For many residents of Lower Manhattan, the terrorist attacks of September 11, 2001, had lasting psychological consequences. New findings, released today by the Health Department's World Trade Center Health Registry, show that one in eight Lower Manhattan residents likely had posttraumatic stress disorder (PTSD) two to three years after the attacks. The findings show that Lower Manhattan residents developed PTSD at three times the usual rate in the years following 9/11. The rate among residents (12.6%) matched the rate previously reported among rescue and recovery workers (12.4%). Residents who were injured during the attacks were the most likely to develop PTSD. The new study, published online this week in the Journal of Traumatic Stress, is available online at http://www3.interscience.wiley.com/journal/109882595/home.
The new study – based on surveys of 11,000 residents through the World Trade Center Health Registry – is the first to measure the attack's long-term effect on the mental health of community members. Aside from injured residents – 38% of whom developed symptoms of PTSD – the most affected groups were those who witnessed violent deaths and those caught in the dust cloud after the towers collapsed. Roughly 17% suffered PTSD in each of those groups. The symptoms most commonly reported were hyper-vigilance, nightmares and emotional reactions to reminders of 9/11.
Divorced residents reported symptoms at twice the rate of those who were married – possibly because they received less emotional support. Women were affected at a higher rate than men (15% versus 10%), a disparity documented in other disasters. And black and Hispanic residents reported more symptoms than whites. Low levels of education and income also increased people's risk of PTSD.
Lower Manhattan Residents with PTSD in 2003-2004
African American: 20.6%
Earn $50,000 to $74,999: 11.3%
Earn less than $25,000: 19.8%
Less than high school diploma: 18.3%
College graduate: 11.1%
"These findings confirm that the experience of 9/11 had lasting consequences for many of those affected by it," said Dr. Thomas R. Frieden, New York City Health Commissioner. "Any New Yorker who is still struggling with fear, anxiety, depression or substance use should seek treatment. Please call 311 if you need help finding treatment, or paying for it. Help is available."
Mental Health Treatment Options
In April, the Health Department announced a benefit program specifically for people experiencing mental health or substance-use problems related to 9/11. The Health Department will reimburse out-of-pocket costs for mental health or substance-use treatment through a claims process similar to any insurance benefit. In addition, free mental health services are available through the World Trade Centers of Excellence. New York City residents, and city workers in surrounding areas, can check their eligibility by calling 311 or visiting www.nyc.gov/9-11HealthInfo.
PTSD is an anxiety disorder that stems from experiences involving intense fear, horror or hopelessness. People who develop the condition may become emotionally numb or hyper-alert. Many relive their trauma when reminded of it, and their lives are diminished by their efforts to avoid reminders. Many people recover with counseling or medication, but PTSD can lead to family problems, work problems and substance abuse.
Research at the World Trade Center Health Registry
The Health Department is now analyzing results from a follow-up survey conducted six years after the 9/11 attacks. New findings on the health status of registrants will be released in coming months. Research findings from the Registry's first survey are available online at http://query1.health.nycnet/wtc/indexint.html.
The World Trade Center Health Registry, the largest public health registry in U.S. history, was launched in 2003 to track the health of people exposed to the collapse of the World Trade Center and those who worked at the WTC site. The registry is a collaborative effort involving the Health Department and the CDC's Agency for Toxic Substances and Disease Registry (ATSDR), with funding from the Federal Emergency Management Agency (FEMA).
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