Agencies help with mental health care

  • Dr. Paul Beighley

As the eruption of Kilauea volcano continues in lower Puna, the uncertainty and ongoing stress can affect the mental health of residents.

Psychiatrist Dr. Paul Beighley, medical director for the state Department of Health’s Adult Mental Health Division for the Big Island, is based in Hilo, but has been working in Pahoa. He said he’s seen different types of emotional responses to what’s happened.


Some individuals show little evidence of stress or difficulty coping, while others may have a more profound experience with the crisis, he explained.

The degree of loss and the availability of financial, community and emotional resources will impact reactions, said Beighley. Age and culture can also play a part in how people experience the “stress of loss and dealing with crisis.”

“We’ve found that we really have to deal with folks on an individual basis and not presuppose we’re going to see (a) typical response,” he said.

In the initial days of the eruption, which began May 3, people were trying to first focus on basic needs, like finding a place to stay and food, according to Beighley. Once those issues were tackled, however, they began to get in touch with their emotional needs.

People are grieving the loss of their homes, lost occupations and even grieving the loss of the tidepools, said Beighley. They’re voicing uncertainty as to what the future might hold. For people facing the loss of a home and lack of resources, there may be significant anxiety as to what’s next.

“There are a variety of emotional responses, but those are the most common,” he said.

The Adult Mental Health and Child and Adolescent Mental Health divisions have small clinics in Pahoa, which are open to walk-in patients for support, crisis counseling, information and referrals, said Mark Fridovich, administrator for Adult Mental Health.

Beighley said they’re also reaching out to displaced people where they’re staying.

“To make care more easily accessible, we have deployed Department of Health teams at the shelters, information center and now resource center,” he said.

According to Beighley, the mental health response to the current eruption has been a collaborative and multi-agency effort.

“The Hawaii Department of Health has integrated our efforts with American Red Cross to avoid duplication of services or role confusion,” he said.

Red Cross emergency mental health workers at the shelters are serving as the “front-line providers” for immediate relief and support while DOH staff is focused on longer-term support or helping with situations that require urgent intervention, Beighley explained.

Fridovich said response and recovery is a “long-term thing.”

“It’s not a day, it’s not a week, it’s (not) a month, but for individuals, depending on the severity of their experience, issues around this may go on for a period of time.”

Although response is individualized, quick intervention and support around the loss or trauma “can help the person recover more quickly and more completely,” he said. That’s why the DOH is interested in supporting outreach “to as many people as possible, getting help more quickly as opposed to waiting.”

According to Beighley, there are a number of coping strategies that can help in the long term.

He encourages folks to use social supports, like friends or church, because “to try to deal with this by yourself really makes it that much harder. To make use of social supports is something that helps people cope with this better.”

To maintain better physical and mental health, Beighley said folks displaced by the flow should be moderate in their use of alcohol, exercise and try to maintain a routine as much as is possible.

Fridovich said parents with children have additional challenges and talking with them with their children will be helpful.

“Older children may not be able to verbalize their particular worries, fears or angers, so it may come out in other forms,” said Fridovich. “Children are also very resilient. We are all resilient and our children are resilient, too.”

Beighley said everyone has to deal with life’s stress, but some individuals will be more severely impacted by the disaster than others and may need additional mental health support.


Individuals should seek help if they have thoughts about self-harm or behaviors that could be harmful, thoughts or behaviors that might hurt someone else, are using drugs or alcohol in unhealthy ways, see a significant weight loss or change in physical health, are unable to take care of their medical needs, experience a prolonged depressed mood, are becoming agitated, unable to sleep or engaging in risky behaviors.

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