NEW YORK CITY, Aug. 28 - Research examining the mental health status of New York City residents following Sept. 11 and looking at the emotional toll of urban disasters on a broader scale dominates the September 2002 issue of the Journal of Urban Health, published by The New York Academy of Medicine. Below are some of the findings reported in the Journal, many authored by Academy researchers.
- At least one symptom of posttraumatic stress disorder (PTSD) was suffered by 57.8% of Manhattan residents who were surveyed within eight weeks of Sept. 11. Intrusive memories (27.4%), insomnia (24.5%) and being jumpy or easily startled (23.6%) were the most common symptoms reported, said lead author Dr. Sandro Galea, a medical epidemiologist at the Academy. One in five Manhattan residents reported a sense of a "foreshortened future." PTSD was more likely to appear in those who lived below Canal Street (close to the Twin Towers), lacked a strong social support network, experienced a life stressor (such as divorce) in the 12 months before Sept. 11, lost possessions in the attack, and/or were involved in rescue efforts. The study also found that more than one-third of the approximately 1,000 adults surveyed witnessed the WTC attacks. Nearly nine percent of Manhattan residents surveyed suffered from PTSD, a rate more than double the national norm. PTSD is an anxiety disorder that can develop after exposure to a terrifying event.
- Victims of Sept. 11 may have been unnecessarily burdened by questions from researchers who launched dozens of post-Sept. 11 studies to gauge the attack's impact on people. There was no centralized way for researchers to learn of colleagues' ongoing projects, writes lead author Dr. Alan R. Fleischman, the Academy's Senior Vice President for Medical and Academic Affairs. A blue-ribbon panel should be created to review and approve all research proposals following any future terror events, Fleischman suggests. This would make it easier to identify whether victims or other studied populations were being oversampled, and to encourage collaboration among researchers to protect victims' interests during research projects. "Investigators must ensure that studies are designed to minimize harms and risks to the subjects," Fleischman writes.
- Heroin and cocaine users in Harlem and the Bronx did not significantly alter their frequency of drug use after Sept. 11, Academy researchers report. An earlier Academy study found that Manhattanites in the general population used more cigarettes, alcohol and marijuana after the terrorist attacks.
- Illegal drugs were no harder to find after Sept. 11 than before the terrorist attack, despite increased security at national borders and at city bridges and tunnels, contrary to expectations. There was a greater police presence in the boroughs after Sept. 11, according to surveys of drug users, outreach workers and service providers. But they said the sale and use of drugs carried on as usual -- perhaps even more openly -- in the two to three months after Sept. 11. This may be attributable to police's focus on security, say authors from the National Development and Research Institutes in New York.
- More than 520,000 residents of New York City and surrounding counties suffered from PTSD after Sept. 11, and about 129,530 New York State residents will seek PTSD treatment this year. Dr. Daniel Herman and colleagues at Columbia University and the state Office of Mental Health estimate that at least 80 percent of those developing PTSD after Sept. 11 would remain afflicted in 2002. Of those people who were physically present in the World Trade Center and their families, 62 percent would still be using treatment services six months after the tragedy, the researchers estimated.
- The bulk of costs for mental health treatment related to Sept. 11 will fall to the private sector. Columbia University researchers found that those most acutely affected by the terrorist attack -- downtown employees and residents, and rescue workers -- have "much higher" private health insurance coverage rates than the city average. "Had the Sept. 11 attack occurred in a poor region of New York City???the public sector cost of providing mental health services would have been much higher," the authors write.
- Calls to the city's toll-free mental health hotline increased dramatically after Sept. 11 and were still rising as of March 2002. Researchers from the "LifeNet" hotline and the city Department of Health and Mental Hygiene reviewed the call history from June 2001 through March 2002. City dwellers made the greatest number of PTSD-related calls to LifeNet in March, the six-month anniversary of the terrorist attacks, and the month that video footage from inside the World Trade Center on Sept. 11 aired on television. Calls for help from the five boroughs increased by nearly 83 percent in the six months after the disaster, compared to the three months before the attack. Researchers expect the volume of calls to remain high for some time, pointing to the 1995 bombing of the Oklahoma City federal building as an indicator. More individuals sought counseling in the second year after the bombing than in the first, earlier studies show.
- Three years after the deadliest shooting massacre in U.S. history, in which a gunman killed 25 people at Luby's Cafeteria in Texas, only half of those who'd been diagnosed with PTSD had recovered. Those who did not recover actually reported more PTSD symptoms as time progressed, especially avoidance behaviors and emotional numbing. About 40 percent of those who'd been diagnosed with major depression after the 1991 massacre were still experiencing it three years later, Dr. Carol North and colleagues from Washington University School of Medicine in St. Louis found.
The New York Academy of Medicine is a non-profit institution founded in 1847 that is dedicated to enhancing the health of the public through research, education and advocacy, with a particular focus on the problems affecting disadvantaged urban populations.
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Posted on August 30, 2002
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