Study reveals mental health burden in Flint community five years after water crisis

Data from the largest community mental health survey in Flint, Michigan, indicates that one in five adults, or about 13,600 people, suffered from clinical depression, and one in four, or 15 000 people, suffered from PTSD five years after the water crisis began.

“The mental health burden of America’s largest public works environmental disaster clearly continues for many adults in Flint,” said Aaron Reuben, a postdoctoral fellow at Duke University who led the research, which appears September 20 in JAMA network open.

April 25e, 2014, the City of Flint switched its water supply from Lake Huron and the Detroit River to the Flint River and failed to properly treat the water supply to prevent lead and other elements from escaping of the city’s old water pipes. Virtually all Flint residents have therefore been exposed to drinking water containing dangerous levels of bacteria, disinfection byproducts and lead, a neurotoxin.

Flint’s drinking water was not declared lead-free until January 24, 2017. During the crisis, tens of thousands of children and adults in Flint developed high levels of lead in their blood, exposing them to an increased risk of cognitive deficits, mental health problems and other health problems later in life.

We know that large-scale natural or man-made disasters can trigger or exacerbate depression and PTSD. »

Dean Kilpatrick, PhD, University Professor Emeritus, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina and senior study author

Kilpatrick noted that there was clear evidence of high rates of mental health issues in the Flint community during the early years of the crisis. “What we didn’t know until now was the extent to which Flint residents continued to have mental health issues at the clinically diagnosed level five years into the crisis.”

According to Kilpatrick, the rates of depression and PTSD from the previous year identified in Flint today are three to five times higher than national estimates among American adults overall, and likely result from a combination of rates higher baselines of mental health issues in Flint before the crisis. as a significant aggravation of the problems resulting from the crisis.

“The vast majority of our respondents never received mental health services,” Reuben said, “despite clear indications that the crisis was psychologically traumatic.” Most Flint residents who were offered mental health services continued to use and benefit from them. “Now that the pipes are being replaced, the time has come to begin a second phase of recovery from the water crisis – a phase that focuses on providing additional resources to heal psychological wounds,” said Reuben.

Kilpatrick said residents of Flint, a low-income, predominantly black community, faced many challenges before the water crisis that can erode mental health, including socioeconomic disadvantage, racism and a strong exposure to potentially traumatic events, including previous physical or sexual assaults.

Particularly striking is that people who had ever experienced physical or sexual assault were more than three times more likely to suffer from depression and more than six times more likely to suffer from PTSD than those who did not. “This underscores the importance of considering the cumulative effects of previous exposure to traumatic events when assessing the effects of environmental disasters on mental health,” Kilpatrick said.

Depression and PTSD are among the most common and disabling mental disorders, costing well over $326 billion a year in America in lost work hours and medical care costs.

“We study these issues after disasters because they are common outcomes and because they significantly harm individuals and communities,” said Sandro Galea, MD, DrPH, Robert A. Knox Professor and Dean of Boston University. School of Public Health and a study co-author. “But we’re also looking at these issues because we have good treatments that work for most people.”

The study results suggest that more should be done to provide mental health treatment to Flint residents.

“There’s a clear unmet need,” said Reuben, who is also a postdoctoral fellow at MUSC. “Nearly 100% of Flint residents surveyed said they had changed their behavior to avoid consuming contaminated water during the crisis, and the vast majority are still concerned that the exposures they experienced could cause future problems. health for themselves or their family members.

According to Reuben, uncertainties about future exposures and harm contribute significantly to psychological distress after environmental disasters, and the study found that adults who believed exposure to contaminated water had harmed their health or that of a family member were significantly more likely to suffer from depression and PTSD in the past year. .

The study, funded by a grant to MUSC from the U.S. Department of Justice’s Office for Victims of Crime, surveyed a random household sample of 1,970 adults in Flint between August 13, 2019 and April 10, 2020. The surveys were conducted online and by mail. by Abt Associates, a national survey research firm. Rothbaum was also supported by a grant from the National Institute of Mental Health (T32-MH018869)

Data were collected on perceived exposure to contaminated water, prevalence of depression and PTSD in the previous year using DSM-5 diagnostic criteria, and risk factors potentials for depression and PTSD, including previous exposure to potentially traumatic events, previous physical or sexual assault, and low social support. . Adults were also affected if they were offered or received mental health services.


Journal reference:

Ruben, A. et al. (2022) Prevalence of depression and post-traumatic stress disorder in Flint, Michigan, 5 years after the onset of the water crisis. JAMA network open.


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