The psychological toll of recovering the bodies of flood victims in Texas is drawing increased attention as the death toll grows.

At least 118 people are dead and dozens are still missing after devastating flash floods slammed Texas Hill Country, with water rescues taking place along the Guadalupe River, which rose rapidly early Friday morning to the height of a two-story building.

According to local authorities, at least 109 people died on July 4 and 5, most of which were swept up in floodwaters from campgrounds along the Guadalupe River. That’s just shy of the 118 deaths reported as a result of Hurricane Rita in 2005.