County presents CASPER household survey: behavioral health impacts and mold, water and preparedness needs identified

Buncombe County public health staff and partner agencies presented results and recommendations from a Community Assessment for Public Health Emergency Response (CASPER) household survey conducted June 4 following Hurricane Helene.

Dr. Ellis Matheson, who presented the survey findings, said the county completed the planned sample of 210 household interviews over two days with door‑to‑door visits and a high completion rate. “The total of surveys that we wanted to get was 210, and we got 210,” Matheson said.

The survey identified three main themes: whole-person health care (particularly behavioral health), emergency preparedness and environmental health. Key findings included:

- Behavioral health: 45.7% of households reported at least one member with new or worsening behavioral health symptoms since Hurricane Helene. Anxiety, worry and depressed mood were the leading symptoms reported. - Access to care: 7.9% of households reported difficulty accessing medical care; reasons included clinic closures, provider unavailability and insurance or cost barriers. - Evacuation and preparedness: About 38% of households reported some or all members evacuated at some point; among respondents who did not evacuate, reasons included not thinking evacuation was necessary. Approximately 8.5% said they did not receive evacuation alerts or warnings. - Environmental health: One‑fifth of households reported they did not feel their tap water was safe at the time of the survey. Fourteen point three percent reported seeing mold or smelling musty odors after the storm; 61% of those households continued to report mold or musty odors at the time of the survey. Cost and landlord responsiveness were cited as barriers to remediation.

Matheson said survey teams provided materials and warm handoffs to the Helene Resource Center during visits, including wildfire prevention education and well-testing kits for households on private wells. “We made sure people understood what resources were available at the Helene Resource Center and actually did a warm handoff for any resources they need through that,” Matheson said.

Recommendations in the report include expanding access to coordinated whole-person health care with focused behavioral health investment; partnering with community organizations to strengthen emergency preparedness awareness; and developing an environmental health education initiative that links households to cleanup, mold remediation and well-testing resources. The full CASPER report — including methodology and the survey instrument — was included in the commissioners’ packet and will be posted on the county website.

Commissioners asked follow-up questions about mold remediation and how the county will ensure residents who remain affected can access assistance; public health staff recommended disaster case management as an immediate resource and said the recovery planning and community pod work will include supply distribution and outreach about remediation resources.