Mental health stigma and barriers to care in World Trade Center responders: Results from a large, population‐based health monitoring cohort

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.

Investigating the impact of terrorist attacks on the mental health of emergency responders: systematic review

“…68 This could be another important tool for mental health prevention, as the perceived stigma of the emergency workers involved is comparatively high. 38 There are some study limitations to report. Results may be limited because only two databases were used, only English-language literature was considered, results for female emergency services are limited because of the high proportion of males in emergency services personnel jobs, and the search strategy may have missed other events.…”

“…68 This could be another important tool for mental health prevention, as the perceived stigma of the emergency workers involved is comparatively high. 38…”

“…The stigma associated with mental disorders remains a major barrier for emergency services personnel in seeking professional help. 38 Destigmatisation programmes should therefore be implemented or further expanded in all relevant institutions. There are already a number of established options.…”

“…The prevalence of any kind of mental disorder was 17.4%. 38 Prevalence rates 6-10 years after the terrorist attack…”

“…'Trying to deal with it yourself' was the most common reason for the reluctance to seek help. 38 Problems in daily life after the events…”