This is the fourth story in our series chronicling the 20th anniversary of Hurricane Katrina. Trigger warning: This article contains descriptions of suicide, gun violence, and child deaths that may be distressing to some readers.

As the 10th anniversary of Hurricane Katrina approached in 2015, Michelle McCullum, a 25-year-old mother of two, drove her children, ages 3 and 5, to a once bustling but now desolate industrial area of New Orleans. It was there that police said she shot her two young children and then herself. 

The sudden death of McCullum and her babies was a devastating and bewildering loss for their loved ones, friends, and the city of New Orleans, the family said at the time. It reverberated across the city.

The children’s grandmother, Crystal McCullum, called for city residents and elected officials to open their eyes and to invest in more mental health resources for one of America’s poorest and Blackest cities. 

“If you have anybody — anybody — that you know that needs help, just help them please,” she said at a vigil shortly after the death of the mother and her children. 

Michelle McCullum’s story became a haunting symbol of a new post-hurricane legacy: a young Black mother unable to find a foothold in a city still battered by loss, dislocation, and the slow erosion of opportunity while carrying the weight of mental illness in a fractured health care system.

McCullum was a teenager living in the city’s Treme neighborhood when the deadliest natural disaster in over a century remade New Orleans. At the time, the Treme neighborhood, one of the nation’s earliest free Black communities, was also a cornerstone of the area’s African American culture. 

But in the aftermath of Katrina, the neighborhood – and opportunities for residents — shifted. The share of Black residents dropped by 40% while the share of white residents increased by 460%. And the city’s manufacturing hub, which was anchored by NASA and was one of the main pillars of middle-class Black families, lost nearly 100,000 jobs that never returned.

Rita Gardner, who escaped the flooding on an air mattress because she cannot swim, laughs in the B.W. Cooper housing project in New Orleans. Before Hurricane Katrina, the complex was the city’s largest housing project. The U.S. Department of Housing and Urban Development demolished it in 2014. (Mario Tama/Getty Images)

In the year before her death, McCullum had been laid off from the NASA manufacturing hub (she later ended her and her children’s lives just minutes from her former job). Her husband had also worked at the facility. After she lost her job, she tried to pivot and aim for a career in dental health, but struggled to afford classes. While the factors that led her to take her own life and the lives of her toddlers are unknown, her family, neighbors, and loved ones could not separate her anguish from Katrina. That anguish could not be untangled from the catastrophic storm, and the lingering disruptions that continued to ripple through New Orleans in heartbreaking ways.

A decade later, as New Orleans approaches the 20th anniversary of the hurricane, researchers have found that Louisiana holds the ominous distinction of being the state most vulnerable to what psychologists call “deaths of despair.” That phrase refers to fatalities from suicide, substance abuse, or chronic issues like respiratory and cardiovascular diseases linked to hopelessness and poverty. 

The findings were part of a study by a team of researchers from Texas A&M University and the Environmental Defense Fund that explored 184 social and environmental metrics across 70,000 neighborhoods. 

In New Orleans, and especially among Black residents, those numbers illuminate the visible and invisible scars left by compounded climate change disasters over the last two decades — besides Katrina, the city has experienced several tornadoes, winter storms, and hurricanes, including Hurricane Ida in 2021, the strongest storm in Louisiana history.

Today, residents living in McCullum’s old neighborhood are more vulnerable to die a death of despair or experience poor mental health than 99% of America’s neighborhoods. 

When the concept of deaths of despair was first introduced in the late 1990s, white Americans were more likely to experience such outcomes. But deaths of despair among Black Americans have increased dramatically in recent years, with rates now surpassing those of white Americans.

For many in New Orleans, mental health experts say the absence of meaningful recovery after disasters, persistent poverty, and memories of abandonment have fueled an undercurrent of despair. 

“Essentially, this is a city where, if you’re from here, your life is [impacted by] PTSD, which is connected to depression and anxiety,” said Danielle Burton, a licensed professional counselor and member of NOLA Black Mental Health Matters.

Burton said what makes these vulnerabilities so acute is the way disaster is layered atop decades of inequity: limited access to mental health care, systemic racism in employment and housing, and a slow, uneven recovery have deepened the roots of despair. 

“All of this is not just because of the immediate aftermath of Hurricane Katrina, but in the environmental damage that comes from gentrification, that comes from the whitewashing of culture and life here,” she added.

When a neighborhood loses its good jobs, safe parks, and health clinics overnight, research shows that daily life becomes a struggle just to meet basic needs, and constant worries about bills, safety, and getting help when you’re sick can make people feel hopeless and alone. For instance, when someone like McCullum is laid off as businesses close and the local mental health clinic disappears, she and her neighbors may find themselves with nowhere to turn when sadness or stress becomes too overwhelming. 

New Orleans lost more than half its psychiatrists, social workers, psychologists, and other mental health professionals in Katrina’s aftermath, and in the years following, suicide rates nearly tripled. In the two decades since the storm, the city’s suicide rate has grown 37% compared to national growth.

The fallout of storms on victims’ quality of life was recently explored in a study published in Nature, a peer-reviewed scientific research journal. Researchers found that Black people experience the greatest increase in mortality after tropical cyclones like Katrina, for up to 15 years after the event.

When Black and white populations are exposed to the same storm, Black people have more than three times the increase in deaths in comparison. This is not because the hurricanes hit them harder right away, but because Black communities are more likely to face challenges like less money, fewer resources, worse health care, and more stress for many years after a storm, researchers said. 

Before the storm, Robert Green, 70, said that despite whatever social inequities might have been present, it was clear that a sense of community and the ability of neighbors to depend on each other were what kept people afloat. 

“It was evident. You could look outside and feel like there actually was no room for improvement,” he said, while sitting in his living room this spring. “I knew all my neighbors by name and all my neighbors knew me and my children. But we lost that, either to Katrina or the storm of neglect that followed.” 

On the wall across from him, a portrait of his mother Joyce in her U.S. Air Force uniform and a painting of his 3-year-old granddaughter Shanai “Nai Nai” looked back at him as he spoke. Joyce and Nai Nai were killed when the hurricane’s floodwaters sent his home floating down the street and straight into a massive oak tree.

He said it took him years to battle through the depression and anxiety that followed their deaths and work toward happiness. “The loss of my mother and granddaughter, just like the loss of all our neighbors, was detrimental to my well-being,” he said, “but, I couldn’t run.” 

In Robert Green’s front yard, visitors are greeted with a headstone and memorial for his mother Joyce and granddaughter Shanai Green. (Adam Mahoney/Capital B)

In New Orleans, Black therapists are fighting for more resources 

Social and scientific researchers have distilled the components of measuring quality of life into five key metrics: access to health care, education, economic stability, safety, and a clean environment. When considering those factors, researchers say it is not difficult to see why Louisiana residents are most vulnerable to deaths of despair. 

In 2004, before Hurricane Katrina, the state’s life expectancy stood at 74 years; today, it has dropped to 72 — making it the fourth lowest in the nation. Educational attainment also remains a concern, with only about 86% of adults holding high school diplomas, which is the third-lowest rate nationwide. Economic stability is especially troubling, as Louisiana has the highest share of residents living in poverty in the United States, and New Orleans’ poverty rate is double the national average. When it comes to safety, Louisiana led the nation in murder rates for 31 consecutive years between 1980 and 2021, and as of the most recent federal data released in 2022, the state holds the second-highest homicide rate.

Environmental vulnerability compounds these issues: Louisiana is the second most vulnerable state in the country to extreme environmental and climate events, contributing to negative health, social, economic, and ecological outcomes.

A vulnerability map of the Greater New Orleans area highlights the neighborhoods most at risk for mental health struggles and “deaths of despair.” Nearly all of the city’s neighborhoods are among the nation’s most at-risk. (Source: U.S. Climate Vulnerability Index)

This fragility is woven into the city’s infrastructure. But people like Burton, the mental health worker, said they gather hope and pain in the same hands. On Thursday evenings, as a curtain of humidity hangs in the New Orleans air, Burton and other Black therapists gather in the halls of the city’s African American Museum. There, they arrange chairs into a circle, inviting anyone to simply sit and speak. This is Therapeutic Thursday: a local ritual where Black New Orleanians lay bare what usually goes unsaid. The ache of remembering, the fatigue of being pushed out, and the grit of surviving each day with so little of a safety net beneath them.

“Depression and anxiety are here,” Burton said, “but what makes them unique in New Orleans is that here, trauma is not just a personal burden. It’s social, it’s historical.” 

It is also generational. According to the Society for Research in Child Development, up to 50% of children report post-traumatic stress symptoms after disasters like Katrina. But culturally competent care is hard to find — only 3% of psychologists in the U.S. are Black. 

And every year, as Katrina’s anniversary comes round again, the wound is reopened, Burton said. “It’s hard to move forward when the trauma is so present, as long as gentrification is still happening, as long as the culture keeps getting erased without any care.”

Through the NOLA Black Mental Health Matters Therapy Fund, the group hopes to provide free mental health services to Black community members while ensuring equitable pay for clinicians. (Courtesy of NOLA Black Mental Health Matters)

Accessing care, Burton said, is also a struggle with layers of red tape and economic instability. The shortage of therapists is only the first wall. Most Black New Orleanians rely on Medicaid, but therapists who take it often cannot survive on the slim reimbursements. And private-pay care — sometimes the only option — is financially out of reach for families stretched thin by decades of underinvestment. Many can’t even get to appointments: New Orleans lacks robust public transit, has spotty internet access, and because one out of three Black residents live in poverty, they cannot afford time lost to jobs that barely cover the rent. 

“There are Black therapists here who want to help,” she said, “but the same systemic forces that wall off clients, wall off the therapists too. We all have to survive.”

So Burton and her colleagues build what they can. Support in the form of a “therapy fund,” fueled by small donations to cover a dozen free sessions at a time for those struggling with mental health issues; open conversations in community spaces; partnerships with local political power brokers and community festivals. 

“We want people to see Black faces — people like them — talking about and doing this work,” she said. “Not just to tell them to get help, but to show them: you’re worth it, your story matters, and there are ways to heal.” 

Survival should be the bare minimum, Burton said. Yet in New Orleans, it is not a guarantee. But with each story shared in a circle, each grandmother’s plea for help, each new effort to clear a path to healing, she said, a different legacy becomes possible. 

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Adam Mahoney is the climate and environment reporter at Capital B. He can be reached by email at adam.mahoney@capitalbnews.org, on Bluesky, and on X at @AdamLMahoney.