**3. Literature: Effects on Mental Health Post-Disaster and Women in Disasters**

The following literature looks at the mental health effects immediately after a disaster and years later.

Roque (2022) examined the psychological effects on persons during and after the passing of Hurricane Maria in Puerto Rico. She reports that in terms of mental health, the greatest impact came months after the hurricane. There were feelings of despair at seeing nothing return to normal, for example, the availability of drinking water, electricity and food. Many had not recovered mentally or psychologically and needed psychological intervention. She adds that seeking such help is taboo. Maria led to persons being separated from their families and other support systems. There was an

increased number of calls to suicide hotlines as opposed to the year before in 2016, from 91,333 to 113,830. Some of the mental health problems included post-traumatic stress disorder (PTSD), loneliness, the sense of loss and isolation, to name a few. PTSD seems to be most common among Puerto Ricans since the hurricane. This may appear immediately, weeks or years after the event (Roque 2022).

According to Martin (2015), Hurricane Sandy affected millions in 2012. It was found that depression levels increased by 25% post-storm and doctor's visits also increased by a significant number. She adds that large-scale disasters have a great effect on the physical and emotional health of disaster survivors. Understanding of these mental issues can improve future disaster relief programs and policies. This can assist government and non-government organisations to assist communities in the aftermath of such disasters.

Ruggiero et al. (2012) add to the studies of the effects of hurricanes and found that after a storm, 15% of individuals reported anxiety and stress related to the storm. They suggest that issues emanating from the aftermath of a hurricane, such as lack of electricity, food, money and/or transportation significantly correlated with mental health problems.

In the aftermath of Hurricane Sandy, many experienced despair, hopelessness, anger and anxiety, and instead of acknowledging anxiety or depression, some complained of a headache, stomach ache or some other physical ailment (Graham 2012).

Unequal opportunities with respect to education and health care means that in times of disaster women are more vulnerable than men. The socio-economic status of women and gender-specific factors increase women's disaster vulnerabilities (Kashyap and Mahanta 2018). Armas, and Gavris, (2013) add that gender-based inequality can increase women's vulnerabilities in disasters. They argue that gender inequality has greatly contributed to the vulnerability of women to floods and other disasters. Gender exclusion is also reflected in all levels of the disaster process, for example, exposure to risk, preparedness, response, physical impact, psychological impact, recovery and reconstruction. Exclusion can contribute to the vulnerability of women during and after disasters (Armas, and Gavris, 2013). This was supported by Chanty and Samchan (2014), who state that women's vulnerability to disasters is rooted in their traditional gender roles, such as reproductive, productive and social, inclusive of childcare responsibilities.

The theoretical framework utilised concepts from social support theory. According to Leahy-Warren (2014), social support is seen as a middle-range theory that focuses on relationships and the interactions within those relationships. Drageset (2021) asserts that social support has proven to have a significant impact on psychological distress, quality of life, loneliness, burden of care, anxiety and depression. As a result, this research sought to examine the psychosocial issues that impacted the women, what support they received, how they perceived that support and what needs they deemed unmet.

The objectives of the study were:


There is distress from a mental health perspective immediately after a hurricane or natural disaster. Manifestations may include anxiety, depression and PTSD. This study fits into the existing studies and contributes to existing knowledge by providing direct feedback on the psychosocial issues that impacted a purposive sample of female-headed households post-disaster in a Caribbean country, namely, Dominica. Presently, there is a dearth of research that examines female-headed households in the Caribbean post-disaster.
