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Pictured are Outreach Workers providing crisis counseling in a FEMA trailer park on the Mississippi Gulf Coast. Outreach Workers go door-to-door providing referrals, education and public information for anyone affected by Hurricane Katrina.

"Believe it or not, I was just about ready to retire," said Jennie Hillman, the director of Mississippi's Project Recovery (PR). "Then Katrina hit, and they asked me to be the director of the project."

PR, which is funded by a grant from the Department of Homeland Security's Federal Emergency Management Agency (FEMA) and facilitated by the Substance Abuse and Mental Health Services Administration (SAMHSA), is a division of the Mississippi Department of Mental Health. Their vision: to provide crisis counseling for those countless individuals affected by Hurricane Katrina.

PR provides free crisis counseling services through community outreach, public education, and information and referral. Since September 22, 2005, PR has had more than one million brief encounters (less than 15 minutes) and over 186,000 individual contacts (more than 15 minutes). The project's toll-free, 24/7 helpline has received more than 6,100 calls.

"It's been almost a year," said Hillman, "and we're still getting serious calls."

Hillman explained that the program offers its field workers training in crisis counseling, especially active listening and "psychological first aid." The organization works to utilize local people, giving priority to those displaced by the hurricane. These outreach workers, currently some 371 of them (over 400 at their peak), reach out to Katrina's survivors and make themselves available to individuals, families, community groups, businesses, and service organizations at no charge.

Though PR is not authorized to provide case management, the counselors make referrals to mental healthcare professionals as needed. "Most of the people we encounter will not be long-term mental health cases," Hillman said. "They need to talk and to be listened to."

There are 27 team leaders, who are masters-level certified counselors. Individuals who need more than one session of counseling are referred to these team leaders. They, in turn, can make referrals into the regular mental health system.

Hillman said, "One of the long-term concerns we have is the burden on the state's mental health system. Especially in the six coast counties, there are facilities that are only operating at two-thirds of their staff capacities, and some centers have taken an enormous hit in terms of building damage. We refer patients in, but we know the centers have real problems."

As of the first week of August, with the anniversary of Katrina's landfall looming on the horizon, it would be an extreme understatement to note that Hillman and the PR staff are aware of just how serious are the problems facing Mississippi's survivors.

"There are many mentally ill people who have relapsed," Hillman said. "There are several factors here, including anxiety, depression, and fear. Also, we know that large numbers of substance abusers have really gone backward as they have had to deal with all of this. Typically, we refer 7 to 9 percent of the people we talk to for further treatment. That's a lot of people into an overtaxed system."

She pointed to other harsh realities, such as the prevalence of post-traumatic stress disorder (PTSD). "With PTSD, we think that the peak has not even hit yet," she said. "I don't have a number on hand for suicides, but they have been increasing."

In light of these concerns and the stresses associated with Katrina's anniversary, she offers a simple and strong message: "We want people to know that we are still here and steadily providing our services to the public. You do not have to go through the anniversary of Katrina alone. We are here 24 hours a day to help you cope and provide referrals that can help get you back on your feet and on the road to recovery."

Make no mistake, though: Hillman is full of hope. "People are working together," she said. "I hear stories every day about people who are finding incredible strength inside themselves. We have a group meeting every month, and everyone is in tears as we share our success stories."

The staff's overwhelmingly challenging task does not deter Hillman. "I work well under pressure," she explained. "This is the most rewarding thing I have ever done."

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