Unmet Mental Health Care Needs among Asian Americans 10⁻11 Years After Exposure to the World Trade Center Attack.

Winnie W Kung,Emily Goldmann,Xiaoran Wang,Debbie Huang,Xinhua Liu

doi:10.3390/ijerph16071302

Abstract

This study investigated the prevalence of unmet mental health care needs (UMHCN) and their associated factors among 2344 Asian Americans directly exposed to the World Trade Center (WTC) attack 10–11 years afterwards. Given the pervasive underutilization of mental health services among Asians, their subjective evaluation of unmet needs could provide more nuanced information on disparities of service. We used the WTC Health Registry data and found that 12% of Asian Americans indicated UMHCN: 69% attributing it to attitudinal barriers, 36% to cost barriers, and 29% to access barriers. Among all the factors significantly related to UMHCN in the logistic model, disruption of health insurance in the past year had the largest odds ratio (OR = 2.37, 95% confidence interval: 1.61–3.48), though similar to functional impairment due to mental disorders. Post-9/11 mental health diagnosis, probable mental disorder and ≥14 poor mental health days in the past month were also associated with greater odds of UMHCN, while greater social support was associated with lower odds. Results suggest that continued outreach efforts to provide mental health education to Asian communities to increase knowledge about mental illness and treatment options, reduce stigmatization of mental illness, and offer free mental health services are crucial to address UMHCN.

Highlights

Numerous studies have examined the mental health impact of the September 11, 2001 attack at the World Trade Center (WTC) on those who were directly exposed to the disaster, but fewer have investigated these individuals’ use of mental health services [1,2]
We further investigate the unmet mental health care needs (UMHCN) of Asian Americans affected by the WTC attack and correlates of having unmet needs
A sizeable proportion of Asian Americans had UMHCN 10–11 years after direct exposure to the WTC attack (12%), which is much higher than that reported in other community samples (e.g., 4.5%) [5], indicating greater unmet needs in those affected by this mass trauma more than a decade later

Summary

Introduction

Numerous studies have examined the mental health impact of the September 11, 2001 attack at the World Trade Center (WTC) on those who were directly exposed to the disaster, but fewer have investigated these individuals’ use of mental health services [1,2]. We further investigate the unmet mental health care needs (UMHCN) of Asian Americans affected by the WTC attack and correlates of having unmet needs. Mental health service utilization is a typical measure of whether mental health care needs are met among persons with potential mental health issues [5]. It has been used as an objective measure. Public Health 2019, 16, 1302; doi:10.3390/ijerph16071302 www.mdpi.com/journal/ijerph

Objectives

Methods

Results

Discussion

Conclusion