Mental health service and medication use in New York City after the September 11, 2001, terrorist attack

OBJECTIVE: A survey assessed use of mental health services and psychiatric medications in New York City four to five months after the September 11, 2001, attack on the World Trade Center. METHODS: A telephone survey using random-digit dialing was conducted among 2,001 adult householders. RESULTS: During the interviews, 7.6 percent of respondents reported use of mental health services in the past 30 days and 7.7 percent reported use of psychiatric medications. Factors associated with service use included experiencing four or more lifetime traumatic events, experiencing two or more stressful life events in the past 12 months, having posttraumatic stress disorder (PTSD), and having depression. African-American and Hispanic respondents were less likely than white respondents to use services. Greater service use after the attack was associated with a graduate education, increased alcohol use after the attack, and depression. Factors associated with medication use included being in either of two age groups (25 to 44 years and 45 to 64 years), having a primary care physician, experiencing two or more stressful life events in the past 12 months, and having depression. African-American and Hispanic respondents were less likely than white respondents to be taking medications. Greater use after the attack was associated with having depression. Mental health visits in Manhattan appeared to decrease compared with the first two months after the attack. However, among respondents with PTSD or depression, those who were nonwhite, younger, without a primary care physician, or without health insurance were less likely to use postdisaster services. CONCLUSIONS: Service use after the terrorist attack was related to mental status and to the amount of trauma and stress experienced. Overall, white respondents, those aged 25 to 64 years, and those with a primary care physician were more likely to use services.