In Clendenin, most of the buildings are still standing. Volunteers from all over have descended on the town. The dust is flying. Piles of debris are everywhere.
But when you look at many of the buildings from the outside, you can barely tell they were submerged in several feet of water less than two weeks ago. You can’t always tell if they’re completely gutted inside.
The people, too, will tell you that they’re holding up well. They’re focused on immediate needs — salvaging what they can, ensuring food and shelter. They’ll tell you they’re “blessed” and that others have it much worse.
Even displaced flood survivors at Capital High School will say they are just taking it a day at a time and they’re doing fine.
But the crisis counselors who have been on scene since the beginning will tell you about the panic attacks they’ve witnessed.
The counselors are passing out cleaning supplies and bottled water, and asking what the flood survivors need, like many other volunteers. But they also are teaching deep breathing techniques and talking to survivors about how they’re coping.
When rain is in the forecast, there are frequent glances toward the sky.
Janet Rollyson sat in her front yard on Maywood Avenue on Friday with her neighbor, Carol Williams, a week after several feet of water rushed inside their homes.
“I think we’re all good because we’re busy,” Rollyson said. “I think when we’re less busy, that’s when it will hit us.”
A few minutes later, the forecast came up in conversation. “I want you to worry with me,” Williams said to Rollyson.
In the past week and a half, West Virginians have heard a lot about resilience; “West Virginia strong” is the refrain.
But before the floods hit last Thursday, West Virginians were already suffering. According to the 2014 National Survey on Drug Use and Health Report, West Virginia had the highest rate of serious mental illness in the country, at 5.5 percent.
Tracy King, a licensed social worker and disaster response team coordinator at FMRS Health System, noted that West Virginia already has a high rate of some of the factors that make people more vulnerable in times of trauma, including domestic violence, poverty and experiencing previous traumatic events.
“When something like this flood happens, it’s insult to injury,” she said.
Her team of counselors has been working with flood survivors in Lewisburg and Rainelle. She predicts that FMRS Health System will see more clients suffering from post-traumatic stress and other forms of anxiety, and that existing mental health problems will get worse.
For the most part, at least for now, people are exhibiting inner strength, King said.
“A lot of people have been like, ‘We’ve been through this before, we’ll get through it again,’ ” she said. And many people will bounce back from the flood relatively unscathed, according to mental health experts.
But a group of people, particularly those with pre-existing mental health conditions or those who had been through traumatic events before, might experience long-term mental health effects as a result of the disaster.
Studies show a post-traumatic stress disorder prevalence ranging from about 5 percent to about 60 percent in the first one to two years after a disaster, with most studies showing prevalence in the lower half of this range, according to a 2005 literature review in Epidemiologic Reviews.
“I think we’re going to see individuals who will be very resilient and weather this and I think we are going to have individuals coming out in droves wanting to help,” said Karen Yost, CEO of Prestera. “That’s going to be comforting to people.
“We’re going to have another group of individuals that’s not going to be so easy for,” she added. “Some of those individuals may have mental illness and previous trauma. It’s going to be from one end to the other. We’re going to see both.”
Prestera has also had mental health counselors working on the ground.
Dr. Emily Selby-Nelson, a psychologist with Cabin Creek Health Systems, has been going from door to door in Clendenin, passing out hygiene products, baby wipes and other items. She passed out crayons and paper for children.
“Toys are familiar,” she said, gesturing to the destruction around her. “This is not. This is completely not like home.
“I’m going to try to get something with music, because all they hear is trucks and generators.”
Cabin Creek Health Systems set up two tents to give people tetanus shots, attend to their medical needs and ask about their mental health, as well.
Many of the people they see are too focused on immediate needs to really process what’s happening to them.
“Many of them are in shock because this is their life and it’s just been washed away,” Selby-Nelson said.
She predicts that by the time some of the effects start sinking in, much of the help that has descended on Clendenin will have left the area.
Selby-Nelson said her organization will be there for them whenever they’re ready. Even though its building was flooded too, workers plan to make repairs and stick around.
Her organization’s mission is to provide integrated medical and behavioral health services in rural areas with less access to care, like Clendenin — areas that already had less access to transportation and money for health care, before the flood.
“Those barriers are just going to increase exponentially, and that’s why we’re staying,” she said.
She noted that the rebuilding process will take time.
She said it’s “not just the rebuilding of the structures and the homes and the communities.”
“It’s also the rebuilding of the people.”
Mental health care providers said they want to encourage the flood survivors to seek help if and when they need it.
“Sometimes in West Virginia, we’re stoic people,” Yost said. “We take care of our own. People are sometimes hesitant to admit that ‘I’m not doing well with this.’ Sometimes people don’t seek services when we need them. I would say to people, help is available. Don’t hesitate to ask for it if you need it, because we can help. People don’t have to suffer in silence.”
Reach Erin Beck at email@example.com, 304-348-5163, Facebook.com/erinbeckwv, or follow @erinbeckwv on Twitter.