Mental Health Stigma and Barriers to Care in World Trade Center Responders: Results from a Large, Population-Based Health Monitoring Cohort

Details

• Alternative Title:
  Am J Ind Med
• Personal Author:
  DePierro, Jonathan ; Lowe, Sandra M. ; Haugen, Peter T. ; Cancelmo, Leo ; Schaffer, Jamie ; Schechter, Clyde ; Dasaro, Christopher R. ; Todd, Andrew C. ; Crane, Michael ; Luft, Benjamin J. ; Moline, Jacqueline M. ; Harrison, Denise ; Udasin, Iris G. ; Feder, Adriana ; Southwick, Steven M. ; Pietrzak, Robert H.
• Description:
  Background.
  
  Nearly 20 years after the terrorist attacks of 9/11/01, multiple studies have documented the adverse mental consequences among World Trade Center (WTC) rescue, recovery and cleanup workers. However, scarce research has examined mental health stigma and barriers to care in WTC-exposed individuals, and no known study has examined whether rates of endorsement may differ between police and “non-traditional” responders, the latter comprising a heterogeneous group of workers and volunteers.
  
  Objective.
  
  To identify the prevalence and correlates of mental health stigma and barriers to care in WTC responders.
  
  Methods.
  
  Mental health stigma and barriers to care and their correlates were examined in 6,777 police and 6,272 non-traditional WTC responders.
  
  Results.
  
  Non-traditional responders endorsed more stigma/barriers to care concerns than police responders. Within a subsample who screened positive for a psychiatric disorder, police were more likely than non-traditional responders to endorse “Concerns that negative job consequences might result” (17.9% vs. 9.1%), while non-traditional responders were more likely to endorse “I don’t know where to go to find counseling services” (18.4% vs.6.6%). Within this subsample, a mental health service need and more severe WTC-related PTSD symptoms were associated with increased likelihood of endorsing stigma or barriers; and pre-9/11 psychiatric history and non-Hispanic Black race/ethnicity were associated with lower likelihood of endorsing stigma or barriers.
  
  Conclusions.
  
  Results of this study underscore the burden of mental health stigma and barriers to care in WTC responders, and highlight the need for targeted interventions to address these concerns and promote mental healthcare utilization in this population.
  
  
• Subjects:
  Adult Emergency Responders Female Health Services Accessibility Humans Male Mental Disorders Middle Aged Occupational Diseases Patient Acceptance Of Health Care Police Prevalence Registries September 11 Terrorist Attacks Social Stigma Stress Disorders, Post-Traumatic

  More +
• Source:
  Am J Ind Med. 64(3):208-216
• Pubmed ID:
  33241583
• Pubmed Central ID:
  PMC8099036
• Document Type:
  Journal Article
• Funding:
  U01 OH010407/OH/NIOSH CDC HHSUnited States/ ; U01 OH011473/OH/NIOSH CDC HHSUnited States/ ; 200-2017-93325/OH/NIOSH CDC HHSUnited States/ ; 200-2011-41919/OH/NIOSH CDC HHSUnited States/
• Place as Subject:
  New York City, NY
• Volume:
  64
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:e30f6b5c615a2a5108c4edd2b1faabb45339c338004157f9f86cd07629c0955a
• Download URL:
  https://stacks.cdc.gov/view/cdc/105968/cdc_105968_DS1.pdf
• File Type:
  [PDF - 815.58 KB ]