Texas flood survivors need more than physical help

By Lee Ann Rawlins Williams, Clinical Assistant Professor of Education, Health and Behavior Studies, University of North Dakota.

The devastating losses from the historic flooding in Texas Hill Country on July 4, 2025, are still coming into grim focus, with more than 130 deaths confirmed and more than 160 still missing as of July 14.

As emergency responders focus on clearing debris and searching for victims, a less visible and slower disaster has been unfolding: the need for ongoing mental health support long after headlines fade.

This phase is no less critical than restoring power or rebuilding bridges. Disasters destabilize emotional well-being, leaving distress, prolonged recovery and long-term impacts in their wake long after the event is over.

Without sustained emotional support, people and communities face heightened risks of prolonged trauma and stalled recovery.

As an educator and practitioner focused on disability and rehabilitation, I explore the intersection of disaster recovery and the impact of disasters on mental health. Both my research and that of others underscore the vital importance of support systems that not only help people cope in the immediate aftermath of a disaster but also facilitate long-term healing over the months and years that follow — especially for vulnerable populations like children, older adults and people with disabilities.

Emotional toll of disasters

Natural disasters disrupt routines, displace families and challenge people’s sense of control and security. In the immediate aftermath, survivors often experience shock, grief, anxiety and sleep disturbances. Often these symptoms may evolve into chronic stress, depression, post-traumatic stress disorder or a combination of these conditions.

A 2022 study found that Texans who experienced two or more disasters within a five-year span had significantly poorer mental health, as reflected by lower scores on standardized psychological assessments, which highlights the cumulative toll repeated disasters can have on mental well-being.

After Hurricane Katrina ravaged New Orleans in 2005, nearly a third of survivors continued to experience poor mental health years later.

And reports following Hurricane Maria in Puerto Rico in 2017 revealed surging rates of anxiety, depression and suicidal thoughts, especially in areas where services remained unavailable for extended periods of time.

Strained recovery systems

Disaster response understandably focuses on immediate needs like rescue operations, providing post-disaster housing and repairing damaged infrastructure. In addition, short-term mental health supports such as mobile health clinics are often provided in the immediate aftermath of a disaster.

However, although emergency services are deployed quickly after a disaster, long-term mental health support is often delayed or under-resourced, leaving many people without continued care during the recovery period, especially in remote or rural communities, exposing deep structural gaps in how recovery systems are designed.

One year after Hurricane Harvey devastated parts of Texas in 2017, more than 90% of Gulf Coast residents reported ongoing stress related to housing instability, financial hardship or displacement. Yet less than 10% of people stated that they or someone in their household had used mental health services following the disaster.

Hurricane Helene in 2024 similarly tested the resilience of rural mental health networks in western North Carolina. The storm damaged roads and bridges, schools and even local clinics.

This prompted a news organization, North Carolina Health News, to warn of rising “trauma, stress and isolation” among residents as providers scrambled to offer free counseling despite legal barriers stemming from licensing requirements to provide counseling across state borders.

State health officials activated community crisis centers and helplines, while mobile mental health teams were dispatched from Tennessee to help those impacted by the disaster. However, state representatives stressed that without long-term investment, these critical supports risk being one-off responses.

These events serve as a powerful reminder that while roads and buildings can often be restored quickly, emotional recovery is a slower, more complex process. Truly rebuilding requires treating mental health with the same urgency as physical infrastructure. This requires investing in strong mental health recovery systems, supporting local clinics, sustaining provider networks and integrating emotional care into recovery plans from the start.

Finding mental health support

Lessons learned from previous disasters and an abundance of research show how sustained mental health supports can help people recover and build resilience.

These six lessons are particularly helpful for finding needed mental health support following a disaster:

• If you’re feeling overwhelmed after a disaster, you’re not alone, and help is available. Free and confidential support is offered through resources like the Disaster Distress Helpline (1-800-985-5990 or text TalkWithUs to 66746), which connects you to trained counselors 24/7.
• Many communities offer local mental health crisis lines or walk-in centers that remain active well after the disaster passes. Check your county or state health department’s website for updated listings and information.
• Even if physical offices are closed, many clinics now offer virtual counseling or can connect you with therapists and medication refills remotely. If you’ve seen someone before, ask if they’re still available by phone or video.
• After major disasters, states often deploy mobile health clinics that include mental health services to shelters, churches or schools. These temporary services are free and open to the public.
• If someone you care about is struggling, help them connect with resources in the community. Share hotline numbers, offer to help make an appointment or just let them know it’s OK to ask for support. Many people don’t realize that help is available, or they think it’s only for more “serious” problems. It’s not.
• Mental health support doesn’t always arrive right away. Keep an eye on local news, school updates or health department alerts for new services that may become available in the weeks or months after a disaster.

Disasters don’t just damage buildings; they disrupt lives in lasting ways.

While emotional recovery takes time, support is available. Staying informed and sharing resources with others can help ensure that the road to recovery isn’t traveled alone.