WATERLOO - The damage from May 25's tornado was visible in a four-county swath of destruction, but some of the more profound effects on those residents often can't be seen.

Victims of major disasters like the tornado can suffer an array of problems, from depression to post-traumatic stress, long after the initial incident. A small army of counselors and therapists saturated some of the hardest-hit areas like Parkersburg and New Hartford to kick-start the heeling process. But for those counselors, the best thing they can do so far is to just listen to the victims' stories.

"That's very powerful for people," said Carollyn Hartsfield, an social worker at Covenant Clinic in Waterloo.

Hartsfield volunteered to help in Parkersburg during the weekend after the storm. She said most of the people who suffered damage are still in a state of "shell shock."

For them, the immediate goals of finding a place to bed down and a bite to eat outweigh emotional needs.

"I assume once people get out of shell shock, they'll more want to talk to someone maybe or get us to listen," Hartsfield said.

The tornado destroyed up to 240 homes and damaged an additional 400 homes after a tornado ripped through town on May 25. Several hundred more homes in New Hartford, Dunkerton and Hazleton were also hit. Eight people died as a result of the tornado.

The National Weather Service said the twister, which rated the as an EF5, was the second most destructive tornado in Iowa history.

Karen Hyatt, the state emergency and mental health disaster specialist, said more than 1,700 people have had contacts with workers through either state or local mental health workers or through specially trained staff members of the American Red Cross.

Those can range from a simple conversation about their experience to helping them get information about emergency Red Cross funding.

Hyatt said workers have also been careful to meet with volunteers, public officials and other area emergency workers who also may be suffering from the storm's effects. Sixty-five emergency workers sat in on a debriefing after the storm, she said.

"It's hard for people in authority, especially at this time when everything is so busy and overwhelming, to accept help," she said.

That also extends to private citizens, who will usually set their own problems aside to help neighbors, said Amanda Schara, a family counselor with Allen Hospital.

Problems those people will encounter can include anxiety, depression, insomnia or post-traumatic stress disorder. And it's not always immediately that those symptoms surface. For some, it can be a few hours after an incident. For others, it can be six months.

"Everybody's going to experience it differently, so there's no way you can just label all of the town one category," Schara said.

Symptoms of a bigger mental health problem include confusion, poor concentration or decision-making or being hyper-vigilant of one's surroundings, she said.

Lately, the weather seems to be causing lingering problems for people as rain continues to fall across the area, Hyatt said. That's delayed some people from being able to collect their belongings. For other people, it stops them from clearing debris out of farm fields.

Those can boost already high stress levels, she said. Other things like trying to find groceries or other needs gets more stressful after the only grocery store and gas station in Parkersburg were destroyed, Hyatt said.

That's where the workers' listening abilities come in. Rather than going into a full-blown counseling session, victims are given a few minutes to vent, Hyatt said.

"People are busy, they're still in shock, they don't have time" to analyze their problems, she said.

In about two to three weeks, Hyatt said she expects to see a "sea change" in the attitudes of victims toward counselling. But the healing is progressing. Simple things like finding a rental place has helped many move along, Hartsfield said.

And while all that's going on, Hartsfield and others will be walking around, looking to see if people needed an sympathetic ear.

"You always hope people will find a way to get back to optimal functioning," she said.

Contact Josh Nelson at (319) 291-1565 or josh.nelson@wcfcourier.com.