Studies Point NY Officials to Better Mental Health Preparedness
In October 2001 Columbia Mailman School of Public Health researchers responded to requests from the New York State Office of Mental Health, the Federal Emergency Management Administration, and the Center for Mental Health Services to conduct a rapid assessment of the nature and magnitude of mental health needs in the state resulting from the 9/11 attacks.
“We really needed to look at what the treatment services needs would be and then focus on preparedness for the future,” explained Daniel Herman, D.S.W., a professor of public health at Columbia and lead author of the report, which appeared in the September Journal of Urban Health.
“It was and is a collaborative and ongoing process, and we continue to update the numbers as we go along,” Herman said at a post-9/11 conference held at the New York Academy of Medicine (NYAM) in September (see above story).
Herman said the team had few data to go on and therefore the assessment was inherently a rough estimate, based in part on data from previous disasters and on preliminary data from NYAM researchers.
Herman’s team divided the affected population into a “World Trade Center (WTC) population,” who included all those hospitalized or injured in the attacks; families of the dead and missing, hospitalized, or injured; rescue workers; uninjured WTC employees; families of rescue workers and WTC employees; and subpopulations consisting of people who lived in Manhattan below 110th Street, New York City as a whole, and the surrounding 10 counties for a composite metropolitan area.
Within the broader population groups, Herman estimated that by the end of 2002 an additional 20,000 residents living below 110th Street would need treatment and a total of 78,000 new patients in New York City. In the greater metropolitan area, a grand total of 130,000 new patients were expected to seek treatment by the end of 2002.
“We adopted conservative needs for treatment of PTSD,” Herman said. “Nevertheless, the cost of the expected treatment was estimated to be about $200 million.
“In terms of planning for future preparedness, what this points to is confirming the need for mental health preparedness to be considered within the broader sense of disaster planning. We need to be able to anticipate the impact and the needs for services.”
Herman’s colleague at Columbia Mailman, Christina Hoven, Dr.P.H., a professor of public health, and her colleagues completed a needs-assessment for the Board of Education of the City of New York. Hoven presented the results of the study at the same NYAM conference in September.
In sampling 8,266 students in grades four through 12 in 94 public schools throughout New York City, Hoven estimated that “as many as 75,000 children (10.5 percent) had symptoms consistent” with PTSD. In addition, Hoven reported 60,000 children (8.4 percent) with major depression and 107,000 children (15 percent) with agoraphobia (fear of going out or taking public transportation).
All totaled, Hoven told the Board of Education, “It is estimated that 190,000 (26.5 percent) of New York City public school children in grades four to 12 have at least one of the assessed mental health problems (excluding alcohol abuse) and require some form of intervention.”
Both needs assessment studies were widely reported in the press when they were released and were the subject of significant criticism during their presentation at the September NYAM conference. In particular, attendees questioned the lack of consistency in using different assessment tools for different groups within the school board’s study and noted that none of the tools used was capable of full diagnosis.
In part two of this series, disaster and trauma mental health specialists discuss concerns about methodology of post-9/11 research, including these two studies.
An abstract of “Mental Health Needs in New York State Following the September 11 Attacks” is posted on the Web at http://jurban.oupjournals.org/cgi/content/abstract/79/3/322. “Effects of the World Trade Center Attack on NYC Public School Students” is posted at www.nycenet.edu/offices/spss/wtc_needs/firstrep.pdf. ▪
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Published online: 18 October 2002
Published in print: October 18, 2002
Notes
Two needs-assessment studies were commissioned by New York City authorities in the weeks after 9/11. The conclusions are being used to help the city rework future emergency-preparedness planning.
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