Citation
Journal of Traumatic Stress, Vol. 18, No. 4, August 2005, pp. 287–297 <http://hdl.handle.net/2027.42/40262>
Publisher
Journal of Traumatic Stress
Description
To assess disparities in mental health treatment in New York City (NYC) after theWorld Trade Center
Disaster (WTCD) reported previously related to care access, we conducted analyses among a crosssectional
survey of adults who had posttraumatic stress disorder (PTSD) or major depression (N = 473) one year after the event. The dependent variables examined were use of mental health services,
in general, and use of mental health services related to the WTCD. Similar dependent variables were
developed for medication usage. Although a number of bivariate results were statistically significant
for postdisastermental health visits, in a multivariate logistic regression model, onlyWTCD exposure
remained significant. For service utilization related to the WTCD, the multivariate results indicated
that African Americans were less likely to have had these visits compared toWhites, while thosewith a
regular doctor, who had greater exposure toWTCD events, and those who had a perievent panic attack
were more likely to have had such visits. In terms of medication use, multivariate results suggested
that African Americans were less likely to use postdisaster medications, whereas persons 45 + years
old and those with a regular doctor, were more likely to use them. For WTCD-related medication use,
multivariate models indicated that African Americans were less likely to use medications, relative
to Whites, while those between 45 and 64 years old, those with a regular doctor, those exposed to
more WTCD events, and those who had a perievent panic attack, were more likely to have taken
medications related to the disaster. The primary reason respondents gave for not seeking treatment
(55% of subsample) was that they did not believe that they had a problem (73%). Other reasons were
that they wanted to solve the problem on their own (5%), had problems accessing services (6%),
had financial problems (4%), or had a fear of treatment (4%). Despite the availability of free mental
health services offered in a supportive and potentially less stigmatizing environment post disaster,
there still appeared to be barriers to receiving postdisaster services among those presumably in need of
care.