NEW ORLEANS, LA. -- Billy Bob Hopson finds his therapy in rusted lawnmowers, mangled wall clocks and other debris that his neighbors toss on the curbs as they clear hurricane wreckage. "I'm trying to keep my mind busy," he said while hefting junk into his battered trailer. "I've got a hurting thing. ... I lost more than I can handle. It's like someone cut off your arm. You keep looking for your arm, and you can't find it."

The "hurting thing" is an epidemic confronting mental health experts a year after Hurricane Katrina struck. Suicide rates in New Orleans have nearly tripled, and the region's few remaining psychiatrists are swamped with cases of depression, post-traumatic stress disorder and related problems.

By several estimates, half of New Orleans' population needs mental health care, said Dr. Janet Johnson, a psychiatrist at Tulane University.

"We really have a mental health crisis, and we've had it for months," Johnson said.

Most psychiatrists have left, she said, and major hospitals with mental health beds have closed, as have wards for substance abusers.

A few cases have hit the headlines -- two police officers shot themselves in September, a prominent pediatrician hanged himself in November, a news photographer snapped this month and taunted police to kill him.

But those are only the most visible signals of massive and often hidden trauma.

It isn't surprising that serious psychological after-effects would surface now, said Simon Rosser, a University of Minnesota professor who joined the first wave of mental-health experts treating survivors in Louisiana in September.

"Some people are experiencing now what they couldn't afford to experience at the time of the disaster," Rosser said. "If you are in the middle of a bomb blast, you are not experiencing post-traumatic stress disorder. You are just trying to get out of the bomb blast."

In response, officials plan to revamp New Orleans' health care system, including mental health services. Private help is stepping in, too. A project funded by the W.K. Kellogg Foundation, for example, aims to train parents, clergy and counselors to ease anxiety. And officials have asked Congress for clearance to use crisis counseling money for long-term treatment.

Meanwhile, most of New Orleans is handling the "hurting thing" the way Hopson does, treating themselves as best they can, Johnson said.

Let the sweet dreams roll

Hopson's strategy is to call forth pre-Katrina memories in hopes they can overpower flashbacks to a hellish scene at Charity Hospital. A year ago he had sat at the hospital with his wife, who was suffering from colon cancer. After Katrina hit, they and others were trapped for days with no power and little food while looters attacked and snipers fired on the hospital.

When boats evacuated patients, Hopson begged to go with his wife. Instead, he was sidetracked to a plane that landed in San Antonio. Eventually, they found each other before she died earlier this year.

Standing on the lawn of their ramshackle 8th Ward house earlier this month, Hopson, 61, wound into his self-styled therapy. The hum of cicadas rose and fell in the background as he let the sweet dreams roll -- of his wife, Amelia, enjoying the shade of a pecan tree while he worked on his "Zebra," a garish pickup truck adorned with a veritable flea market of ornaments.

"She would sit under the pecan tree," he recalled. " 'What you going to put on there next, Billy?' she would ask, laughing at me."

But Katrina knocked down the pecan tree and left the Zebra a rusty mess. Snakes slither through waist-high debris in the yard.

Hopson tried talking to a doctor about his fear and grief, "but sometimes it can't come out," he said.