As the COVID-19 pandemic began to spread, public health officials around the globe scrambled to provide support. But in Puerto Rico, suicide prevention workers faced a different challenge: helping marginalized populations already affected by recent natural and economic disasters.
Over the last five years, Puerto Ricans have experienced a cascade of traumatic events-enduring a series economic recession, category five Hurricanes Irma and Maria, a series of earthquakes, the COVID-19 global pandemic, and, most recently, Hurrican Fiona.
The impact of these disasters was widespread. Around 1.5 million Puerto Ricans lived without power in the months following Hurricane Maria, and 95% of Puerto Ricans lacked clean drinking water. In all, 90% of households applied for assistance. Nearly 3,000 people died in storm-related incidents during this period and around 4% of the population was displaced from the archipelago.
For many, picking up the pieces between crises was difficult. In a Washington Post/Kaiser Family Foundation survey conducted one year after Hurrican Maria, more than 20% of Puerto Rico's residents reported needing or receiving mental health services, and 13% said they started new or higher-dose prescription medicaitons to treat emotional problems.
In the six months after Hurricanes Irma and Maria, the Puerto Rico Violent Death Reporting System documented 22 suicides where exposure to a natural disaster was believed to be a precipitating factor for suicide.
Reports indicate the victims experienced a range of hurricane-related challenges. Many felt anxious in the aftermath of the hurricane. Some had lost their belongings or lacked water and/or electricity. Others watched their businesses go bankrupt or didn't have the resources to rebuild their homes.
Two years after the hurricanes—and six months before the COVID-19 pandemic—Silma Quinones Roldan, PhD, counseling psychologist and then-president of the Puerto Rico Psychological Association, noted that "people on the island are still experiencing post-traumatic stress and flashbacks. They are not psychologically going about their daily routines as they did before the hurricane."