Unmet Mental Health Care Needs Among World Trade Center Disaster Survivors

Details

• Personal Author:
  Brackbill RM ; Farfel M ; Nair HP ; Stellman SD
• Description:
  Post-traumatic stress disorder (PTSD), depression and anxiety are common among persons exposed to the 9/11 World Trade Center (WTC) disaster. It is important to understand factors underlying unmet mental health care needs (UMHC) and barriers to care in this population in order to increase access to mental health care. Methods: We studied 46,602 participants in the WTC Health Registry first follow-up (2006-7) survey, which included questions on perceived lack of care and barriers to needed care, diagnosed conditions in the past 12 months, and a screen for probable PTSD. Logistic regression was used to examine factors associated with UMHC. Results. 18% reported unmet health care need in the past 12m; of these 28% (2418) reported an unmet need for mental health care or counseling whether or not they were receiving mental health services. Those most likely to report UMHC were young adults (18-24 yrs) (adjusted Odds Ratio (aOR) ¼ 5.0, 95% confidence interval (CI) 3.3-7.4), persons with annual household income < $25,000 (aOR ¼ 1.7, 95% CI, 1.4-2.0) and no social support (aOR ¼ 1.9 CI-1.5-2.3). Other risk factors were 14 or more days of poor mental health in the past 30 days (aOR ¼ 3.2, 95% CI, 2.9-3.6) and having probable PTSD or a previously diagnosed mental health condition (aOR ¼ 5.2, 95%CI, 4.6-5.8). No association was found between having any chronic physical condition and UMHC. The two most frequently reported barriers to mental health care were lack of money (51%) and insurance (41%). Conclusion: These findings are highly important to Registry's treatment referral program that employs personalized outreach to encourage enrollees with UMHC to seek care with no out-of-pocket costs at WTC Centers of Excellence. [Description provided by NIOSH]
• Subjects:
  Mental Health Nervous System Occupational Health Safety September 11 Terrorist Attacks
• Keywords:
  Disaster Response Health Care Mental Health Post-traumatic Stress Disorder PTSD World Trade Center WTC
• ISSN:
  0002-9262
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Abstract or Summary
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  173
• NIOSHTIC Number:
  nn:20062358
• Citation:
  Am J Epidemiol 2011 Jun; 173(Suppl 11):S104
• Federal Fiscal Year:
  2011
• NORA Priority Area:
  Services
• Performing Organization:
  New York City Health/Mental Hygiene
• Peer Reviewed:
  False
• Start Date:
  20090430
• Source Full Name:
  American Journal of Epidemiology
• Supplement:
  11
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:d3e3a057169efcf72010ffd634b84d738396062245fa6fe482cd93e351e332cd70aa1b6a756212eb5da01dd991db4655bacc4b2ce8068491e598434c53974925
• Download URL:
  https://stacks.cdc.gov/view/cdc/225625/cdc_225625_DS1.pdf
• File Type:
  [PDF - 62.97 KB ]