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

Details

• Personal Author:
  Cancelmo L ; Crane M ; Dasaro CR ; DePierro J ; Feder A ; Harrison D ; Haugen PT ; Lowe SM ; Luft BJ ; Moline JM ; Pietrzak RH ; Schaffer J ; Schechter CB ; Southwick SM ; Todd AC ; Udasin IG ; Cancelmo L ; Crane M ; Dasaro CR ; DePierro J ; Feder A ; Harrison D ; Haugen PT ; Lowe SM ; Luft BJ ; Moline JM ; Pietrzak RH ; Schaffer J ; Schechter CB ; Southwick SM ; Todd AC ; Udasin IG
• Description:
  Background: Nearly 20 years after the terrorist attacks of September 11, 2001, multiple studies have documented the adverse mental consequences among World Trade Center (WTC) rescue, recovery, and clean-up 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 "nontraditional" 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 nontraditional WTC responders. Results: Nontraditional responders endorsed more stigma or barriers to care concerns than police responders. Within a subsample who screened positive for a psychiatric disorder, police were more likely than nontraditional responders to endorse "concerns that negative job consequences might result" (17.9% vs. 9.1%), while nontraditional 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, mental health service need and more severe WTC-related posttraumatic stress disorder symptoms were associated with increased likelihood of endorsing stigma or barriers; 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. [Description provided by NIOSH]
• Subjects:
  Cohort Studies Delivery Of Health Care Emergency Responders Mental Health Nervous System Occupational Health Safety September 11 Terrorist Attacks Stress Disorders, Post-Traumatic
• Keywords:
  Author Keywords: Emergency Responders Cohort Studies Emergency Responders Medical Care Mental Health Police Psychological Effects Rescue Workers Stigma Terrorism Response Trauma Traumatic Incident Stress World Trade Center WTC

  More +
• ISSN:
  0271-3586
• Document Type:
  Text
• Funding:
  Contract ; Cooperative Agreement
• Genre:
  Journal Article ; Journal Article
• Place as Subject:
  Connecticut ; New Jersey ; New York ; OSHA Region 1 ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH) ; National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health ; Workplace Safety & Health
• Location:
  North America ; North America
• Pages in Document:
  208-216
• Volume:
  64
• Issue:
  3
• NIOSHTIC Number:
  nn:20061523
• Citation:
  Am J Ind Med 2021 Mar; 64(3):208-216
• Contact Point Address:
  Jonathan DePierro, Icahn School of Medicine at Mount Sinai, New York, NY 10029
• Email:
  jonathan.depierro@mssm.edu
• Federal Fiscal Year:
  2021
• Performing Organization:
  Icahn School of Medicine at Mount Sinai, New York
• Peer Reviewed:
  True
• Start Date:
  20170701
• Source Full Name:
  American Journal of Industrial Medicine
• End Date:
  20210630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:cca92c3fccaccc7614371e85fb646dea6b321b1a093e28dabbe855a16bc75f3e80605b83aa261986b1477ec14b385e66cdeda75a6cec9c3058fa04e32afc67d0
• Download URL:
  https://stacks.cdc.gov/view/cdc/225037/cdc_225037_DS1.pdf
• File Type:
  [PDF - 1.09 MB ]