When Cathy Orlando heard she was going to lose her roof, the stress made her vomit.
Having her home in jeopardy as Sudbury, Ont., grappled with a massive snowfall in 2019 was "probably the most stressful thing [she] had ever been through," she told Cross Country Checkup.
Her family packed belongings in a panic and took what they could. Her home was insured and they later got a new roof, but the experience stays with her.
"This is extreme weather and it's only going to get worse," she says, noting that the threat of climate change still haunts her even now.
Climate change is something Orlando says she cares deeply about; she works for Citizens' Climate International, a group that lobbies governments to take action on climate change.
Orlando's family, including her child, spent roughly six months living in a hotel. Things that stand out are comparatively simple but personal: she lost an entire season of gardening, a passion she has nurtured since childhood.
Experts say the long-term economic costs associated with supporting those impacted by natural disasters, including their mental health, are just beginning to be understood and that Canada's decentralized response to disasters is falling short.
Peter Silverstone, a professor of psychiatry at the University of Alberta, studied evacuees from the 2016 Fort MacMurray fires. His research on the long-term mental health impacts began three years after the disaster, but he says the trauma remains long after.
He told Checkup the anxiety and symptoms of post-traumatic stress disorder aren't a "good story." He notes the damage can extend beyond the individual and lead to deteriorating family relationships.
Can you prepare yourself?
People don't manage risk well when faced with the visceral stress of an unfolding natural disaster, says Silverstone. In fact, the stress of having your home evacuated can leave a person in a state of "learned helplessness."
That said, Silverstone says, "there are things you can control."
Preparation is crucial, says Silverstone, and anyone who might need to evacuate their home should plan what they'd take with them to avoid being sorry later.
"Are the photos important? Do you have them stored elsewhere? What about your financial documents? What happens if you get locked out? Are there mementos that you have in your house that are really important?"
Financial loss is a huge consideration. If you have irreplaceable records, including banking documents, have a picture of them in the cloud, says Silverstone.
"And the more things you do that are in your control, the better your psychological outcome will be; the better you plan … the less anxious you will be."
Orlando and her family learned from their experience during the 2019 snowfall and now keep supplies ready to go.
"We have a kit at the door with an emergency radio, batteries, flashlights. We have kits where we can quickly fill up with water."
People often rush to gather replaceable material goods like clothes when their home is evacuated, Silverstone says, but it's things like lost heirlooms that weigh on people for years.
Peggy Moore Savery and her family lost their home after Hurricane Fiona last year in Port aux Basques, N.L. The image of her house teetering near destruction became a symbol of the damage done by the storm.
She told Checkup she now has a new home in Grand Bay West, N.L., but to this day a few times a week something sets off the pain of what she lost.
"I went to the store the other day to look for as simple a thing as a candy dish. And while I was looking, it dawned on me right out of the blue that my baby silver cup with my name on it that I had as an infant was gone."
She was so overwhelmed she had to leave the store.
"I know it could have been a lot worse," says Moore Savery. "We're lucky. We have a beautiful [new] home. We have nice new things. But most of us would give anything to have what we lost back."
Silverstone stresses that victims of disasters need long-term support, both within families and communities.
"Think about how you can strengthen not just your resiliency, but other family members'. See how you can reach out," he says.
"And last but not least, a lot of people will not admit to the psychological traumas they're going through, 'Oh, no, I'm fine. Oh, no, it's good. I'm coping.' Please ask over and over."
An uncounted cost
Jason Thistlethwaite, an associate professor at University of Waterloo's environment, enterprise and development department, says that Canada needs to have a much more cohesive approach to disaster management.
"Generally, what we're measuring is fixing the broken bridge or rebuilding a property. We're not thinking about a lot of that trauma and how much that actually leads to cost disruptions in the economy," he told Checkup.
Those disruptions to the economy can look like missed work in the short term, he said. But longer-term outcomes are more likely to impact communities "associated with lower income, less stable housing and large families."
WATCH | Residents forced out by fire or flood in their community five times in six years
The Dene Tha' First Nation in Alberta is setting up a temporary camp to house 400 wildfire evacuees. It's the fifth time residents in the community have been forced out by fire or floods in six years.
He says people who seek help for, say, PTSD at a local level are tough to track because it's difficult to say later if it's related to a disaster.
"There really isn't sort of a government organization that has a responsibility or mandate for finding that type of information."
The lack of a centralized disaster management agency like the U.S. Federal Emergency Management Agency (FEMA) is an issue, he says.
"Poor governmental co-ordination is leading to a lot of unnecessary finger pointing. And as a consequence of that, we get delays, we get costs being passed down to individuals."
One advantage to an agency like that is it could create a standing group of people who prep residents for disasters like floods or fires. It could also be built to incorporate follow-up supports for disaster victims, he says. Models Thistlethwaite looks to include Germany's Technisches Hilfswerk (THW) or even flood wardens in the U.K.
Serena Lewis, who works as a grief counsellor, lives in Great Village, N.S. near Portapique, N.S., the site of the 2020 mass killings. The next year, she says, water rushed into her home during Fiona.
She worries disasters can create a hierarchy of suffering in communities and also leave victims without the ability to feel safe in their own space.
"I have heard many people downplay some of what happened in our area around Fiona, for instance, because no one lost their lives here. But so many people have lost their homes," she told Checkup.
"I keep thinking about, you know, our disaster management lens. I think about our first 24 or 48 hours of stabilizing things, but I really do think that we need to have less reactive and more responsive work being done for the long haul for communities."