175: The Gap After The Crisis

The strange part of a crisis is not the first week. It’s the months after, when the debris is cleared, the headlines move on, and your body finally stops running on adrenaline. That’s when many people begin to notice the insomnia, anxiety, irritability, brain fog, and avoidance they couldn’t afford to feel earlier. And too often, that’s exactly when the surge of support has already disappeared. 

We dig into the gap between when help is offered and when people are actually ready to accept it, using the aftermath of the 2018 Camp Fire in Paradise, California as a vivid example. 

We talk through why survivors often say “we’re fine” in the immediate aftermath, how triage and stigma shape help-seeking, and why leaders can’t rely on early utilization numbers to judge long-term community wellbeing. Along the way, we connect the dots to what disaster research shows about delayed stress responses and post-traumatic stress symptoms after events like 9/11 and Hurricane Katrina. 

We also name the deeper mismatch: psychological timing, institutional timing, and social timing rarely align. 

Emergency funding ends, staff burn out, and reporting systems reward what’s measurable early, while many people only feel safe enough to ask for support later, when it’s socially less acceptable to still be struggling.

 We close with practical, realistic ways to keep mental health support accessible after disaster recovery begins, including 3, 6, and 12-month follow-ups and partnerships with schools, faith communities, and primary care. 

If this resonates, subscribe for more conversations on resilience, share this with someone who leads in a crisis, and leave a review telling us what kind of support you wish existed six months after the emergency.

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Transcript

Paradise After The Fire

Manya Chylinski 0:00

In the weeks after the campfire destroyed Paradise, California in 2018, all sorts of people mobilized. Volunteers filled the aid centers, were counselors who staffed temporary clinics, resources distributed, you know, the media covered the response daily. Residents stood in line for housing forms and insurance claims and getting food. And a lot of people said the same thing. You know what? We're fine. We just need to rebuild. But months later, after the debris had been cleared and the media attention had largely moved on, people started reporting anxiety and insomnia and difficulty concentrating because that immediate response phase was over. And in some cases, funding was no longer there and services were consolidated. You couldn't have as many people providing support in this at this time. So by the time some people realized that they might need mental health support, it was harder to find. At the beginning, after something happens, everyone just converges to help. And that is wonderful. And it's so important. And that help is loud and lots of it. But for some people, the need for support emerges later. And so it's a mismatch, and that has consequences. Welcome to Notes on Resilience. I'm your host, Manya Chylinski. Today we're talking about timing, specifically the gap between when help is offered and when people are ready to accept it. So this is about understanding how we respond after a crisis and how our institutional timelines just don't quite work on the same timelines as our human response. So after a mass disruption, wildfire like the campfire, a shooting, a terrorist attack, a natural disaster, our systems mobilize quickly for the most part. Jurisdictions launch hotlines, you know, family assistance centers, nearby counseling centers might expand their hours or bring in extra counselors. Nonprofits are, you know, brought into action. And the local government, the state government, sometimes the federal government will allocate emergency funding. And all of that, all of those activities and numbers become a metric of success. How many people we dealt with in the first day, the first week, how many counselors were utilized in the first day or week? And that's great. And that assistance is absolutely important and needed. It's just not the full picture. So, in terms of survivor, what's happening is in the immediate aftermath of a crisis, a lot of us are in survival mode, depending on our experience in the event, if we were physically injured or not, if we had property damage or not, if our experience is largely mental health related or not. But we're in survival mode. And so depending on what happened to you, you might need to secure housing for yourself or your family. Share with your family and friends your status and if you're okay. If you had property damage, you've got insurance claims. If you had physical damage, you've got health insurance questions. After a certain point, there might be funerals to go to. And then it's time to rebuild. So some people need to rebuild their homes, some people need to rebuild their businesses. If you've got children involved, you're focused so much on taking care of them and dealing with their emotions and their fears. And early on, you know, you're just running on that adrenaline and the need to survive and the need to do these things to take care of yourself. And early on, for a lot of people, you think that you're fine because you're just focused on these really important tasks. Other people resist help. They may be feeling unsettled and scared and all of those things, but they resist help because maybe they want to seem like they're strong and in control. They don't want to burden first responders. Certainly in a mass casualty event, triage is really important. And I know I never thought to approach a first responder for help or to go to a hospital. And on one hand, it was that early on I didn't realize I'd been affected. And also I recognized the sheer number of people who were clearly going to hospitals needing medical attention. And I didn't want to get in the way of that. And people resist help also because they assume others need help more. Now, in direct contradiction to what I just said, yes, had I been physically injured, I don't know if my behavior would have been different. I don't know if I would still have assumed, oh, okay, I'm bleeding, but other people need help more. But some people do. And I know a survivor who said that all the time, all the time, that other people needed more help than they did. The other thing is early on, people might not seek help because they don't recognize the symptoms in themselves. Or they recognize them and just think they're going to go away on their own, which for some people they absolutely do, just go away on their own without any kind of formal mental health intervention. And other people resist help because we're not that great in this country about talking about our mental health issues. So people want to be quiet because we just don't, we're not as open to that kind of disclosure. So that's all in the immediate aftermath. I mean, in some cases, I'm thinking minutes or hours, but days and maybe weeks. But as we move on the timeline and months pass, then those feelings can change. That immediate sense of emergency is gone and needs to be gone. But then maybe people are struggling with sleep issues and concentration issues or irritability. People are avoiding, maybe talking about it. Maybe they're avoiding the location. And that can be a time when somebody thinks, oh, maybe I need help, maybe I need to talk to somebody. And by then, that surge response that happens in the immediate aftermath might be gone. Now, as I mentioned, not everybody needs formal mental health intervention. When someone thinks maybe I should talk to someone, for some people, yes, that means a mental health professional, a counselor, a licensed social worker, a psychologist. For other people, that might mean clergy member, family member, peers, other people who were there, a boss if you have a particularly close relationship. But again, by the time we're a few months out, that surge of support is gone. And for people who weren't affected, they also aren't thinking about it in the same way. Leaders in organizations, cities, workplaces often think well, if we offer support in whatever way it is, maybe through an EAP or an ongoing hotline, whoever needs it is going to use it. And if somebody says no early on, you know what? That means they're resilient. They're not going to need it. And there's also a belief sometimes that if there's a lot of participation early, that that maybe negates the need for long-term coverage. Now, in some cases, absolutely. If we can intervene with someone early on, if we can help them understand that their feelings are normal in response to this abnormal event, we can often ameliorate future symptoms and we can turn someone, we can protect someone from potentially getting PTSD. So early participation is an important metric, and it does help people for the long term. It just isn't helping everyone necessarily. And we also think sometimes, well, if someone doesn't access those services early on, they're probably not going to need them. And you know what? That simplifies the response. It simplifies the reporting and the metrics and the numbers for the after-action report, but it doesn't reflect how delayed stress responses happen. And research across disasters shows that there's just a lot of variability in when symptoms start for people. Some people show immediate distress, others have delayed responses, and some are kind of all over the map, up and down, fluctuating, like a roller coaster. You know, I had some pretty immediate distress, but I have met survivors of the bombing who didn't have immediate distress, but did have that delayed onset. And after 9-11, there are studies that show both the immediate and the delayed onset of symptoms that are consistent with post-traumatic stress. And after Hurricane Katrina, same thing. There were prolonged mental health challenges, but they evolved over time and they didn't peak necessarily in those first few weeks. Now, no one can reliably identify on day one, day three, day seven who's going to be struggling a few months from now. Often not even the person who is actually struggling. So I don't want to discount the importance of those early responses and those early resources. Those are important. And for many people, that can be the difference between recovering earlier or developing longer-term symptoms like post-traumatic stress disorder. From my own experience, those first few days and weeks, they're confusing for sure. But there's also kind of a structure to it. There are press conferences, and there's collective attention, and the news is paying attention, and there's a sense that we're all in this together. But later, those things go away. They should go away. We don't need to continue to pay attention to a lot of these things. And certainly life moves on. But for some people, that's when that internal experience starts to make itself apparent. And, you know, admitting that you need help later on for many people feels harder than saying it early on, because the conversation has shifted and people are now talking about gratitude and sharing survivor stories. And there's a sense that we should, quote unquote, have moved on. So if you feel the need come up later and you know it's connected to the event, people hesitate. And the other thing is later you might struggle with symptoms and not necessarily connect it to the event, depending on how long it takes for you to experience those symptoms. And you know, in these events, leaders of all kinds across municipalities, governments, organizations, there are real constraints. There's emergency funding that has limited use. The media moves on. Staff who's dealing with all of these things get tired and burnout. And after that initial surge, probably utilization rates drop. And we prioritize those visible crisis phases. And again, we are not wrong to do so. It's later when people still need support that we don't have that structure set up quite as well. And there's also a bit of a reporting bias. When there's early engagement, it's it's measurable. You can get the metrics of the number of people who called the hotline, who came to the family assistance center, et cetera. But when someone doesn't recognize their symptoms until later, then that isn't part of the community story. That becomes an individual story. And so this mismatch is kind of three things. It's psychological timing. When does someone feel safe enough to admit that they're vulnerable? Institutional timing when we fund and promote services, and social timing, does it feel acceptable to still be struggling? And these three timelines rarely synchronize with each other. And you can't hold emergency infrastructure forever. You can't hold it indefinitely. It's not that's not the purpose of it. But we can think about smarter timelines. We can understand that emergency infrastructure is one phase. So that might look like re-offering support at three months, six months, 12-month intervals, continuing to send follow-up communications to people you know who have been impacted for a long time, probably longer than you're thinking, making it simple and easy for people to find support. And other thing is really important is being careful about your language. So we don't want to make it seem as if somebody who early on said, no, I'm okay, that's a permanent decision that now you they can't get help later. And partnering with organizations and institutions, schools, faith institutions, community groups, primary care offices to extend those support pathways long after the surge period. So that is right now, it feels like the support is this one-time invitation. If you miss your window in the first days or weeks after to say that you need help, then you're probably not going to find it and you're on your own. I believe that's something that better serves our communities if that continues longer term, or if there's a door that is just more visible for people to knock on or walk through. In the early days after a crisis or disruption, people often say they're fine. And sometimes they truly are. And sometimes they're not ready to know that they are not fine. Leadership after crisis requires patience with that uncertainty and finding a way to make that support available and reachable when someone does feel ready to receive it.