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Many Gulf Coast residents still feel the wallop of Hurricane Katrina nearly two years later.

Mental illness is double the pre-storm levels, rising numbers suffer from post-traumatic stress disorder, and there is a surge in adults who say they're thinking of suicide.

A government survey released Wednesday to USA TODAY shows no improvement in mental health from a year ago.

About 14% have symptoms of severe mental illness. An additional 20% have mild to moderate mental illness, says Ronald Kessler of Harvard Medical School, who led the study.

The big surprise: Post-traumatic stress disorder (PTSD), which typically goes away in a year for most disaster survivors, has increased: 21% have the symptoms vs. 16% in 2006. Common symptoms include the inability to stop thinking about the hurricane, nightmares and emotional numbness.

"We're getting delayed-onset PTSD, and we're not getting any evidence of recovery," Kessler says. His team surveyed 800 Katrina survivors in Louisiana, Mississippi and Alabama.

Gulf Coast mental illness rates are much higher than typical after natural disasters, says psychiatrist Bessel van der Kolk, a pioneering PTSD researcher and director of The Trauma Center in Boston.

"They're expected numbers for refugee camps, for people who have lost their communities, their sense of direction, whose core issue is being uprooted," he says.

A spark of hope in last year's survey was that only 3% were considering suicide, fewer than before Katrina. But 6% now are suicidal, 8% in parishes in the New Orleans area.

Last year, most said the hurricane fostered a deeper sense of meaning in life. This part of the new survey hasn't been analyzed yet.

With more thinking of suicide and post-traumatic stress rising, Kessler questioned whether these positive outlooks still held. "Before it was, 'I'm just happy to be alive.' … Now they not only want to be alive, they want a house to live in."

When disaster strikes, the body revs up to solve problems, and that's healthy, van der Kolk says.

Feeling trapped, that you can't move on, causes post-traumatic stress disorder, which may be rising because of barriers that delay rebuilding and freeze people in a limbo of inaction. Memories of Katrina abound in trailers, destroyed neighborhoods and levees that remain unfixed, says Howard Osofsky, chairman of psychiatry at Louisiana State University Health Sciences Center.

"When you're constantly reminded, that prolongs trauma," he says. "People have been very brave, but it's wearing them down."

A sense that the rest of the country doesn't care anymore also is worsening morale, says Charles Figley, a trauma expert at Florida State University.

"They feel the nation is turning its back on them, forgetting them," Figley says. "The clock on recovery hasn't started for a lot of them. Post-traumatic stress? There's no 'post' here."