Extreme weather events pose significant mental health risks for youth, yet few studies have examined the temporal dynamics of crisis help-seeking following multiple hurricanes using real-time anonymized transcripts. We analyzed 2,149 anonymized crisis text conversations from Louisiana youth (2018–2023) using structural topic modeling (STM) to identify thematic patterns and temporal trajectories following six hurricanes, including Hurricane Ida. Conversations were assigned to the closest hurricane using a temporal proximity algorithm and classified into eight mutually exclusive recovery periods based on days elapsed since landfall, ranging from the immediate hurricane period (days −1 to +2) through beyond one year post-exposure (>365 days). Compound disaster effects (hurricane + COVID-19) were also examined. We identified 12 distinct crisis topics organized into four domains (Crisis, Coping, Stressor, Resource/Process) and documented a systematic “three waves” pattern of post-disaster psychological response. Wave 1 (Immediate: 0–30 days) was characterized by resource-seeking, with Crisis Hotline Protocol (17.4%) and Louisiana Services (9.8%) peaking during active storms. Wave 2 (Delayed: 31–90 days) revealed the emergence of acute crises, with Suicide Ideation & Self-Harm increasing from 5.1% during hurricanes to 8.9% at 61–90 days post-landfall (p = 0.006). Wave 3 (Long-term: 3 + months) was dominated by interpersonal stressors peaking at >12 months, including Relationships (17.8%) and Family Conflict (10.3%), with Abuse & Safety Concerns showing delayed emergence at 9 + months. Compound disasters (74% of sample) were associated with elevated Grief (+3.3 percentage points) and Abuse & Safety Concerns (+1.8 percentage points). Crisis text data reveal distinct temporal phases of youth mental health help-seeking following hurricanes, with a critical delayed suicide ideation peak at 61–90 days. These findings suggest potential windows for stepped-care frameworks and demonstrate the utility of crisis hotline data as a real-time tool for disaster mental health surveillance.
Sugg et al. (Tue,) studied this question.