PTSD identified in Flint today is 5 times greater than national estimates among US adults, according to the new findings.
Five years after the water crisis began, the largest mental health survey of the Flint, Michigan indicates that one in five adults, or about 13,600 people, have clinical depression and one in four, or about 15,000 people, have PTSD.
“The mental health burden of America’s largest public-works environmental disaster,” according to lead author Aaron Reuben, “clearly continues for many adults in Flint.”
The findings of the study were published today in JAMA Network Open.
On April 25, 2014, the city of Flint switched its water supply from Lake Huron and the Detroit River to the Flint River without adequately treating the water to prevent lead and other contaminants from seeping from the city’s ancient water pipes. As a result, almost all residents of Flint were exposed to drinking water that included dangerous amounts of bacteria, disinfection byproducts, and lead, a neurotoxin.
It wasn’t until January 24, 2017, that Flint’s water supply was officially deemed lead-free. Tens of thousands of children and adults in Flint experienced high blood lead levels throughout the crisis, increasing their risk of developing cognitive deficiencies, mental health issues, and other health issues in later life.
“We know that large-scale natural or human-caused disasters can trigger or exacerbate depression and PTSD,” adds senior author Dean Kilpatrick.
Kilpatrick pointed out that there was clear evidence that there were a lot of mental health problems in Flint in the first few years of the crisis.
“What we did not know until now was the extent to which Flint residents continued to have mental health problems at the clinical diagnosis level five years after the crisis began.”
According to Kilpatrick, current rates of depression and PTSD in Flint are three to five times higher than national estimates for adults in the United States as a whole. This is likely due to a combination of higher baseline rates of mental health issues in Flint prior to the crisis and a significant exacerbation of problems caused by the crisis.
“The vast majority of our respondents were never offered mental health services,” adds Reuben, “despite clear indication that the crisis was psychologically traumatic.”
Most Flint residents offered mental health services used them.
“Now that pipes are being replaced, the time is right to begin a second phase of recovery from the water crisis – one that focuses on providing additional resources to heal psychological wounds,” Reuben adds.
Kilpatrick said that people in Flint, which is mostly a low-income Black community, had to deal with many problems that can hurt mental health before the water crisis. These problems include being poor, being treated unfairly, and being exposed to a lot of potentially traumatic events, such as being physically or sexually abused.
The finding that those who had experienced physical or sexual assault were more than three times as likely to have depression and more than six times as likely to experience PTSD was particularly startling. This underlines how crucial it is to take into account the cumulative impacts of earlier exposure to traumatic events when assessing how environmental disasters would affect mental health, according to Kilpatrick.
Depression and PTSD are two of the most common and debilitating mental illnesses. They cost the United States well over $326 billion a year in lost work hours and medical costs.
“We study these problems after disasters because they are common outcomes and because they are significantly impairing to individuals and communities,” says co-author Sandro Galea. “But we also study these problems because we have good treatments that are effective for most people.”
According to study findings, more has to be done to offer Flint citizens mental health care.
“There is a clear unmet need,” according to Reuben, who is also a postdoctoral scholar at MUSC. “Nearly 100% of surveyed Flint residents reported that they changed their behavior to avoid consuming contaminated water during the crisis, and the vast majority still worry that the exposures they had may cause future health problems for themselves or their family members.”
The study found that adults who believed exposure to contaminated water had harmed their or a family member’s health were significantly more likely to have depression and PTSD within the past year. According to Reuben, uncertainties about exposures and future harms meaningfully contribute to psychological distress after environmental disasters.
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