It’s appropriate for BP to dedicate $20 billion to an escrow fund for oil-spill claims, and I hope the fund’s independent administration will allow for quick payment of claims. Nicholas Beaudrot points out that the fund’s structure means BP has an incentive to resolve claims quickly – in contrast to the 20 years that it took ExxonMobil to pay claims related to the Valdez oil spill.

Though the process of compensating financial losses will be complicated, it’s far easier to quantify lost income than to tally the costs to Gulf residents’ mental health. The New York Times’ Mireya Navarro focuses on the feelings of hopelessness, anxiety, and depression many Gulf workers from the fishing industry experience as they’re unable to do their jobs.

Navarro notes that local estimates suggest as many as one-third of Louisiana’s 12,400 fishermen are Vietnamese; in addition to the difficulty of moving to a new country and, in some cases, losing their homes to Hurricane Katrina, they now don’t know how long it will be before they can start fishing again. Hong Le, 58, can no longer send money to his wife and children in Vietnam, and he told Navarro that he’s now “surviving on handouts after a lifetime of self-sufficiency.”

Community groups are trying to address Gulf residents’ psychological difficulties along with their financial ones:

Mindful of the surge in psychological ailments after Hurricane Katrina hit the Gulf Coast in 2005, community groups are trying to tend to the collective psyche of fishermen like Mr. Le even as they address more immediate needs like financial aid.

… Catholic Charities reported this week that of the 9,800 people the counselors had approached since May 1 in Orleans, St. Bernard and Plaquemines Parishes, 1,593 were referred for counseling because of signs of depression.

… Officials with the Louisiana Department of Health and Hospitals said staff members had counseled 749 people in the last week of May and the first week of June to “mitigate” symptoms that could lead to destructive behavior.

“Most people are in disbelief,” said Dr. Tony Speier, deputy assistant secretary of the department’s office of mental health. “There’s fear not just for economic survival, but for a way of life.”

Workers’ families are also suffering under the stress, Navarro reports:

… At the Center for Wellness and Mental Health in Chalmette, which opened last year to treat cases of post-traumatic stress disorder lingering from Hurricane Katrina, the staff is checking in on fishermen’s families, mining relationships that were forged when volunteers helped rebuild homes after the hurricane.

An effort is under way to invite wives to receive counseling and learn breathing techniques and other skills to cope with stress, said Joycelyn Heintz, the coordinator of the center, which was founded by the nonprofit St. Bernard Project and the Health Sciences Center at Louisiana State University.

Rachel Morris, one of the wives who has agreed to counseling, said her husband, Louis Lund Jr., 34, was a shell of his formerly joyful self.

After the oil spill grounded fishing, Mr. Lund managed to get a job cleaning the gulf waters for BP, the oil company responsible for the spill, Ms. Morris said. But he is stricken by the sight of dead fish on his cleanup outings, she said, and for the first time has started to frequent bars with other fishermen.

Mr. Lund frets over whether he will be able to pass on his trade to his children, a 13-month-old son and 10-year-old daughter, or even remain in New Orleans, where volunteers just finished rebuilding the family’s Katrina-flooded home last October.

“When I saw the oil rig explosion on television, I was, like, ‘O.K., oil rig explosion,’ ” Ms. Morris, 26, said, adding that she told herself to pray for the 11 rig workers who were killed. “Two days later it was, ‘The oil is not stopping.’ That’s when my husband went from a happy guy to a zombie consumed by the oil spill.”

She said Mr. Lund had refused to accept counseling. He has lashed out occasionally, she said, venting his anger one evening last week after waiting in line for nearly four hours at the local civic center to pick up his two-week paycheck.

The Exxon Valdez spill in 1989 is probably the most relevant example we have for considering the likely longer-term effects on Gulf residents’ mental health – although we have to account for the fact that this disaster comes just five years after a devastating hurricane that’s still affecting many people’s wellbeing. A quick PubMed search pulls up studies from two groups of researchers who studied mental health in communities affected by the Exxon Valdez disaster.

Palinkas et al – a group of researchers from Impact Assessment, Inc and University of California, San Diego, funded by the Oiled Mayors Subcommittee of the Alaska Conference of Mayors – surveyed 599 men and women from 11 communities close to the spill area and two distant Alaska communities a year after the spill. Respondents were placed into three different groups based on the severity of their exposure, which was determined through questions regarding participation in cleanup, use of resources affected by the spill, and spill-related property loss or damage. The researchers used questions from the National Institute of Mental Health Diagnostic Interview Schedule to assess symptoms of generalized anxiety disorder and post-traumatic stress disorder, and compiled scores for respondents using the Center for Epidemiologic Studies Depression Scale; respondents with CES-D scores above 16 were classified as being depressed. The authors reported in the American Journal of Psychiatry:

When compared with the unexposed group, members of the high-exposure group were 3.6 times as likely to have generalized anxiety disorder, 2.9 times as likely to have PTSD, 1.8 times as likely to have a CES-D Scale score of 16 and above, and 2.1 times as likely to have a CES-D Scale score of 18 and above. Women exposed to this event were particularly vulnerable to these conditions, and Alaska Natives were particularly vulnerable to depressive symptoms after the oil spill.

Arata et al, researchers from the University of South Alabama supported by the Prince William Sound
Regional Citizen’s Advisory Council, studied the effects of the Valdez spill on Alaska fishers six years after the event. They sent surveys to members of the Cordova District Fishermen United in Cordova, a small fishing community in southeastern Prince William Sound, and respondents returned 125 of the surveys. The researchers used the Symptoms Checklist 90–Revised to assess symptoms of anxiety, depression, and PTSD. They also assessed respondents’ measures of coping and resource loss related to the spill. In the Journal of Traumatic Stress, the authors report:

The hypothesis that the participants would have higher levels of depression,
anxiety, and PTSD symptoms compared to a normative sample was supported.
One-fifth of the fishers had clinically significant symptoms of anxiety and over
one-third had significant symptoms of depression and/or PTSD.

This study considers the Exxon Valdez spill as a “technological disaster” rather than a “natural disaster,” and notes that technological disasters can have longer-term impacts on mental health because of how they’re addressed:

Given the human origins of technological disasters, relief and compensation strategies are often negotiated through litigation, thereby extending the time period for rehabilitation and recovery of victims (Picou & Rosebrook, 1993). Technological disasters, in particular, have been found to lead to a pattern of social deterioration referred to as the “corrosive community” (Freudenburg, 1997; Freudenburg& Jones, 1991; Kaniasty&Norris, 1993; Kroll-Smith&Couch, 1993a). Freudenburg and Jones (1991) suggest that this corrosive context includes community members struggling over where to place blame, authorities being evasive and unresponsive, and victims becoming suspicious and cynical.

BP’s $20 billion won’t be able to make up for the harm this disaster is doing to people’s mental health. If the establishment of an independent fund can reduce the amount of years-long litigation that residents have to endure, though, it might at least avoid exacerbating the problem.