This article marks the first in a series highlighting Youth Voices in Hurricane Melissa Recovery. It will feature perspectives from youth as they reflect on key areas of the recovery process, offering insights into resilience, rebuilding and the future in the wake of the storm.

“Every emergency has two faces, one in shattered infrastructure and the other in disrupted lives,” said Dévora Kestel, Director of Non-Communicable Diseases and Mental Health at the World Health Organization (WHO).

Hurricane Melissa stands as one of the most traumatic episodes in Jamaica’s history. While there is little doubt the country will rebuild its physical infrastructure, a critical element of recovery that demands closer attention is the restoration of the population’s mental well-being. Addressing the psychological trauma caused by this unprecedented disaster is essential.

In heavily impacted areas like Black River, as much as 90 per cent of all physical structures have been damaged or destroyed. Yet, beneath the rubble lies the hidden psychological toll on those who lived through and witnessed this tragedy.

Research has shown that almost everyone who experiences a large-scale traumatic event will display some signs of psychological distress. This can include feelings of fear and hopelessness, sudden onsets of flashbacks and troubled sleep. Thankfully, most people make a full recovery without needing medical intervention. However, data suggests that one in five persons go on to develop conditions, such as post-traumatic stress disorder, psychosis, anxiety and depression.

To cope with the stress and trauma, persons often turn to alcohol and other substances. Evidence from studies conducted after natural disasters reveal a marked increase in hospital admissions for overdose-related emergencies and heavy drinking. For example, researchers from the University of Ontario identified that after the 2010 earthquake in Haiti, alcohol consumption increased by as much as 20 per cent.

Furthermore, untreated or poorly managed mental health conditions can also impose a heavy economic burden. Mental illness costs the global economy around US$1 trillion each year in lost productivity alone. While a 2020 investment case report prepared by the Pan-American Health Organization (PAHO) highlighted that mental health conditions are estimated to cost Jamaica US$2.76 billion in lost output from 2015 to 2030.

This does not include the additional costs associated with an uptick in mental health illnesses in the aftermath of natural disasters. These findings underscore the often-hidden toll of psychological trauma. Therefore, as Jamaica begins to chart its path to recovery, it is imperative that mental health be placed at the forefront.

Experiences From Other Countries

Strengthening mental health services may seem like an impossible task amid such widespread devastation. Although, experiences from other countries have shown that such crises can provide an opportunity for meaningful change. In the aftermath of major disasters, there is often a heightened focus on the plight of those affected from the media and other stakeholders.

This is buoyed by a surge in attention from policymakers as well as an increase in humanitarian aid and technical expertise from the international community. These factors bring about the rare alignment between public awareness, political will and the availability of resources, which are necessary for kick-starting lasting reforms.

Reports like the WHO’s ‘Building Back Better’ strategy, highlight that it is possible to turn moments of crises into sustained momentum for mental health reforms. A notable case study is Sri Lanka which significantly expanded community-based mental health care following the 2004 Boxing Day Tsunami. Similarly, in the aftermath of Typhoon Haiyan, the Philippines trained over 200 community health workers and 130 non-specialist health professionals to recognise and manage common mental health conditions.

Important Lessons

Drawing from these examples, three lessons emerge. Firstly, countries should design response programmes that are both sustainable and scalable. Crucially, emergency efforts must align with the country’s long-term vision for the healthcare sector. For example, Jamaica’s Ministry of Health and Wellness has a clearly stated objective of decentralising mental health care across the country.

In line with this goal, one strategy to meet the surge in psychological needs is to train non-specialists, such as community health workers, to deliver basic mental health support. This would include providing psychological first aid, identifying at-risk individuals in the community for referral and following up with patients to ensure that they adhere to treatment plans. In the short term, such a programme could be introduced in the most affected parishes.

Importantly, these efforts should be sustained and expanded even after the crisis has abated. This would help address Jamaica’s high burden of mental health conditions that predate Hurricane Melissa. According to PAHO, psychiatric, neurological and substance use disorders account for up to 40 per cent of the total burden of disease in Jamaica.

Secondly, strengthening local technical capacity is crucial for the success of mental health care reforms. This ensures that advocacy for continued investment in mental health services persist long after international assistance decreases. Institutions such as the University of the West Indies and the University of Technology, Jamaica are uniquely positioned to play this role. During the immediate response, these universities can help to train frontline workers, thus ensuring that interventions are evidence-based and culturally appropriate.

Additionally, these institutions can spearhead the scaling up of new interventions and secure grants to conduct further research. With climate-related disasters increasing in frequency, there is a growing stream of international funding dedicated to studying the mental health impacts of environmental crises. By taking the lead on such research, Jamaican universities could not only strengthen national resilience but also position themselves as global leaders in this emerging field.

Lastly, coordination among actors like government agencies, universities, communities and international partners is essential. Such coordination helps to avoid duplication of efforts and ensures that resources are directed where they are most needed.

What Can Each of Us Do?

The Minister of Education, Skills and Information, Dr Dana Morris Dixon noted that, “We’re all going through collective trauma. I see it. Everywhere you go, you see it, and we have to think about that as a country.”

The good news is that one of the most effective ways to mitigate the effects of psychological trauma is something we can all do – providing strong social support. This means checking in with friends, family, and neighbours, especially those most vulnerable to developing psychiatric conditions. Among the most vulnerable include persons who have lost loved ones, those living in the most affected areas and individuals with pre-existing mental health conditions.

This year’s World Happiness Report highlighted how Jamaica ranked first in the world for being most likely to help a stranger. Perhaps this spirit of generosity and kindness is for a time such as this!

Gloria Charite is a Rhodes Scholar and PhD student in Clinical Neurosciences at the University of Oxford. To send feedback, email charite.gloria@balliol.ox.ac.uk.