Jonathan DePierro1, Sandra M Lowe1, Peter T Haugen2, Leo Cancelmo1, Jamie Schaffer1, Clyde B Schechter3, Christopher R Dasaro4, Andrew C Todd4, Michael Crane4, Benjamin J Luft5, Jacqueline M Moline6, Denise Harrison2, Iris G Udasin7, Adriana Feder1, Steven M Southwick8,9, Robert H Pietrzak8,9,10. 1. Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA. 2. New York University Grossman School of Medicine, New York, New York, USA. 3. Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, New York, USA. 4. Department of Environmental Medicine and Public Health, Icahn School of Medicine, New York, NY, 10029, USA. 5. Stony Brook WTC Wellness Program, Stony Brook University, Stony Book, New York, USA. 6. Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, Rego Park, New York, USA. 7. Environmental and Occupational Health Sciences Institute (EOHSI) Clinical Center, Rutgers University, Piscataway, New Jersey, USA. 8. Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA. 9. Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA. 10. U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, Connecticut, USA.
Abstract
BACKGROUND: Nearly 20 years after the terrorist attacks of September 11, 2001, multiple studies have documented the adverse mental consequences among World Trade Center (WTC) rescue, recovery, and clean-up workers. However, scarce research has examined mental health stigma and barriers to care in WTC-exposed individuals, and no known study has examined whether rates of endorsement may differ between police and "nontraditional" responders, the latter comprising a heterogeneous group of workers and volunteers. OBJECTIVE: To identify the prevalence and correlates of mental health stigma and barriers to care in WTC responders. METHODS: Mental health stigma and barriers to care and their correlates were examined in 6,777 police and 6,272 nontraditional WTC responders. RESULTS: Nontraditional responders endorsed more stigma or barriers to care concerns than police responders. Within a subsample who screened positive for a psychiatric disorder, police were more likely than nontraditional responders to endorse "concerns that negative job consequences might result" (17.9% vs. 9.1%), while nontraditional responders were more likely to endorse "I don't know where to go to find counseling services" (18.4% vs.6.6%). Within this subsample, mental health service need and more severe WTC-related posttraumatic stress disorder symptoms were associated with increased likelihood of endorsing stigma or barriers; pre-9/11 psychiatric history and non-Hispanic Black race/ethnicity were associated with lower likelihood of endorsing stigma or barriers. CONCLUSIONS: Results of this study underscore the burden of mental health stigma and barriers to care in WTC responders, and highlight the need for targeted interventions to address these concerns and promote mental healthcare utilization in this population.
BACKGROUND: Nearly 20 years after the terrorist attacks of September 11, 2001, multiple studies have documented the adverse mental consequences among World Trade Center (WTC) rescue, recovery, and clean-up workers. However, scarce research has examined mental health stigma and barriers to care in WTC-exposed individuals, and no known study has examined whether rates of endorsement may differ between police and "nontraditional" responders, the latter comprising a heterogeneous group of workers and volunteers. OBJECTIVE: To identify the prevalence and correlates of mental health stigma and barriers to care in WTC responders. METHODS: Mental health stigma and barriers to care and their correlates were examined in 6,777 police and 6,272 nontraditional WTC responders. RESULTS: Nontraditional responders endorsed more stigma or barriers to care concerns than police responders. Within a subsample who screened positive for a psychiatric disorder, police were more likely than nontraditional responders to endorse "concerns that negative job consequences might result" (17.9% vs. 9.1%), while nontraditional responders were more likely to endorse "I don't know where to go to find counseling services" (18.4% vs.6.6%). Within this subsample, mental health service need and more severe WTC-related posttraumatic stress disorder symptoms were associated with increased likelihood of endorsing stigma or barriers; pre-9/11 psychiatric history and non-Hispanic Black race/ethnicity were associated with lower likelihood of endorsing stigma or barriers. CONCLUSIONS: Results of this study underscore the burden of mental health stigma and barriers to care in WTC responders, and highlight the need for targeted interventions to address these concerns and promote mental healthcare utilization in this population.
Authors: Christopher R Dasaro; William L Holden; Karen D Berman; Michael A Crane; Julia R Kaplan; Roberto G Lucchini; Benjamin J Luft; Jacqueline M Moline; Susan L Teitelbaum; Usha S Tirunagari; Iris G Udasin; Jean H Weiner; Patrice A Zigrossi; Andrew C Todd Journal: Int J Epidemiol Date: 2017-04-01 Impact factor: 7.196
Authors: 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 Journal: Adm Policy Ment Health Date: 2020-05
Authors: N Mehta; S Clement; E Marcus; A-C Stona; N Bezborodovs; S Evans-Lacko; J Palacios; M Docherty; E Barley; D Rose; M Koschorke; R Shidhaye; C Henderson; G Thornicroft Journal: Br J Psychiatry Date: 2015-11 Impact factor: 9.319