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Lessons learned from the Joplin tornado: peer-to-peer mental health programs

SARAH MCCAMMON, HOST:

As Mayfield, Ky., and other areas hit by this month's tornado outbreak try to rebuild, Joplin, Mo., offers some insights. An EF5 tornado took out a third of Joplin a decade ago, and the lessons learned since then have been applied to disasters around the world. Frank Morris of member station KCUR reports.

FRANK MORRIS, BYLINE: An enormous tornado with winds topping 200 miles an hour turned Joplin, Mo., into a case study on building failure.

BRYAN WICKLUND: I remember after the tornado, we had one home just a few blocks from here that was actually sitting in the middle of the road upside down.

MORRIS: Bryan Wicklund is Joplin's chief building official. He says new homes going up here now use more steel to secure roofs to walls and walls to foundations following national standards established after the Joplin tornado. And it's not just houses that are better prepared. The tornado forced officials, like Joplin's emergency management director, Keith Stammer, to think big.

KEITH STAMMER: If I had walked into a disaster planning committee meeting with a scenario in my back pocket that basically wiped out a third of Joplin and caused us to not be able to help ourselves from the get-go, I'd have been laughed out of the meeting. Not now - that is in our planning.

MORRIS: So planners like Stammer are now gaming out bigger and more complex disasters. He says that the tornado also forced a cultural change in the way that first responders deal with post-traumatic stress. Stammer says the old model was to just suck it up.

STAMMER: But all of a sudden, when all of you or many of you are having psychological problems, emotional problems with this, you become much more empathetic. You become much more sympathetic.

MORRIS: And that goes for average citizens, too. Doug Walker is a clinical psychologist from New Orleans who travels the world helping communities struck by disaster. When he got to Joplin, he found residents reluctant to talk about their feelings.

DOUG WALKER: When you asked someone, how are you doing? They'd say, I'm fine; I'm good. You know, Joe Smith needs you down the way.

MORRIS: Walker had a list of five things to check on - work, relationships, play, sleep and consumption of food, drugs and alcohol. He says a Joplin focus group hit on a simple question that opens up informal therapy. How's your five?

WALKER: And a lightbulb went off in my head. And I'm like, you just managed to put together a peer-on-peer support that really has never been done before.

MORRIS: ...Peer-on-peer support that Walker says he's used to get disaster victims talking from Florida to Fukushima. But of all the good ideas following the tornado, Vicky Mieseler, executive director at Ozark Center, a group of mental health clinics in Joplin, says one stands out like a light at the end of a tunnel.

VICKY MIESELER: The best thing that happened to us is when the school superintendent said, we're going back to school in August.

MORRIS: The superintendent was C.J. Huff, and the goal he set was a tough one. Half the schools were severely damaged, and many of the teachers and students were homeless. Huff's timeline gave him less than three months to get the district back on its feet.

C J HUFF: That was a walking heart attack. I gained about, gosh, 60 pounds, I think. I'm a stress eater. And we all have our coping mechanisms, and mine was ice cream and lots of coffee - lots of coffee and lots of ice cream.

MORRIS: C.J. Huff got schools started on time by building classrooms in abandoned big-box stores. He was a local hero, all over national news. But he says that a few months later, exhausted, distraught citizens began fighting him at every turn.

HUFF: One of the things I learned is that when emotion and logic collide, emotion wins every time. It didn't matter what we brought, whether it was data or subject matter experts. It didn't matter.

MORRIS: Huff was demonized by some residents. He says he considered suicide and was eventually driven out of the job. Vicky Mieseler says he wasn't alone.

MIESELER: Several years after the tornado, you started to see major change in leadership positions.

MORRIS: She says that includes the city manager and a hospital president. Now Huff is a disaster consultant, and he says that every single one of his colleagues are former public officials ousted after a disaster.

HUFF: All of them (laughter). We call it the exclusive club that nobody wants to belong to.

MORRIS: Huff says disillusionment follows every disaster as recovery timetables push back. Ashley Micklethwaite, who was Joplin School Board president when the tornado hit, sees it as a cautionary tale.

ASHLEY MICKLETHWAITE: So Kentucky, listen up. Don't do that. Just know that your leaders today are making the very best decisions that they can.

MORRIS: Joplin's recovery has gone pretty well. The tornado killed 161 people and destroyed 8,000 structures, but the city has managed to grow since. And there's little doubt that Joplin and probably the rest of the country is better prepared for the next one.

For NPR News, I'm Frank Morris in Joplin, Mo. Transcript provided by NPR, Copyright NPR.