Nearly One-Quarter of City Children Received Counseling After September 11 Attacks

NEW YORK CITY, June 26 -Nearly one in four Manhattan children received counseling in the month following the Sept. 11 terrorist attack, according to a new study by The New York Academy of Medicine. Children whose parents suffered from severe stress were most likely to have received counseling, according to the study, which will appear in the July 1 issue of the journal Psychiatric Services.

This marks the first peer-reviewed research about children's mental health following Sept. 11. Parents' level of distress - not children's behavior - was the biggest determinant of whether a child received care, the study found. Children whose parents suffered from post-traumatic stress disorder (PTSD) after Sept. 11 were more likely to receive counseling, as were children whose parent had a friend or relative killed, the study found. A child who saw a parent crying about the attacks was also more likely to be taken for mental health counseling.

Lead author Jennifer Stuber, Ph.D., a researcher in the Academy's Division of Health and Science Policy and in the Center for Urban Epidemiologic Studies, said the findings raise questions about how accurately parents assess their children's need for mental health care. If parents base the decision on their own mental health rather than their children's, some youths may fail to receive needed intervention.

"Parents have been shown to underestimate their kids' distress," Stuber said. "It is critical to understand how parents assess their children's mental health, because this assessment often determines whether or not children receive counseling."

The study is based on a random-digit dialing telephone survey examining the psychological impact of Sept. 11 on Manhattan residents living south of 110th St. All parents or primary caretakers of a child or children between the ages of 4-17 (112 parents in total) were asked questions about one child's disaster-related experiences in the month following the World Trade Center attacks. The survey, conducted from Oct. 16 to Nov. 15, 2001, was part of a broader Academy study published in March in the New England Journal of Medicine, examining the post-Sept. 11 prevalence of PTSD and depression among 1,008 Manhattan adults. That study found that 13 percent of residents reported symptoms of PTSD or depression five to eight weeks after the disaster.

About one-third of the parents reported having seen some aspect of the disaster in person, the new study found. Ten percent of the parents said a friend or relative was killed, and 17 percent said their child knew a teacher or coach who lost someone in the disaster. A large number of youths were repeatedly exposed to images of the tragedy, parents said. More than 80 percent of children watched television news coverage on Sept. 11 and in the days after the attack. About half (55%) of the children watched between one and two hours of coverage daily, parents said, while one-fourth (26%) were exposed to more than four hours of televised coverage daily in the weeks after Sept. 11.

Other key findings include:

• 41 percent of children living below 110th St. saw a parent cry about the attacks.

• More than 67 percent of parents said they were concerned about their child's safety on Sept. 11, and fewer than half (45%) were able to reunite with their child within four hours of the attack.

• Most Manhattan children (86%) were in school or daycare during the Sept. 11 attacks, and nearly one-quarter (24%) of those facilities were below Canal Street or near the World Trade Center.

• More than half of the children (58%) who received counseling, did so in school, from a teacher or school psychologist.

• Boys were more likely than girls to get counseling, as were children with siblings.

The findings build upon a recent survey showing that six months after the World Trade Center collapse, 76 percent of 8,266 public school students still thought frequently about the terrorist attacks. The survey, released in May, was conducted for the New York City Board of Education by Dr. Christina Hoven of the Columbia University Mailman School of Public Health and colleagues.

The Academy study provides the first snapshot of how many Manhattan children received counseling in response to Sept. 11, as well as the first analysis of the factors influencing parents' decision to get help for their children. The Academy is presently compiling data from follow-up surveys involving larger groups of parents and direct interviews with adolescents, conducted four and six months after Sept. 11.

"It's not enough to directly screen the kids," said Gerry Fairbrother, Ph.D., a senior scientist at the Academy and a co-author of the paper. "Parents should receive education about how to identify signs of their children's distress."

Parents themselves may also need more and better services to deal with their own distress after traumatic events, Stuber said. Parents were twice as likely as non-parents to suffer from PTSD in the month following Sept. 11, according to a comparison of the new study and the Academy's March report. Stuber and colleagues are conducting further research to explain that compelling finding.

This work was supported by grants from the United Way of New York City, The New York Community Trust, and the William T. Grant Foundation. Psychiatric Services is a journal of the American Psychiatric Association. The New York Academy of Medicine is a non-profit organization founded in 1847, dedicated to enhancing the health of the public through research, education and advocacy with a focus on urban populations.

Read media coverage of the study:

• Reuters

• Crain's New York Business

• New York 1 News

Posted on June 26, 2002

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Contact:
Andrew J. Martin
Director of Communications
The New York Academy of Medicine
1216 Fifth Avenue
New York, New York 10029
212-822-7285
amartin@nyam.org

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