A representative survey of nearly 2,000 Flint residents conducted in late 2019 and early 2020, nearly five years After the start of the water crisis, it was found that one in five people was thought to have suffered from major depression in the past year, one in four had post-traumatic stress disorder (PTSD) and one in 10 have both conditions (“self-assigned” only because the respondent met the DSM-5 diagnostic criteria for disorders but were not individually diagnosed by the clinician). It is clear that this rate of depression is more than twice that of the general US population, while this rate of PTSD is almost five times greater.
These numbers speak to the great psychological damage of the crisis – in fact, a secondary crisis is likely still ongoing. Dean Kilpatrick said: “When we studied other types of environmental and man-made disasters like 9/11, we found that even though the majority of people crash shortly after, that number drops within a few days. first month before basically leveling off. , PhD, the study’s lead author and Distinguished University Professor in the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina. “I have no doubt that if we go back to the same Flint residents now, we will see a lot of improvement.”
“They’re dealing with the impact of potentially being exposed to something toxic, they don’t know their exposure, how deadly it is, how long it takes for the effects to show up.” —Dean Kilpatrick, PhD, senior investigator at the Medical University of South Carolina
This slow and terrible burn reflects the very path of the crisis — which, like many crises involving exposure to toxic substances, doesn’t really end when it does. Even when officials deemed Flint water safe to drink in January 2017, “residents had a hard time believing that this was indeed the case, and rightly so, because it was these officials who misled them first. This is about the quality of the water,” said Dr. Kilpatrick. “At that point, they were still dealing with the psychological impact of potentially being exposed to something toxic, they didn’t know their exposure level, how deadly it was, how long the effects took. present.” He suspects all these remaining uncertainties are what makes the mental health crisis in Flint so protracted.
Why environmental disasters like the Flint water crisis are also triggers for mental health disorders
Any environmental disaster that threatens the security of a person’s livelihood or reduces their access to basic resources such as food, water or shelter has the potential to become a disaster. traumatic event, in its own right. For example, consider the traumatic consequences of moving from your home, suffering environmental health consequences, or struggling to access the things you need to survive or thrive.
In fact, numerous studies have shown that environmental disasters from hurricanes and tornadoes to oil spills and wildfires often lead to psychological distress that can lead to mental health consequences such as depression, PTSD, anxiety, and substance use.
In the case of the Flint water crisis, the impact on mental health could be increased by both its sudden onset and its prolonged duration, according to the researchers. “Consider the mechanism of suddenly being unable to drink water or shower, and having to switch to bottled water for everything,” says Dr. Kilpatrick. “It’s a stressor, in and of itself.” And it went on for five, also, since the contamination levels in Flint’s water remained elevated for a long time after the water supply was restored (and even when the water was once again drinkable, understandably, residents people are still skeptical).
Add to that the real health effects of exposure to toxins — in Flint’s case, mainly lead — and the mental health effects of this kind of crisis are further magnified. Not only can lead exposure it’s him causes certain psychological problems (such as mood swings, energy and irritability), in addition, its damage to physical health can send a person into a state of distress.
“Imagine knowing that you may have or may have consumed something that will kill you, or have other adverse physical effects, and maybe these effects will be immediate or in 10 or 20 or 30 years,” said Dr. Kilpatrick. “You’ll be stressed.”
The psychological distribution of environmental crises is uneven
As with most crises, the people hardest hit by the mental health burden of the Flint water crisis are those who are most vulnerable at the start — and likely to continue. most restrictive. For example, people who believe their or their family’s health is “moderately or heavily damaged by the water crisis” are 123% more likely to develop depression, 66% more likely to have PTSD and 106% more likely to have both conditions. time of the survey. Meaning, people who experience physical harm from the water crisis are also more likely to be affected by mental health problems.
Research also shows that people who feel they can’t trust information from city officials about water safety are also more likely to suffer from depression or PTSD. And likely, many of these people are also members of racial minorities, due to the ways in which systemic racism has perpetuated and increased institutional distrust in the past. This group.
In fact, Flint is a predominantly black community, which makes it more vulnerable to this crisis. in first place. The residual effects of segregation and segregation practices make Blacks more likely to live in under-resourced neighborhoods rife with environmental hazards. Just take Jackson, Mississippi, which is also a predominantly Black city, in this case city officials failed to invest in a water treatment center so efficient that it easily was knocked down by a downpour last month, leaving residents without drinking water for weeks. Likewise, the lack of investment by city officials in Flint (to effectively ensure that the water of the Flint River is safe to drink) has endangered the city’s mostly black residents. .
To take it a step further, the study also found that people in Flint had the lowest income, lack of social support and had previously experienced traumatic events, particularly physical or emotional assault. education, are also more likely to experience depression and/or PTSD after the water crisis. And this shows how quickly and catastrophically a crisis like Flint can have the greatest double impact on those least equipped to handle them.
What can be done to reduce the psychological burden of environmental disasters?
This study is proof that environmental disasters don’t just have physical-health consequences; also has a very real and lasting mental health consequence. And while this certainly underlines the need for infrastructure investment – especially in life-critical resources like water and in under-resourced areas like Flint – it also shows the importance of local officials in reviewing long-term mental health outcomes. in formulating their response to disaster.
Part of that simply means acknowledging that the disaster is, in fact, happening, in the first place. As noted above, Flint residents who distrust government officials during the water crisis experienced worse mental health consequences than those who did – and much of that distrust stems from from these officials’ initial response was denial, denial, denial. Instead, authorities fighting a similar environmental problem “should think to themselves: ‘What if this is really a real crisis? ” And they should avoid telling people outright, ‘No problem here, nothing to see here,’ says Dr Kilpatrick, ‘because if they lose their credibility in the first place, it would create much more serious problems.”
At the same time, it is essential that communities expand their access to mental health resources in a crisis like Flint’s. Although Flint city officials rolled out several new mental health support services in 2016, with the help of federal funding, these initiatives may be too little, too late. . Only about 34% of respondents in the above study said they were provided with mental health services to help with crisis-related concerns, despite clear survey evidence at the time. shows significant demand.
Of the inhabitants of Flint, who to be provided mental health support, nearly 80% used it (and those who did so were significantly less likely to meet the criteria for depression at the time of the study). That number is not 100%, though, which reflects an additional need to reduce stigma in accessing mental health care when it is available, Dr. Kilpatrick said.
City officials can help by normalizing the fact that psychological consequences can and do occur in response to ecological disasters (the same way that physical disasters do), and by promoting psychological care in the first place. This will be especially important for people with pre-existing risk factors, such as those who have experienced traumatic events in the past, Dr Kilpatrick adds: “It is essential to be understand that these have a cumulative impact on the likelihood that PTSD will survive — and survive. “