Five years after Flint water crisis – depression, PTSD highly prevalent

Depression and PTSD were highly prevalent 5 years after the onset of the water crisis in Flint, Michigan, suggesting that public-works disasters have large-scale, long-term psychological impacts.

“Early surveys of Flint residents during and shortly after the water crisis onset identified elevations in PTSD symptoms among those who believed they were exposed to poor-quality tap water, and more diffuse concerns involving stress, anxiety and depressive symptoms among residents worried about the health and economic consequences of the crisis,” Aaron Reuben, PhD, MEM, of the department of psychology and neuroscience at Duke University, and colleagues wrote in JAMA Network Open.

Reuben and colleagues aimed to investigate the prevalence of, and factors associated with, current presumptive diagnostic-level major depression and PTSD among Flint residents after the onset of the water crisis.

The researchers conducted a cross-sectional study, in which a household probability sample of 1,970 adults living in Flint during the crisis was surveyed about their experiences, psychological symptoms 5 years later, as well as access to and use of mental health services in the intervening years. Analyses were weighted to produce population-representative estimates.

Results showed that 435 (22.1%) respondents met DSM-5 criteria for presumptive past-year depression, 480 (24.4%) for presumptive past-year PTSD, and 276 (14%) for both disorders.

Residents who believed that their or their family’s health was harmed by contaminated water risk (RR for depression, 2.23; 95% CI, 1.80-2.76), who had low confidence in public official information (RR for PTSD, 1.44; 95% CI, 1.16-1.78), who had previous exposure to potentially traumatizing events (RR for both disorders, 5.06; 95% CI, 2.99-8.58), or who reported low social support (RR for PTSD, 2.58; 95% CI, 1.94-3.43) had significantly higher risk for depression, PTSD and comorbidity.

Data additionally showed that potentially traumatic events involving prior physical or sexual assault were especially potent risk factors (RR for both disorders, 7.30; 95% CI, 4.3-12.42). Only 685 respondents (34.8%) were ever offered mental health services to assist with water-crisis-related psychiatric symptoms, and 79.3% of those respondents who were offered services utilized them.

“These findings suggest that community-level public works environmental disasters have large-scale and lasting psychological sequelae,” Reuben and colleagues wrote.