Poor sleep was the most commonly reported PTSD indicator. 

• The odds of reporting poor sleep were 202% higher for volunteers who reported a mental health diagnosis, compared to those who did not, and 121% higher among those who engaged in aid distribution, compared to those who did not.

• Hurricane exposure, specifically communication issues (1,003% higher), experiencing injury or death (85% higher), and fearing for one's own or a loved ones safety (174% higher) were significantly associated with higher odds of poor sleep, compared to those who did not experience that hurricane exposure. 

• Negative coping strategies were associated with 288 times the odds of poor sleep, while acceptance was associated with 122 times the odds of reporting poor sleep.

The second most reported PTSD indicator was associated with individual-level factors, notably prior mental health diagnosis and identifying as a woman. 

• Hurricane exposures, specifically being exposed to injury or death and being trapped or having to evacuate, were also associated with higher odds. 

• Similar to poor sleep, volunteers who engaged with negative coping strategies were associated with 284 times the odds of avoidance, and greenspace was associated with protective effects . 

• Distracting oneself was associated with higher odds of reporting avoidance.

Infrastructure failures (e.g., communication outages) were the strongest predictors of reporting PTSD indicators.

Feeling anxious/nervous was the most commonly reported mental health concern after Helene. 

• Prior mental health remained a significant predictor, associated with 217% higher odds of reporting feeling anxious/nervous.

• Self-reporting lower income (i.e., <$40,000) was associated with 170% higher odds of reporting feeling anxious/nervous.

• Coping strategies also remained consistent predictors, with negative coping associated with 300 times the odds of reporting feeling anxious/nervous.

• Distraction and active engagement in recovery to cope were also associated with higher odds.

Depressed/hopeless was the second most respite GAD indicator. 

• The odds of feeling depressed/hopeless were higher among volunteers with a prior history of mental health. 

• The most significant predictors of reporting feeling depressed/hopeless are related to coping strategies: 555% higher for negative coping and 285% for creative outlets. 

• As for avoidance, greenspace was associated with protective associations.

Community volunteers face significant mental health risks following disaster response, with over half reporting at least one poor mental health indicator.

In the online survey, 97 respondents (~24%) provided narrative reflections on Hurricane Helene. Four predetermined themes were used to tag narratives mentioning: mental health, hurricane exposure, volunteering, and/or positive reflection.

Trauma and fear emerged as important contexts, with volunteers identifying trauma related to collective loss.

• An estimated 35% of narratives mentioned mental health: PTSD (10.3%), emotional (10.3%), and those related to fear such as scary (6.9%), worried (6.9%) and worry (6.9%) mentioned most frequently.

Conversations most frequently mentioned basic services, like water and power, contextualizing widespread infrastructure failures and outages for months after the storm.

• Nearly half (47%) of narratives mentioned hurricane exposure: Water (30%), power (17.5%), damage (10%), road (5%), and service (5%) were mentioned most frequently.

Volunteers often mentioned damages observed and the emotional toll of the devastation.

• Roughly 25% of narratives mentioned volunteering: Volunteered (27.8%), volunteering (16.7%), volunteer (16.7%), center (11.1%), and responder (11.1%) were the keywords mentioned most often.

Narratives mentioned gratitude for community and neighbors, extending beyond the initial response period.

• Over 15 narratives (16.5%) shared positive reflections: Feeling grateful (15.8%), helped (15.8%) and proud (10.5%) were mentioned most often.