Saturday, 15 January 2005 - 4:00 PM

This presentation is part of: Community Trauma and Access to Mental Health Care: Using Mixed Methodology to Uncover Need, Barriers and Innovative Pathways

New York's Mental Health Response to the World Trade Center Attacks of September 11, 2001: Event Reaction and Referral Data

Research Purpose: The terrorist attacks on the World Trade Center on September 11, 2001 created an unprecedented disaster throughout the United States. New York City and 10 surrounding counties were declared disaster areas, making the state eligible for federal funding to address the mental health needs of those affected. Funding was provided by the Federal Emergency Management Agency (FEMA), which funds the Crisis Counseling Assistance and Training Program (CCP), through an interagency agreement with the Center for Mental Health Services of the Substance Abuse and Mental Health Services Administration. Data was collected capturing the risk categories of individuals served, reported event reactions and referral status to inform the community outreach efforts and future disaster mental health programs.

Methods: A needs assessment conducted by the New York State Office of Mental Health (NYSOMH) in collaboration with the Mailman School of Public Health at Columbia University indicated that there was a potential need to serve 1.5 million individuals through the disaster declared area.

A descriptive study was conducted on the demographic, risk category, event reaction and referral data that were collected on anonymous log forms during crisis counseling. The demographic data detail the risk categories of those seeking help, and the event reactions describe those suggestive of posttraumatic stress disorder and/or depression. The referral data inform the need to evaluate the current capacity of the community mental health system to address the more intense counseling needs of those affected by the disaster.

Results: Over one million crisis counseling contacts have occurred throughout the declared disaster area. The state mental health response project found through descriptive analysis that percentages of persons exhibiting event reactions suggestive of posttraumatic stress disorder and depression were 30 and 31% respectively at 27 months post disaster. The percentages of individuals referred for formal mental health treatment varied from a high of 18% in the first three months of the project to a low of 6% at 9 months post disaster, with an overall average of 10% at the approach to the second anniversary. While European Americans, African Americans and Latino Americans received services in similar numbers, 31, 30.3 and 25.3% respectively, a very small percentage of Asian and Pacific Islanders, Middle Eastern and Native Americans were served, 11.6% collectively.

Implications: Crisis counseling, education and supportive group services are widely used community interventions to help mitigate the psychological effects of disasters. Due to the scope of the World Trade Center attacks in NYC, a structure was needed to address the significant number of persons requiring more formal mental health services. Cultural variables and proximity to the site of the attacks should be considered in outreach efforts. At risk individuals should be identified as part of the early surveillance activities of the mental health response staff offering opportunity for more intensive services in the appropriate time frames. Recommendations to the CMHS and SAMHSA have been made in this regard resulting in approval to deliver short-term cognitive based, psychoeducational and traumatic grief interventions in this as well as future disasters.

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