Carissa Cabán-Aleman, MD
Assistant Professor, Florida International University – College of Medicine 
When Hurricane Maria scoured Puerto Rico in September 2017 as a Category 4 storm, gaining strength through global warming, it ripped away roads, homes, power lines – and the stability and security of ordinary life. As a result, the arduous work of rebuilding extends beyond physical infrastructure. Maria and its aftermath exert a mental toll on caregivers as well as those who receive care, as psychiatrist Carissa Cabán has seen.
Although Dr. Cabán works as an assistant professor at Florida International University’s College of Medicine, her roots and cultural ties are in the island where she was born, raised, and went through school; she received her medical degree at the University of Puerto Rico. “All my family is there, except for my brother and cousins,” she says. “I go back very often.”
Dr. Cabán’s post-hurricane trips to Puerto Rico include voluntary work as a founding member of CrearConSalud, Inc., an organization that has done several workshops in the island to help community leaders deal with stress as they try to help others through a long and ongoing recovery process. Dr. Cabán has provided psychological first aid for the affected local leaders. “We developed an informal curriculum about how to prevent burnout, and tools to help communities remain hopeful as they recover”, she says.
Dealing with the losses and challenges after a disaster can foster mental conditions akin to grief, Dr. Cabán says. The survivors she has interacted with, many of them social workers, educators and volunteers from church groups, sometimes report feeling emotionally drained, and having problems such as flashbacks, crying spells, sleep and appetite changes.
Dr. Cabán also is researching, with colleagues, the mental health response efforts of organizations that responded to Maria.
Dr. Cabán also tries to address her mental wellness through this, particularly handling survivor guilt. “Trying to accept my reality, that I am not there, is not easy – struggling with wanting to help but accepting the reality that I can only do so much,” she says. Her self-treatment includes mindfulness, making sure she gets regular sleep, and yoga – “I’ve done yoga for about eight years, and I say that’s my therapy,” she says.
And if Maria is a harbinger for further effects of climate change on health, as it probably is, Dr. Cabán expects the need for mental health care to grow. “There’s a lot of work ahead for the psychiatric community,” she says.