JIM LEHRER: Now: two takes on New Orleans and Southern Louisiana after Hurricane Katrina. We begin with a look at the psychological impact, first from the storm and then from the Gulf oil spill.
NewsHour health correspondent Betty Ann Bowser reports for our Health Unit from Saint Bernard's Parish. Our unit is a partnership with the Robert Wood Johnson Foundation.
BETTY ANN BOWSER: To watch him sanding a boat engine cover on a hot Louisiana afternoon, you would never know it, but Marty Nunez is stressed out.
MARTY NUNEZ, shrimp buyer: This was going to be our year to where, you know, we get our two feet on the ground.
BETTY ANN BOWSER: Five years ago, the 46-year-old's shrimp buyer's business at Yscloskey in Saint Bernard Parish was destroyed by Hurricane Katrina. Virtually every structure in the parish was underwater for weeks, leaving residents traumatized.
Now the oil spill has increased the psychic toll. With a lot of sweat equity and a $70,000 loan from the small business administration, Nunez and his wife, Dawn, rebuilt their marine store, and were back in the shrimp buying business once again.
MARTY NUNEZ: I think we would have did pretty good this year. Then comes the oil spill. This was we got blindsided by this, you know?
BETTY ANN BOWSER: Even though fishermen who aren't working cleanup for BP are back out in the Gulf shrimping again, few processors are buying from Nunez. And, at the store, customers aren't showing up for Dawn's homemade meals.
MARTY NUNEZ: I have never been this far in debt like I am right now. I mean, I owe you know, I'm borrowing. Every time I turn around, I'm borrowing money. It's scary, you know, if we're going to be able to come out of this.
BETTY ANN BOWSER: The last thing Nunez needs right now is anxiety. In the months after Katrina, he had double bypass heart surgery to fix a total blockage of one of his main arteries.
Have you ever had this much stress before?
MARTY NUNEZ: No, no. I mean, you know, not getting any shrimp, I'm not going to be able to pay the bills. So I'm going to try to hang in there as long as I can to see if some more shrimp come in or, you know, if we can make it work. But it's scary.
BETTY ANN BOWSER: Nunez knows he needs help, but:
MARTY NUNEZ: There's a group. And that's what they come down here. They was down here today. And they trying to get people to talk and emotional and stuff. We just avoid that. You know, we don't we just throw that on the side. We ignore that.
You know, I know it's not good for you, for your health, but that's what we do. We don't we don't seek out that.
BETTY ANN BOWSER: You don't talk about feelings?
MARTY NUNEZ: No, we don't try to go get any help, talk to any...
BETTY ANN BOWSER: Why?
MARTY NUNEZ: I don't know. I guess we don't we ignore it. We don't maybe don't want to, you know, admit that it exists, you know, that we are stressed out.
MARTY NUNEZ: That's what worries mental health professionals like Dr. Howard Osofsky.
DR. HOWARD OSOFSKY, psychiatry chair, Louisiana State University: That people were still recovering, people were feeling more hopeful, but people this was still very fresh, even in people who had rebuilt their lives. And now they are hit with an additional type of whammy, which is something that that, at least for limited numbers of people, could be much more long-lasting.
BETTY ANN BOWSER: Osofsky is the head of psychiatry at Louisiana State University's Health Science Center in New Orleans. For weeks now, he's been running focus groups to see what kind of services people need.
DR. HOWARD OSOFSKY: I would be interested in how all of your perceptions over the last five years, since Katrina, and now with the oil spill and what the parish is going through and what you're personally experiencing.
WOMAN: The fear is something that you can't say.
BETTY ANN BOWSER: We sat in recently as Osofsky talked with four women from Saint Bernard Parish. Gina Stechmann's husband is a shrimper.
GINA STECHMANN, wife of shrimper: You know, with Katrina, we hit a big road, a big bump in the road, but we got over it, and we picked up the pieces, and we was able to put it together. With this, we don't know what tomorrow is going to bring. We don't know what a year or 10 years down the road, how it's going to affect our kids, our our lives.
BETTY ANN BOWSER: Susan Serpas' husband is also a shrimper.
SUSAN SERPAS, wife of shrimper: He is actually devastated. He really is. It is his passion. It is his other woman, in other words, you know?
SUSAN SERPAS: And his boat is, I would say, more important to him than his house. And he's just he's on the boat, but what he does, goes down (INAUDIBLE) bayou, come back. That's it. He can't go catch the shrimp. And it just kills him. And I know he is depressed.
WOMAN: They don't talk about it.
SUSAN SERPAS: He's not the same person he was.
BETTY ANN BOWSER: Studies show mental health problems roughly doubled in the months after Katrina. There were also increased reports of stress, alcohol and drug abuse, and domestic violence.
Julie Kenny works with the local battered women and children program and says, it's happening again.
JULIE KENNY, Works With Battered Women and Children: We get a lot of phone calls where there's first-time abuse. They are with their spouse or significant other for could be 25 years and you have a one-time issue now. He's working on on with BP, but how long will that last? The rumors get started. And then he goes home and he has we always take things out on the closest people to us.
BETTY ANN BOWSER: There was a shortage of mental health services in the Gulf even before Katrina. And like many states with a budget deficit, Louisiana had cut back on funding for mental health facilities. But officials say they're shifting money to community-based services. Now Dr. Osofsky says the challenge is taking services to people where there is a tradition of not seeking help.
DR. HOWARD OSOFSKY: You will find this in some cultures. We certainly see it in the fishing community. But we also find, if we're out there, we're there, are they get to know us and trust us, over time, people do talk with us. The men talk with us.
BETTY ANN BOWSER: And Osofsky says, without help, there are going to be long-term psychiatric problems.
DR. HOWARD OSOFSKY: There is some post-traumatic stress disorder that will be developing. But more more of it anxiety and generalized anxiety disorder, symptoms of depression, symptoms of conflict at home, and as they are trying to cope, and the children trying to be more grown up and be available to the parents, but the children worry.
BETTY ANN BOWSER: And that's one of the lingering effects of Hurricane Katrina. According to a study released this week by the Children's Health Fund, one in three children who lost their homes in the flooding are still having emotional or behavioral problems today.
BP recently announced it's giving $52 million to the four states here in the Gulf most affected by the oil spill to provide mental health services. The state of Louisiana is getting $15 million of that amount or a little less than half what state officials had asked for.
Larry Carbo is a crisis counselor for Catholic Charities, which will get $6.6 million of the BP funds.
LARRY CARBO, crisis counselor, Catholic Charities: I don't think it's enough. I think we have to have monies that's going to make us go into the future. It's going to be here a while. Katrina, we did counseling services with Katrina for five years. And we're still getting people, firefighters that will call us on a regular basis and tell us that they're still having trouble.
LARRY CARBO: How has the spill affected you in particular?
BETTY ANN BOWSER: Every day, Carbo goes looking for crabbers, fishermen and shrimpers at Pointe a la Hache 50 miles south of New Orleans, where he says people are under a lot of stress.
LARRY CARBO: And when you see grown men cry, when you see their wives tell me that they have been ragging on their husbands all day long for five days a week, and they don't know what else to do, because they don't know when the next money is going to be due for a boat note, you know, and they don't know where the house note is going to come from.
So, they're very sad about that. And they will cry. Where we come in that is that we're there to listen to them. Just by listening means so much to people.
MARTY NUNEZ: Yes, that's all we got, is a couple hundred pounds of shrimp.
BETTY ANN BOWSER: But the issue for many mental health professionals is how to get to people like Marty Nunez.
MARTY NUNEZ: We eat, live and we breath this. You know, that's how we grew up, doing this. You know, we hope and we pray for the best. But that's why I have said this the thing that scares me the most is what's going to happen if which I think our seafood may be impacted for years to come. And what's going to happen then? I mean, you know what I mean? You know, I don't think everybody wants to keep working for oil cleanup. You know, that's not no future.
BETTY ANN BOWSER: Mental health professionals in the Gulf say that's the biggest challenge of all right now: How do you treat uncertainty?