ew Orleans continues to experience a shortage of mental health care facilities following Hurricane Katrina. Further complicating matters, a significant number of mental health workers never returned to the region. Dr. Kathleen Crapanzano, of the Louisiana Office of Mental Health, explains the city's conflict.

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MICHEL MARTIN, host:

And as the country braces for another hurricane season, we felt that it was important to examine the lasting effects of Hurricane Katrina on New Orleans. The city services have yet to fully recover from the storm, in particular, New Orleans is experiencing a shortage of mental health facilities.

Two local hospitals that provided hundreds of beds for psychiatric patients are still closed, and many of those health care workers have not returned. That's left thousands of people without adequate resources as they struggled to rebuild the city and their lives.

For more on the mental health crisis in New Orleans, we're talking with Dr. Kathleen Crapanzano. She is director of the Louisiana Office of Mental Health. She joins us from her office in Baton Rouge.

Dr. Crapanzano, thank you so much for speaking with us.

Dr. KATHLEEN CRAPANZANO (Director, Louisiana Office of Mental Health): Thank you for calling.

MARTIN: Talk to us about the mental health system in New Orleans before Katrina. Were there adequate resources at that time?

Dr. CRAPANZANO: You know, our state mental health system has never been adequate to meet the mental health need here in our state. New Orleans was no exception. We weren't adequately funded to serve the whole spectrum of mental illness. We were seeing just the most severely mentally ill in our clinics, and our hospitals were able to barely meet that need prior to the storm.

MARTIN: What's the status on the rebuilding of the hospital wards, the mental wards, which had been shut down because of the storm?

Dr. CRAPANZANO: It's been very difficult. And actually, in your introduction, you said we lost two major hospitals. We lost all the hospitals in New Orleans that provided mental health care. I believe we had about - let me get my numbers here - 578 mental health beds in New Orleans in Jefferson Parish, the region of - around New Orleans before the storm. And we are still 372 down from that number. So it's been very difficult to get those hospital beds back up and running.

MARTIN: And what about your personnel? It's my understanding that there were, what? Almost 200 psychiatrists, licensed psychiatrists in New Orleans before the storm, and you're down to something like 22. Is that about right?

Dr. CRAPANZANO: Well, I've seen all kinds of numbers. But clearly, we have lost a great number of our mental health professionals. Not only our psychiatrists, our psychologists, social workers, nurses. It's been very difficult to get a workforce to reopen service.

MARTIN: And we're talking about numbers. But let's talk about what it means. If I were to have a crisis. If I - let's say if I were living in New Orleans, and I were to have a crisis, what would happen to me? What is typical now?

Dr. CRAPANZANO: Oh, goodness. Well, you know, the police have - let me say, prior to the storm, we - at least for the indigent population - we had Charity Hospital. And the system would have been if the police picked up someone in a crisis or an ambulance, they would take him to a Charity Hospital, where we would assess and get people the services they needed. And so charity no longer exists. The police don't have a one-stop drop-off, a place to bring people and leave them.

So the emergency rooms that are open - many of them that don't have psychiatric beds in that hospital are on a rotation schedule with the police so that they, you know, they try to share the load of people in need to all the emergency rooms across the region. Because there's no psychiatric beds to back them up, however, people end up in the emergency room for days.

MARTIN: Days? You mean, literally, days?

Dr. CRAPANZANO: Yes, I do.

MARTIN: What do they do there?

Dr. CRAPANZANO: I like to think that they are trying to begin the triage and treat people in the emergency room. I've heard stories of all sorts about what actually happens. But I know that the people there are doing their best to try to keep people safe, keep the community safe, keep the people in crisis safe while still meeting the needs of people who have medical problems, who are acutely ill and need the emergency rooms for that reason.

MARTIN: And so does that mean law enforcement officers have to stay with these patients throughout the time? And is it conceivable that a police officer could also be in the emergency room for two or three days?

Dr. CRAPANZANO: I haven't heard of them staying days, but they often had to stay for hours. And that's been quite a problem as well, because the police are tied up, you know, in the emergency room waiting with a patient until they can be seen, and that means they're not on the streets.

MARTIN: We're talking with Dr. Kathleen Crapanzano - she is director of the Louisiana Office of Mental Health - about the mental health care crisis in New Orleans. Doctor, what would help?

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Dr. CRAPANZANO: It's just so difficult and complicated. And I was telling someone the other day, people are often looking for who's the bad guy in this situation. And I don't know that there is anyone. It's just so difficult. From the state perspective, we're trying to reopen the services that we had before the storm. And I think by the end of the summer, we will have more - have opened more than the beds that we lost.

But the private sector has not responded as quickly. I think it's been difficult for them, both from the workforce perspective, as well as the reimbursement perspective because the uninsured rate is so high in this city and mental health is not, you know, a very lucrative specialty that it's - the private sector hasn't come back as quickly. So even if we're able to replace what we had before, it still won't be adequate to meet the needs.

MARTIN: And is that because you have underserved, acutely ill persons who were acutely ill before the hurricane and still need care? Or is it that there are other people who, perhaps, were not in need of service before the hurricane but have post-traumatic stress or, for example, or suffering mental health effects of the storm?

Dr. CRAPANZANO: It's both. It's really both. For that chronic mental health population, our mental health clinics are not back up to capacity to prevent them from needing to be in the hospital because, clearly, the use of the hospital is the last resort. That's what you do when, you know, your outpatient services have failed.

But for the rest of the city, we're seeing large portions of people who never had mental health concerns before, who are now having substance-abuse problems, problems with depression and post-traumatic stress that are coming into the emergency rooms for the first time.

MARTIN: One of our producers spoke with the doctor who had to drive 40 miles to reach the nearest mental health facility where the doctor now works. Is that a typical scenario?

Dr. CRAPANZANO: Yeah, absolutely. You know, it's interesting, because New Orleans is the biggest city in our state and prior to the storm did have enough mental health beds to take care of its needs. And so New Orleans is very used to - you know, when someone needed a psychiatric bed, it was available there in the city. This is not a problem that's limited to New Orleans. It's just more acute in New Orleans. We have a bed shortage and psychiatric services shortage all over the state.

So people from all over the rest of the state have long had to be shipped here and there to try to find a bed or to get services. And it's not unusual at all for someone to, you know, find a bed two to three hours away and be shipped to receive their services. But this is a new situation for New Orleans.

MARTIN: I may be throwing you a curved ball here, but we're down to our last about 30 seconds literally, and there are many people listening to this program who are concerned about New Orleans but don't know how to help. Is there anything that you can think of that others can do who wish to be supportive -could do to be helpful to you at this time?

Dr. CRAPANZANO: We need a workforce. If people would like to come down and work and organize - I know people can't just move their lives here, but if they want to organize an agency to send us shifts of workers of any sort, we would love to accommodate them.

MARTIN: All right. Thank you. Dr. Kathleen Crapanzano is director of the Louisiana Office of Mental Health. She joined us by phone from her office in Baton Rouge. Thank you so much for speaking with us, and good luck to you.

Dr. CRAPANZANO: Thank you.

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MARTIN: Just ahead: Can satellites stop the genocide in Darfur?

Ms. ARIELA BLATTER (Director, Crisis Prevention and Response Center for Amnesty International U.S.A.): It hangs 280 miles over the sky. It doesn't violate any legal infringements on space. You can't control it.

MARTIN: Satellites and human rights. The next big thing is just ahead.

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MARTIN: I'm Michel Martin. You're listening to TELL ME MORE from NPR News.