‘I sit and cry all day’: Suicide hotline calls double in Puerto Rico 6 months after Hurricane Maria

MOROVIS, Puerto Rico — Magdaliz Medina struggles each day to meet life's basic needs: electricity, water, food. 

But there's a darker challenge she faces six months after Hurricane Maria ravaged her island: her mental stability and the crushing depression that visits her each day in her darkened home. 

“I sit and cry all day,” said Medina, 42, who has lived without power or water for more than six months. “I was depressed before the storm. Maria made it worse.”

Puerto Rico is facing a galloping   mental health crisis across the island. Besides working to restore electricity and other basic needs to residents  after Maria’s destructive run Sept. 20, state officials also are scrambling to meet the mental health needs of their residents.

Crisis managers at a suicide prevention hotline in Bayamón, near San Juan, receive 500 to 600 calls a day from people around the island in varying stages of desperation. Some callers just want to talk about their loss of home or income or family members who have fled to the mainland USA. Others call with very specific suicide plans.

The number of suicide-related calls to the hotline more than doubled from 2,046 in August to 4,548 in January, according to department statistics. Suicide attempts also have climbed from 782 in August to 1,075 in January, data show.

More:Hurricane Maria storm victims still need your help

The island already had been wrestling with a rise in mental illness during its 10-year recession that sparked widespread unemployment and family separation caused by  migration. Maria made matters much worse, public health officials say.

The mental health center at Ponce Health Sciences University in the southern part of the island receives about 4,000 to 4,500 patients a month. Many come from the nearby mountains, complaining of anxiety, depression and suicidal thoughts tied to Hurricane Maria's destruction, said Kenira Thompson, a university vice president in charge of mental health services.

Initially, counselors saw patients with acute stress and anxiety, she said. But as the six-month mark approached, doctors recorded surges in post-traumatic stress disorder, depression and suicidal thoughts and attempts, Thompson said.

“We’re very concerned with the suicide rates,” she said. “It’s nerve-racking.”

Besides manning the suicide hotline, public health officials have dispatched more than 400 counselors and mental health professionals across the island to meet the growing need, said Suzanne Roig, administrator of the mental health division of the Puerto Rican health department.

A rapidly approaching hurricane season, which begins June 1, adds to their concerns. “We know that could have a very big impact on the mental health and emotional reaction of people,” Roig said.

On a recent morning at the hotline call center, Claudee Garnett, one of the crisis managers, took a call from a woman who confessed she had taken an excessive amount of Xanax. Her voice was slow and slurred. Calmly, he asked for the names and phone numbers of family members.

While Garnett kept her on the line, another crisis manager called a relative who raced to the woman’s home. Garnett talked to the woman for more than an hour, until the family member was able to arrive and take her to a nearby hospital emergency room.

Many callers display acute mental disorientation brought on by Maria, Garnett said. “They don’t have basic needs: roof, home, water, electricity,” he said. “Their lives have changed.”

Another crisis manager, Alberto Morales, answered a call from a man in Corozal, about 25 miles southwest of San Juan, who said he was suffering panic attacks brought on by living with family members for months. Maria destroyed his home.

In a calm, steady voice, Morales advised him to keep his mind busy with other activities: Read, listen to music, exercise. If the attacks persists, seek professional help, he told him.

“They feel helpless,” Morales said later. “You try to give them the basic tools to survive.”

The crisis managers work eight-hour shifts, five or six days a week, absorbing some of the worst thoughts and behavior wrought by the hurricane.

Silvette Acosta, 27, said all the crisis managers, including herself, have been trained to handle the pressure of other people’s problems. She deals with the stress by going to the beach, reading or watching movies. 

Helping the island's most vulnerable makes it all worth it, she said.

“Some of the cases we work with are difficult,” Acosta said. “But the satisfaction we receive — like saving a life — is all that matters.”

Follow Jervis on Twitter: @MrRJervis.