OBJECTIVES: Psychological reactions in response to disasters have been associated with increased mental health (MH) symptomatology, decreased quality of life (QOL), and post-traumatic stress (PTSD). This study provides a rare opportunity to examine post disaster MH longitudinally in a sample of adolescents. METHODS: From 2018-20, adolescents (12-18 years, RESULTS: Having an MH diagnosis and PTSD are clear indicators of worse Emotional Regulation (ER) ( CONCLUSIONS: Recovery takes time and a clear sex disparity for girls was observed. Results for the different AQOL-MHS domains highlight how the challenges experienced by disasters are multifaceted. Knowing who is at greater risk can allow for better resource allocation and targeted population-based prevention strategies to promote and maintain MH and resolve risk factors for mental illnesses.