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

Olivia Diab, Jonathan DePierro, Leo Cancelmo, Jamie Schaffer, Clyde Schechter, Christopher R. Dasaro, Andrew Todd, Michael Crane, Iris Udasin, Denise Harrison, Jacqueline Moline, Benjamin Luft, Steven M. Southwick, Adriana Feder, Robert H. Pietrzak

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)427-434
Number of pages8
JournalAdministration and Policy in Mental Health and Mental Health Services Research
Volume47
Issue number3
DOIs
StatePublished - May 1 2020

Keywords

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

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

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  • Cite this

    Diab, O., DePierro, J., Cancelmo, L., Schaffer, J., Schechter, C., Dasaro, C. R., Todd, A., Crane, M., Udasin, I., Harrison, D., Moline, J., Luft, B., Southwick, S. M., Feder, A., & Pietrzak, R. H. (2020). Mental Healthcare Needs in World Trade Center Responders: Results from a Large, Population-Based Health Monitoring Cohort. Administration and Policy in Mental Health and Mental Health Services Research, 47(3), 427-434. https://doi.org/10.1007/s10488-019-00998-z