Health services

Abstract

Abstract PURPOSE: To report community mental health and medication utilization following the September 11th attacks in New York and to identify populations that may not have had adequate access to care. METHODS: We conducted a random-digit-dial telephone survey of adult residents south of 110th Street 5–8 weeks after this event (cooperation rate = 64%). RESULTS: Among 988 respondents surveyed (female = 52%; white = 72%; mean age = 42), 8.8% (95% confidence interval [CI] = 6.9–10.8) and 9.7% (95% CI = 7.7–11.8), respectively, met the criteria for current posttraumatic stress disorder (PTSD) or major depression (MD), and 12.6% (95% CI = 10.2–14.9) had a panic attack during the disaster. 19.4% (95% CI = 16.7–22.2) and 11.6% (95% CI = 9.5–13.7%), respectively, had a mental health visit or took psychiatric medications 30-days post disaster, and 10% (95% CI = 7.9–12.0) had increased mental health visits after the attacks. 26.7% (95% CI = 18.4–37.1) and 25.1% (95% CI = 17.1–35.3) of those with current PTSD, respectively, had increased visits or took medications after the attacks, and 25.5% (95% CI = 16.9–36.6) and 25.1% (95% CI = 17.3–35.2%) with current MD, respectively, had increased visits or took psychiatric medications. About 45% [95% CI = 16.8–22.2] of those with PTSD or MD, respectively, had at least 1 mental health visit 30-days post-disaster. However, only 27.5% of males with either PTSD or MD actually received post-disaster treatment, compared to 50.7% of females (p = 0.007). In addition, only 7.3% of 18-24 year olds with either PTSD or MD had a post-disaster mental visit, compared to 58% of 45-64 year olds (p = 0.001). Only 1.1% of PTSD or MD cases without health insurance received post-disaster medications, compared to 24.6% of those with insurance (p CONCLUSION: While mental health services in New York after the Trade Center disaster were extensive, males, those between 18–24 years old, and those without insurance may not have received adequate post-disaster care.