By Monique Fields
TUSCALOOSA, Ala (Reuters) - Emeel Salem Jr. cried as he drove through Tuscaloosa on Saturday for the first time since the April 27 tornado ravaged the Alabama town.
"I'm missing turns because the landmarks that used to be there aren't there," said Salem, a University of Alabama alumnus who plays minor league baseball for the Tampa Bay Rays organization.
The Forest Lake home he rented during the off-season was gone. Where the home once stood, he could see Druid City Hospital, a view he didn't have before the storm.
"I knew it would hit me hard," he said. "I didn't realize I'd be overcome with emotions."
Salem said he wasn't worried about himself, but about fellow residents who lost everything.
It's a common response known as secondary traumatic stress or compassion fatigue, said Karla D. Carmichael, an assistant professor of counselor education at the University of Alabama.
Many of the state's residents are dealing with similar emotions in the storms' wake, and mental health experts are taking action to help.
The Alabama Department of Mental Health and the Federal Emergency Management Agency have partnered to activate Project Rebound, a federally funded program agencies use to assist residents when a natural disaster occurs.
Teams of counselors are on the ground helping residents in hard-hit areas, and the state will be able to hire more counselors for community outreach and educational services with FEMA's help, said John Ziegler, director of the public information office for the state's mental health department.
The state will open a call center to provide free crisis counseling as soon as counselors are hired and trained, he said.
"It's later, after the emergency crisis, that people begin to feel the weight of their emotions, and their loss and their grief," Ziegler said.
Roughly two-thirds of Alabama was ravaged by tornadoes on April 27. More than 230 residents died, including 43 in Tuscaloosa alone.
CHANGED LANDSCAPE FUELS STRESS
Though many of Tuscaloosa's 95,000 residents didn't lose a home or a relative, they have seen the devastation and felt the loss of neighborhoods, businesses and their sense of security.
Residents can no longer purchase craft supplies at Hobby Lobby, shop for discounted items at Big Lots, have a burger at Milo's or pick up coffee at Krispy Kreme Doughnuts. All those businesses were destroyed in the storm.
"Everybody in Tuscaloosa potentially has secondary traumatic stress to some degree or another," Carmichael said. "There's going to be an increase in substance abuse, compulsive behavior, over-spending, over-eating, gambling, addiction."
Children are not immune from the destruction.
The city's Chuck E. Cheese's restaurant was leveled during the storm. In the days following the tornado, Carmichael talked with kindergartners and first-graders who knew the Chuck E. Cheese character lived there and wanted to know where he had gone and whether he was okay.
"Chuck E. was taken care of just like everybody else," Carmichael told the schoolchildren. "Chuck E. has a new home. He is staying with friends until they build Chuck E. Cheese's back."
Alabamians who survived the tornadoes may experience depression, guilt, difficulty sleeping, fatigue, nightmares or extra worry in the wake of the disaster, experts said.
The Family Counseling Service in Tuscaloosa has been offering free counseling since the tornado and is now seeing residents come in for treatment.
At first, they feel shock and disbelief, followed by anger and resentment. There will be a sense of loss of what used to be before reaching the stage of acceptance, said Larry Deavers, the center's executive director.
There will be progression and regression as the city recovers, and it is normal for residents to experience different degrees of those stages, he said.
"It doesn't mean you can wrap a bow around it and be done with it," Deavers said. "That's just the way humans are developed and the way we process loss."
"The intensity of those emotions right now is temporary. The key is to allow one another to talk or not to talk."
(Editing by Colleen Jenkins and Jerry Norton)