCDC, CAS
Association of Persons Affected by Addiction
In the Aftermath of Katrina, several agencies, Mental Health Association, UT Southwestern, City of Dallas, and other agencies and individuals have come together to provide needed services for individuals and family evacuees from New Orleans. The magnitude and duration of mental and emotional consequences of Katrina survivors, who experienced Hurricane Katrina, are at great risk for developing and substance use or Mental Health problems. The Cultural Committee will bring education regarding the African American/New Orleans cultural issues and assisting evacuees with mental health/substance use treatment, recovery support services, disparities, housing, employment, schools, etc, is crucial for the success of Katrina Task Force.
History and Culture
Historically, New Orleans is a place where Africans, both slave and free, and American Indians shared their cultures and intermingled with European settlers. Encouraged by the French government, this strategy for producing a durable culture in a difficult place marked New Orleans as different and special from its inception and continues to distinguish New Orleans today.
New
Orleans is a Southern city known for its multicultural
heritage (especially French, Spanish
and African American influences) and its music and cuisine. It is a
world-famous tourist
destination thanks to its many festivals and celebrations; the most notable annual events
are Mardi Gras ("Fat Tuesday"), Jazz Fest, Voodoo Fest, Southern Decadence, and college football's Sugar Bowl.
The most recent U.S. census put New Orleans's population at 484,674 and
the population of Greater New Orleans at 1,337,726. Due to the
evacuation of the city before and in the aftermath of Hurricane Katrina, the population as of late
2005 is significantly less; a Time
Magazine article with a publication date of 28 November 2005 (written weeks
before) estimated the city's population at about 100,000. The city's population
is trickling back in to see if they will be able to repair their homes or move
someplace else.
The city's several nicknames describe various characteristics of the city,
including the "Crescent City" (describing its shape around the
Mississippi River), "The Big Easy" (a reference by musicians to the
relative ease of finding work in the city), and "The City that Care
Forgot" (associated with the easy going, carefree nature of many of the
local residents). The city's unofficial motto, "Laissez les bons temps
rouler" ("Let the good times roll") describes the party-like
attitude of many residents.
Much of the city is located below sea level
between the Mississippi River and Lake Pontchartrain, so the city is surrounded
by levees. Until
the early 20th century, construction was largely limited to the
slightly higher ground along old natural river levees and bayous, since much of
the rest of the land was swampy and subject to frequent flooding. This gave the
19th century city the shape of a crescent along a bend of the Mississippi, the origin
of the nickname
The Crescent City.
The
city's name is often abbreviated NOLA. Residents of the city are
referred to as New Orleanians.
Culture is Prevention
in Mental Health and Substance Use
Being culturally congruent to African Americans and the New Orleans Culture, Dallas efforts for long term recovery can prevent mental health, substance use problems and other disparities.
Approximately 24-35,000 evacuated to Dallas area with 90% or more of African descent. Defining persons of African descent can be a multifarious task because its people consist of such broadly diverse cultures. Today, APAA three guiding principles of Recovery First, Inclusion and Authenticity (being real and honest about who we are) are utilized to bring about holistic healing and support for the New Orleans, Louisiana culture.
The Surgeon General report on Mental Health(2002), the Psychological Treatment of Ethnic Minority Populations (2003), the Final Report of the President’s New Freedom Commission(2003) and Cultural Competence Standards-In Managed Mental Health Care Services: Four underserved/Underrepresented Racial/Ethnic Groups, set forth a goal of eliminating disparities in behavioral healthcare. The Final Report concludes that people of color have historically been underserved in existing systems of behavioral healthcare.
The help-seeking behavior of African Americans (and other groups of color) is related to the continuation of behavioral healthcare and primary healthcare disparities. These groups often are characterized by help seeking that takes place later in the continuum of disease and disorders, when conditions have become chronic.
We are choosing a more holistic and congruent perspective that defines persons of African descent/New Orleaneans/Louisiana as those who share a spiritual, physiological, and historical connection to their roots, influencing a complex constellation of values, customs, traditions, and practices that shape their response to life circumstances.
The distinguishing cultural features characterizing persons acknowledging New Orleans and identifying with African ancestral tradition are common in various forms throughout Louisiana. While specific histories and experiences vary there are common subtexts of history, spirituality, worldview, culture, oppression and enslavement that are critical to an understanding of the collective and individual mental health of persons of African descent and to efficacious psychological treatment.
Disparities
Texas is ranked 47th in the nation in Mental Health services.
The NorthSTAR
Program is a unique public mental health/substance abuse treatment program
serving indigent and Medicaid clients residing in the seven-county North Texas
service area. It provides access to and choice of providers for low-income
Texans while improving accountability, interagency cooperation, and stakeholder
involvement. The NorthSTAR Program
enables the consumer to be a purchaser of services within a network of qualified
providers. Below is a ethnicity breakdown of persons served by NorthStar.
NorthStar reported persons served by Ethnicity
|
|
2001 |
2002 |
2003 |
2004 |
2005* |
|
Total Customers |
19,464 |
18,747 |
21,630 |
26,972 |
27,125 |
|
White & Other (not Hispanic) |
11,644 |
11,205 |
12,592 |
15,486 |
15,262 |
|
African-American |
5,893 |
5,513 |
6,530 |
8,026 |
8,243 |
|
Hispanic |
1,927 |
2,029 |
2,508 |
3,460 |
3,619 |
|
|
|
|
|
|
|
Substance use only has been neglected by and does not show its face until crisis triggers help. Value Options report little chemical dependency due to the minimal funding for substance use only. The overburden system will collaborate with recovery support services to provide long term recovery for those affected by substance use.
Substance Use and
Mental Health
The influx of evacuees will affect the Dallas economy, criminal justice system, housing, employment, schools. Substance use problems are overlooked by individuals and the community until it becomes crisis.
The National Survey on Drug Use and Health for 2004, reported that the rate of current alcohol use in 2004 among adults with serious psychological distress was similar to the rate among those without SPD = 52.1% VS 53.3.
50.3% (121 million people) of Americans aged 12 or older reported being current drinkers of alcohol. 10.8 million Persons aged 12 to 20 (28.7%) reported drinking alcohol in the past month. Rates for current illicit drug use were highest with American Indians12.3%, whites 8.1, 8.7 Blacks, Hispanics 7.2, and Asians 3.1. Only 1.4 million people received treatment. 6.6 million People needed treatment but did not receive it for illicit drug use problems. 22.5 million Americans aged 12 or older with Substance Dependence
47.5 %( 2.2 million) received treatment for mental health problems and 11.0% received specialty substance use treatment. Half 47.5% of adults with both SPD and a substance use disorder received no treatment for either problem. Only 6.0 received treatment for both. An estimate 21.1 of the 23.5 million needing did not received treatment for a substance use problem
Katrina bring to light, the needs and the issues that will be address throughout mental health and substance use around culture as well as other issues. Dallas responded quickly with crisis interventions, resources and support. The collaborative efforts continue into the next phase of long term recovery for those affected by Hurricane Katrina.
Conclusions
This report is cultural congruent for Katrina Survivors from New Orleans and the beginning of efforts, public and private, to addressed issues surrounding African American evacuee disparities. The discussion continues to highlight the areas of culture and identified cultural problems as evacuees and collaborative efforts proceed toward acculturation. The Child and Family committee, Faith Based and Cultural Committees will continue dialogue on directions for the future. The future areas identified include: recovery support services, disparities, public policy, role of culture, the need for research, cultural competency, advocacy organizations, workforce development, help-seeking behaviors, and recommendations for a cultural congruent plan.
Joe Powell LCDC, CAS
Executive Director
Association of Persons Affected by Addiction
.
References