Friday, September 23, 2022

High Rates of Depression, PTSD Persist Five Years After Water Crisis in Flint, Mich.

Five years after the water crisis in Flint, Mich., residents of the community had higher rates of past-year depression and posttraumatic stress disorder (PTSD) compared with the rest of the nation, a study in JAMA Network Open has found. During the crisis, which occurred from 2014 to 2017, many residents were exposed to drinking water with unsafe levels of bacteria, disinfection byproducts, and lead after the city switched its drinking water supply from Detroit’s system to the Flint River.

Aaron Reuben, Ph.D., of Duke University and colleagues analyzed data from a survey of 1,970 adults who lived in Flint during the crisis. The survey was conducted from August 13, 2019, through April 20, 2020. It asked participants about their crisis experiences, their mental health symptoms five years later, and their access to and use of mental health services in the intervening years. Among respondents, 53.5% identified as Black or African American, 42.5% identified as White, and 97.4% identified as non-Hispanic; 56.8% reported earning less than $25,000 a year.

Overall, 22.1% of participants had symptoms of past-year depression, 24.4% had symptoms of past-year PTSD, and 14.0% had symptoms of both conditions. Participants who believed that their or their family’s health was moderately or greatly harmed by the water crisis were 123% more likely than their peers to have symptoms of depression, 66% more likely to have symptoms of PTSD, and 106% more likely to have symptoms of both conditions. Participants who had a history of potentially traumatic events such as a life-threatening illness, serious accident, or previous disaster were 173% more likely than their peers to have symptoms of depression and 355% more likely to have symptoms of PTSD.

“These findings suggest that the water crisis could have exacerbated existing mental health disparities in Flint—a possibility that should be investigated in future studies,” Reuben and colleagues wrote.

Only 34.8% of participants reported ever being offered mental health services to help address their concerns or problems associated with the crisis. About 79% of those who were offered mental health services used them.

The researchers concluded “that (1) there is a large, unmet mental health need in the Flint community 5 years after the onset of the water crisis and (2) this need for mental health services is unlikely to remit without a comprehensive, systematic, and coordinated response from the local, state, and federal governments and public health communities,” the researchers wrote. “These findings suggest that community-level public works environmental disasters have large-scale and lasting psychological sequelae.”

For related information, see the Psychiatric News article “Preparing for Disasters at the Community Level: Prevention and Social Cohesion.”

(Image: iStock/banusevim)

APA Invites You to Partner on Perinatal Initiative Funded by CDC Foundation

To address training and knowledge gaps regarding untreated perinatal mental illness, it is important to understand providers’ perspectives about pregnant persons with mental health issues during and after pregnancy. APA has been awarded a grant from the CDC Foundation to conduct a needs assessment of these gaps. APA is seeking 400 providers to take a 30-minute survey and 16 providers to participate in two-hour focus groups. Survey respondents will receive a $30 Amazon gift card, and focus group participants will receive a $450 honorarium. Those interested in participating can register at


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