I am heartened, if disturbed, to see a piece in The New York Times this morning examining a looming mental health crisis in Puerto Rico in the wake of Hurricane Maria. Disturbed, of course, that the crisis is happening—the piece reveals huge spikes in mental health admittances, patients unable to access therapy and medications, a spate of suicides—but heartened that the piece even exists. 

Mental illness is rarely mentioned in the chaos after a disaster, except in the case of a frustratingly shallow debate about the role of mental health care (or lack thereof) after a mass shooting. It’s barely registered in the national conversation around Obamacare. And yet mental illness, or rather mental health, in many ways underlies any conversation about keeping a society operating with some level of functionality. Our mental health, individually and collectively, is deeply affected by decisions made by others about our lives and in turns informs every decision we make. It is both a symptom and a cause of the health of a society itself.

From the Times:

“What we have lost is the foundation that holds a society together.” [The psychologist] said that Puerto Ricans would have to adjust their definition of normalcy in order to function: “It’s ‘I survived. My family didn’t die.’ That’s the new definition of O.K.”

If we want our definition of OK to be more than that, we have to think and talk and write about our mental health, not as an afterthought or a special interest, but as the core element it truly is.

P.S. For a more in-depth look at how natural disasters have short- and long-term impacts on mental health, check out this feature about Hurricane Katrina from the Weather Channel.