Emergency Department Burden of Mental Health and Substance Misuse After Hurricane Helene: Insights From Rural Appalachia.

This article examines changes in mental health and substance use emergency department (ED) visits following Hurricane Helene's September 2024 landfall in Western North Carolina, focusing on disparities among vulnerable populations. Using surveillance data from 19 affected counties, the study found sustained increases in alcohol- and anxiety-related ED visits across immediate, early, and short-term recovery periods, with additional rises in mood disorders, schizophrenia, and opioid-related visits during later phases. Counties with higher elderly populations experienced amplified alcohol and anxiety effects, while those with higher uninsured or Medicaid coverage showed lower ED utilization, suggesting access barriers. The findings highlight the need for targeted public health interventions addressing differential vulnerabilities and evolving behavioral health needs in disaster-impacted rural Appalachian communities.