New Yorkers' use of mental health services rose only slightly during the year after the September 11, 2001, World Trade Center attacks compared with the year before the attacks, a recent study suggests. But the number of mental health visits among people already receiving treatment increased after the attacks.
The study is one of the few to look at long-term use of community mental health services within a population after a major catastrophic event, say Joseph A. Boscarino, Ph.D., M.P.H., and colleagues at the New York Academy of Medicine and Florida State University. Their findings appear in the journal General Hospital Psychiatry.
"Following the World Trade Center attacks, mental health service providers geared up to provide mental health services for thousands of New Yorkers potentially affected by this event," Boscarino says. "This major increase in utilization, however, never really materialized."
The investigators conducted telephone surveys with 2,368 English- and Spanish-speaking adults who lived in New York City at the time of the attacks to learn about their post-disaster mental health service and medication use. Two different surveys were used: one of a cross-section of city residents and the other of persons who reported receiving mental health treatment within a year after the attacks.
Residents were queried about their use of counseling for "problems with emotions or nerves or use of alcohol or drugs," and their use of prescription medications such as antidepressants, tranquilizers or sleeping pills for emotional problems. The researchers also asked questions to assess participants' experience with post-traumatic stress disorder, depression, psychological distress and other mental health problems.
Less than 9 percent of New York City residents said they made more mental health visits and 4 percent made fewer visits during the year after the September 11 disaster, compared with the year before the disaster. In addition, only about 4 percent of residents increased their psychotropic medication use during the year after the disaster.
The researchers also found that in the year after September 11, 13 percent of New York residents surveyed said they received mental health counseling related to the WTC disaster at least once, and 4.5 percent of those surveyed took psychotropic medications because of the event.
People who were young, had panic attacks after the WTC disaster, had PTSD or were depressed tended to make more mental health visits related to the attacks. People with PTSD, young people, women and those who were personally exposed to the disaster were among those whose medication use related to attacks.
The study also showed that the greater a person's exposure to the WTC event, the more likely he or she was to make WTC disaster-related mental health visits.
In general, having health insurance coverage did not predict whether a person made mental health visits or used psychotropic drugs.
The results also indicate that African Americans were less likely than others to take more psychotropic medications after the disaster. The researchers suggest that this result merits more research.
"The finding that African Americans were less likely to take post-disaster psychotropic medications, despite the availability of services in NYC, requires further study. Whether this was due to differences in perceptions, actual prescribing practices, or other factors is unclear," Boscarino and co-authors write.
The study was partially funded by the National Institute of Mental Health.