The first thing Dana Jones, 61, tells you to do when you enter her gray-blue house in Melrose Park is walk along the off-white tile, up and down, through her dining room, while she watches carefully for your reaction. "Do you feel it?" she asks.
The flooring is bent, a bit warped. And Jones, too, feels warped, five years after Hurricane Harvey forced her to wade through waist-high water that came too fast.
It took her a month to find somewhere to live, so she lived out of her truck. The thing she fears the most is having to flee her home again.
When it rains, she cries. She hyperventilates. She can't sleep.
"It's destroying me," she says, to live in a wrongly contorted house, a house that she believes is going to flood again. She gives a few quick low exhales, a tactic she uses to try to stop herself from hyperventilating. She doesn't know what the next storm will be named, only that it's coming.
It's not just the floor. The wood siding is deteriorating and has dark water stains from the floods. The mold is back — she thinks it reemerged in the walls after Tropical Storm Imelda in 2019, but she didn't find it until her pipes burst during Winter Storm Uri in 2021. She tries to keep it at bay with bleach.
With the home in disrepair, it's difficult to find the motivation to clean the kitchen. Sometimes it feels easier to not eat, but she forces herself. She doesn't want to be skinny. She doesn't want to be bitter.
You don't understand, she says. There are so many people still hurt by this, people even worse off than her. She quickly exhales, twice more.
For decades, atmospheric scientists have predicted climate change would bring more intense tropical storms and hurricanes. Separate analyses found that climate change likely increased Hurricane Harvey's total rainfall by as much as 19% and Tropical Storm Imelda's by between 9% and 17%.
More intense natural disasters are taking an increasing toll on people’s mental health. An international group of leading scientists concluded in the most recent Intergovernmental Panel on Climate Change report that extreme weather events are followed by increased rates of mental illness.
Houston has been hit particularly hard. Harvey — which made landfall near Rockport and slowly inundated a swath of coastal Texas from Harris County to the Louisiana border — followed two other 500-year flood events in Houston: the Memorial Day flood in 2015 and the Tax Day flood in 2016. Harris County, which includes Houston, has seen seven federally declared disasters due to severe weather in the last decade.
In a small sample of Hurricane Harvey survivors surveyed in the weeks after the storm — which dumped more than 60 inches of rain across the Houston region, causing catastrophic flooding — researchers found that 46% of Houston-area participants met the threshold for probable PTSD symptoms. More than half of the 41 survivors in the study experienced symptoms of anxiety.
"With other kinds of anxiety problems, you might want to try to get people to realize that their fears are overblown, but that's less likely to be the case with climate change," said Susan Clayton, who researches climate change and mental illness and was a lead author of the Sixth IPCC Assessment report. "In some cases, their fears are not overblown."
Researchers are beginning to use new terms including "climate trauma," "climate anxiety" and "eco-grief" — referring to trauma from events made worse by climate change, general distress about climate change and grief for the plants, animals and places that may be lost — to describe mental health conditions precipitated by the effects of climate change. Whether such conditions are unique or simply a psychological response to a specific stressful event is an active area of research.
In 2021, the International Society for Traumatic Stress Studies published a paper by mental health researchers warning their colleagues about the dramatic impact climate change could have on the prevalence of trauma syndromes.
"Climate change, if left unaddressed, is projected to have catastrophic consequences on the mental health of entire populations," the group of 10 leading international mental health researchers wrote.
One review of scientific literature estimated that 30% to 40% of disaster victims develop symptoms of post-traumatic stress disorder, along with 10% to 20% of rescue workers. The mental health conditions can last for several years.
"One might think that folks would adapt in terms of mental health — if you've been through this before, you know you can come out OK — but that's actually not really what we're finding in the data," said Sarah Lowe, an associate professor at the Yale School of Public Health who researches mental health and natural disasters. "The more disasters that folks were exposed to, the more likely they are to have symptoms of PTSD, depression and generalized distress."
Yet studies have found that only a small proportion of disaster survivors receive mental health care. And getting help in Texas is especially difficult — Mental Health America ranked Texas last in the nation for access to mental health care in 2022. Communities of color have even fewer options for help with climate-related trauma than predominantly white neighborhoods.
Therapy alone may not be enough — early research suggests that disaster preparation such as helping people plan for the next storm and designing or retrofitting homes to withstand such disasters could also help reduce anxiety.
When Harvey's rain swept into Jones' home, she couldn't carry her dog, Gigi, to safety — the currents were too strong. She put Gigi, a Jack Russell terrier, in a cage on top of a table and left her. She prayed. Minutes later, a neighbor in a large pickup passed by and rescued Jones and Gigi.
Jones has recounted the story dozens of times to counselors and others. She tells the story quickly in a few breaths, with an urgency as though the faster it's out of her mouth the faster she can rid herself of the memories. Jones has treated her symptoms of anxiety and depression with medication and counseling, she said. Her doctor worked with her to increase her dosage in the years after Harvey.
But she still feels unsafe in her own home. She's on a fixed income and can't afford to leave the house she's lived in for decades to start over.
Being unable to recover a sense of control — such as continuing to live in a home that's vulnerable to another severe weather event — can make symptoms of mental illness associated with trauma last longer than they would otherwise, researchers have found.
Jones wants to have her house elevated and repaired, but that could cost tens of thousands of dollars that she simply doesn't have. Like thousands of others in the Houston area, she's been turned down for federal aid to help her rebuild — in Jones' case, because her flood insurance lapsed.
"You go back home, and the thing that beats you up is still there," she said.
"So what do you do? It's my home."
Climate change "catastrophic" to mental health
Wayne Young, the CEO of the Harris Center, Harris County's government-funded and state-designated mental health authority, said he started noticing in 2017 and 2018 that patients who had lived through the previous devastating floods that hit Houston were showing symptoms of re-traumatization: sleep disruption, anxiousness and an inability to regulate emotions.
"They become kind of hyperemotional, and in ways that aren't typical for them," he said. Young said he saw some of the same symptoms in members of his staff. They became agitated or suggested closing the office when it rained.
"I think [trauma from Harvey] still lingers today," he said. "When we have a heavy rain, the community still has people who have tension that begins to bubble up."
Holly McFarland, a psychotherapist and licensed clinical social worker in Fort Worth, said she first realized about four years ago that some of her clients' mental health conditions were aggravated by climate change.
"It's only in session two or three that it comes out that climate is kind of underlying," she said. "It's this thing in the background [of other problems]."
As a result, she joined a group of psychiatrists who were having similar conversations about the intersection of climate change and mental health. She began to realize that for some of her clients, dread, anxiety or prior trauma related to climate change was preventing them from planning for their long-term future — especially young people. For example, they struggled with big life decisions, such as whether to have children or go back to school.
"The way I treat it is to first normalize it," she said. "Nothing is wrong with you for being fearful or anxious or sad."
From there, McFarland helps her clients work toward hope.
"Even with devastation and grief, we can also have moments of joy," she said.
Some mental health professionals remain skeptical that climate anxiety, eco-grief or climate-related disaster trauma is a fundamentally different type of mental health condition. But they acknowledge that the effects of climate change can bog down the emotional well-being of their clients.
Lane Johnson, a professional counselor and chief of clinical services at the Gulf Bend Center, the regional mental health provider in Victoria, said that in his opinion, "anxiety is anxiety," so climate anxiety may be just another symptom of an already anxious patient, and treatment can be similar. But, he said, it's important to recognize how severe weather events can exacerbate symptoms of mental health conditions.
"During adverse circumstances, it's normal to have abnormal reactions," he said. "But that wears on us if we're not aware of that, and then we can become overstressed and start to fatigue."
Victoria Harrison, a family systems psychotherapist in Houston, has worked with clients affected by flooding and wildfires. She found that people improve when they get involved with community or advocacy groups related to environmental issues.
"People can do better at dealing with a big problem like climate change if they can mobilize action and if they can take steps toward problem-solving," she said.
Harrison also focuses on how previous generations of her clients' families coped with changes in their environment — for example, the Dust Bowl in the 1930s forced millions of people to flee the Great Plains amid intense dust storms brought on by drought and flawed farming techniques.
"Going back and recognizing how their ancestors survived and dealt with adversity lets people recognize they're strong people themselves," Harrison said.
Storm survivors feel forgotten
Jones saw how Harvey damaged the emotional well-being of her north Houston subdivision, Melrose Park, after every quaint, single-family home in the working-class, mostly immigrant neighborhood was ravaged by several feet of water the last week of August 2017.
But now, every house looks different — many have been repaired, some have been elevated to protect from another flood, while Jones' house and others still have flood damage five years after Harvey.
A few doors down from Jones, a house with fresh gray paint and white trim stands on stilts, about 5 feet higher than its neighbors, after a government-funded rebuild. Farther down the street, another home is in such need of repairs that its owners say they can no longer safely occupy it — or afford to fix it.
The Houston Homeowner Assistance Program, which was included in a pool of $7.4 billion allocated by Congress to help Harvey victims, has completed construction on roughly 600 Houston homes. But a bitter political fight between the Texas General Land Office and the City of Houston has plagued the program; the state agency wrested control of the funds from the city, with HUD's approval, in 2020.
GLO spokesperson Brittany Eck says there won't be enough money to meet the demand, and the agency hopes to move money from other recovery funds to fill the gap.
Thousands of homeowners remain in limbo, unsure when or if they will ever be approved. Others moved on, sold their properties — often for far less than they were previously worth — and started over. Many were deemed ineligible due to federal rules that require homeowners to maintain flood insurance if they received aid during a previous disaster.
Jones and her next-door neighbor Maria Monjaras, 38, applied to a government-funded program for Houston homeowners on the same day and helped each other with the applications. Monjaras, who lives with her husband and four children, was approved for assistance while Jones was denied.
Monjaras, who works as an in-home health aide, said even though their house will be rebuilt, she and her children also have struggled with the emotional aftermath of Harvey — the family had to live in a hotel room for almost five months after their house flooded, a nightmare for a family with a newborn. Her youngest son, Alex, was only 2 weeks old when Harvey hit.
Before they were finally able to return to their home, it had to be gutted to remove black mold. They moved back in before the kitchen was rebuilt, and for months, Monjaras cooked and did the dishes in the backyard.
She began to struggle again with high blood pressure in the years after the flood, something she thought she'd gotten under control before the storm. Her doctor prescribed medication for anxiety, hoping it would help reduce her blood pressure. Everyone in her family still has trouble sleeping during storms, she said.
"You don't sleep," Monjaras said. "Or if you sleep, you wake up and check again to see how high the water is."
Melrose Park Civic Club President Judy Hoya, 69, who has lived in the neighborhood for almost half a century, said she and her neighbors all move their vehicles to a nearby park that's on higher ground when a tropical storm is coming.
Hoya attends state and local government presentations on planned flood mitigation projects around Houston, but she feels action is lacking. The threat of another flood is taking an emotional toll on everyone, she said. She loves her neighborhood, she said, but plans to leave if her home floods again.
"It's going to be years before they do anything" to protect Melrose Park, she said. "Why are we on the backburner?"
Lack of mental health resources "another form of neglect"
On a Monday evening in July at Cook Elementary School, about a dozen Houstonians — mostly women, and all people of color — sat in an auditorium at children's cafeteria tables, listening intently as an instructor explained how to evaluate whether "Eleanor," a life-size stuffed fabric dummy, had a back injury.
It was part of a four-week long Community Emergency Response Training course that taught participants how to evaluate victims' injuries in emergency situations and how to speak to survivors of disasters in a way that did not further traumatize them.
Preparing for the next disaster, such as making evacuation plans with neighbors, can help people establish a sense of control and reduce the impacts of weather-related trauma, mental health experts say. Researchers have found that clinical treatment alone is unlikely to be enough to address the mental health problems exacerbated by climate change.
Rain Eatmon, 30, said the training has given her a new sense of confidence in her ability to keep her family safe during a severe weather event.
Eatmon, a resident of the north Houston neighborhood Acres Homes, has survived Hurricane Ike, Hurricane Harvey and Tropical Storm Imelda — which nearly swept her car away while she was driving home. It took about six hours before the waters receded enough for her to escape.
"That was a pretty traumatic event," she said. "I had never been in a situation where I was caught outside during a tropical storm."
While she was open to taking a disaster preparation course, Eatmon said she's hesitant to seek counseling for fear of being misdiagnosed. Eatmon, who has worked as a community organizer, said it's common for Black survivors of disasters to mistrust health professionals.
"I don't feel that there are enough [health] professionals who share my cultural experience," Eatmon said.
Black patients have historically been mistreated and misdiagnosed by medical professionals; in one infamous nonconsensual study of Black men with syphilis conducted by the Centers for Disease Control and Prevention between 1932 and 1972, treatment was withheld from the men even as medical advancements were made, and many died as a result. A 2019 study by researchers at Rutgers University found that clinicians are more likely to misdiagnose patients with schizophrenia if they are Black than if they are white. Only 5% of psychologists in the U.S. are Black, according to the American Psychological Association; 86% are white.
And many survivors of disasters are too burdened by fixing their homes and replacing belongings to seek therapy. In a state where 5 million people lack health insurance — roughly 18% of the population — many simply can't afford it.
Keith Downey, a co-founder of the Northeast Houston Redevelopment Council that organized the emergency response class, said in his north Houston neighborhood, Kashmere Gardens, "The PTSD is real. If anything, it's progressing and gotten worse" because of repeated flooding. Too many neighbors, especially seniors, have been denied financial assistance to help them rebuild their homes and their lives, he said.
Downey said predominantly Black and Latino communities don't have enough counselors nearby to address this growing need. A study George Washington University researchers published in April found that predominantly White and wealthy neighborhoods have several times more mental health professionals than neighborhoods where people of color predominantly lived.
"It's another form of neglect," he said. "Minority community residents do not have parachutes (after disasters). We are freefalling."
Huey German-Wilson, who co-founded the group with Downey, said their small nonprofit — which advocates for resources such as food distribution and disaster planning in northeast Houston neighborhoods — wants to create drop-in counseling centers across north Houston, but one grant proposal after another has been denied.
"We've never gotten funding for [a mental health center], as much as I've tried," said German-Wilson, who lives in the Trinity Gardens neighborhood. "That's the part of funding where people are like, ‘Well, we'd really like to fund that, but we just don't have the capacity for it right now.'"
"Something I can do for myself"
Jones has been through enough natural disasters that she's learning to take charge of her own recovery and manage her anxiety. She's putting herself first.
"I've kept myself together," she said, but, "I have to put this behind me."
In 2019, she enrolled in a community college to study liberal arts; now she's planning to switch to business marketing.
"I wanted to reinvent myself," she said.
She calls public officials and asks them to visit her neighborhood to see the lingering damage she lives with every day. In the mornings, she walks up and down the streets of Melrose Park for exercise and asks her neighbors if they need help with anything.
She knows if she can feel useful, she'll feel better. She knows if she keeps busy with schoolwork, she'll settle her mind.
"I get excited about that because nobody can take that from me," Jones said. "That’s something I can do for myself, and that's what has carried me thus far."
And when it rains, she asks God for safety. She holds onto Gigi. And she tries to keep moving forward.
"I have to," she said.
María Méndez contributed to this story.
This article is published as part of the Mental Health Parity Collaborative, a national partnership between The Texas Tribune and The Carter Center's Rosalynn Carter Fellowships for Mental Health Journalism and other newsrooms throughout the U.S.
Disclosure: Texas General Land Office has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune’s journalism. Find a complete list of them here.
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