Construction workers, clean-up staff and other untrained nontraditional emergency employees who assisted in recovery efforts at the World Trade Center in New York following the terrorist attacks on Sept. 11, 2001, are more than five times as likely than traditional first responders to have considered suicide, according to a Rutgers study.
In an analysis of more than 30,000 World Trade Center emergency responders, researchers found 12.5 percent of nontraditional workers – people whose job descriptions don’t include responding to disaster – have expressed suicidal ideation in the years after their work at Ground Zero, compared with 2.2 percent of police, firefighters and EMTs.
Published in the Journal of Affective Disorders, the study is believed to be the first to examine the prevalence and connection of thoughts of suicide in two occupational groups that participated in rescue, recovery and clean-up efforts following the 9/11 attacks on the World Trade Center.
“Our findings underscore the continuing burden of suicide ideation in Ground Zero responders, particularly nontraditional responders,” said Iris Udasin, director of the Center of Excellence at Rutgers University for the World Trade Center Medical Monitoring and Treatment Program and a coauthor of the study. “It also provides a more nuanced understanding of the risks associated with responding to disasters without adequate training.”
As part of standardized surveys administered by the WTC Health Program, disaster responders were asked how often they are bothered by thoughts of death or of hurting themselves. Researchers used the data to postulate several factors to explain the increased prevalence of suicidal ideation among responders who were inadequately prepared for what they experienced.
Many nontraditional responders were day laborers – young people with limited family support systems – who needed help to navigate these suicidal thoughts. The Rutgers study also found that after 9/11, nontraditional responders had fewer opportunities to assume less strenuous work, raising the risk of financial hardship and depression. A police officer who developed asthma from working at Ground Zero, for instance, might be able to shift to desk work, but someone whose job demands physical labor might have a more difficult time adapting to less strenuous activity.
Udasin said another explanation for the discrepancy is that traditional first responders may be reluctant to answer questions about their mental health because of the professional stigma that can arise.
According to Udasin, lessons learned from the study should be applied to future disaster responses – from a tsunami in the Philippines to the war in Ukraine.
“Something we've learned following the World Trade Center attack is that random people coming in to help is not always a good idea,” Udasin said. “While we can never anticipate every kind of skill that might be needed at a disaster site, from a mental health perspective it is always better to send in trained people than untrained people.”
The research was funded by the Centers for Disease Control and Prevention’s National Institute of Occupational Safety and Health, a branch of the US Department of Health and Human Services. CDC-NIOSH also funds the WTC Health Program at Rutgers, which works to identify and support the thousands of people who responded to the 9/11 terrorist attacks in New York.
Journal of Affective Disorders
Method of Research
Subject of Research
Prevalence and correlates of suicidal ideation in World Trade Center responders: Results from a population-based health monitoring cohort
Article Publication Date