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Adm Policy Ment Health. 2019 Nov 27. doi: 10.1007/s10488-019-00998-z. [Epub ahead of print]

Mental Healthcare Needs in World Trade Center Responders: Results from a Large, Population-Based Health Monitoring Cohort.

Author information

1
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA.
2
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA. jonathan.depierro@mssm.edu.
3
Department of Family and Social Medicine, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY, USA.
4
Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
5
EOHSI Clinical Center, Rutgers University, Piscataway, NJ, USA.
6
Department of Medicine, NYU Langone Medical Center, New York, NY, USA.
7
Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, New York, NY, USA.
8
Stony Brook WTC Wellness Program, Stony Brook University, Stony Book, NY, USA.
9
U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA.
10
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.

Abstract

Nearly two decades after the 9/11 attacks on the World Trade Center (WTC), the prevalence of mental disorders remains elevated among traditional (e.g., police) and non-traditional (e.g., construction workers) responders who were involved in the WTC rescue, recovery, and clean-up efforts. To date, however, scarce research has examined factors associated with perceived need for mental health care, which is critical to promoting engagement in mental health treatment in this population. Data were analyzed from 16,170 WTC responders, including 8881 police responders and 7289 non-traditional responders, who completed their first annual health monitoring visit with the WTC Health Program an average of 6.5 years after September 11, 2001. Predisposing, enabling, and need-based factors associated with perceived need for mental health care were examined using multivariable logistic regression analyses. Nearly half (48.7%) of non-traditional responders and a fifth (20.6%) of police responders reported a need for mental health care. The most common perceived needs were for psychotropic medication, individual psychotherapy, and stress management counseling. Predisposing (e.g., female gender) and need-based factors (e.g., WTC-related posttraumatic stress disorder) predicted perceived need for mental health care in both groups. Among non-traditional responders, Hispanic ethnicity and current suicidal ideation were additionally associated with this outcome. Non-traditional WTC responders are substantially more likely than police WTC responders to perceive a need for mental health treatment. Characterization of factors associated with perceived need for treatment can help inform population-based outreach and monitoring efforts designed to promote engagement in mental health treatment in WTC responders.

KEYWORDS:

Community services; Mental health service needs; Perceived needs; World Trade Center responders

PMID:
31776767
DOI:
10.1007/s10488-019-00998-z

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