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, found that one in five people had suspected major depression in the past year, one in four had suspected post-traumatic stress disorder (PTSD), and one in 10 had both conditions (“suspected” only because the respondents met the DSM-5 diagnostic criteria for the disorders but were not individually diagnosed by a physician). To be clear, this prevalence of depression is more than double that of the general US population, while this rate of PTSD is nearly five times higher.
These numbers speak of the main psychological cost of the crisis; in fact, a secondary crisis that is probably still ongoing. “By studying other types of environmental and man-made disasters like 9/11, we found that while most people experience distress immediately afterward, that number will decline in the first two months before basically leveling off,” says Dean. Kilpatrick. , PhD, lead author of the study and Distinguished University Professor in the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina. “I wouldn’t suspect that if we went back to the same Flint residents now, we would see a lot of improvements.”
“They’re dealing with the shock of potentially being exposed to something toxic, where they don’t know how much exposure they had, how deadly it was, how long it’s going to take for the effects to kick in.” —Dean Kilpatrick, PhD, principal investigator at the Medical University of South Carolina
This terrible slow burn mirrors the path of the crisis itself, which, like many crises related to toxic exposure, didn’t really end when it did. Even when officials deemed Flint’s water safe to drink in January 2017, “residents had a hard time trusting that this was actually the case, and rightfully so, given that these same officials had previously misled them about the quality.” of the water,” says Dr. Kilpatrick. “At that point, they’re also dealing with the psychological impact of potentially being exposed to something toxic, where they don’t know how much exposure they had, how lethal it was, how long it will take for the effects to wear off. appear.” All this remaining uncertainty, he suspects, is what is now causing the mental health crisis in Flint to linger so deeply.
Why environmental disasters like the Flint water crisis also affect mental health
Any environmental disaster that threatens a person’s livelihood security or minimizes their access to basic resources such as food, water or shelter has the potential to be a traumatic event in its own right. Consider, for example, the traumatic effect of being displaced from your home, suffering environmental health consequences, or struggling to access the things you need to survive or thrive.
In fact, extensive research has shown that environmental disasters ranging from hurricanes and tornadoes to oil spills and wildfires often cause psychological distress that can have mental health consequences such as depression, post-traumatic stress disorder, anxiety, and substance use. substances.
In the case of the Flint water crisis, the impact on mental health was likely magnified by both the sudden onset of the crisis and its long duration, according to the study’s researchers. “Consider the mechanics of suddenly not being able to drink your water or shower, and having to switch to bottled water for everything,” says Dr. Kilpatrick. “That’s a stressor, in and of itself.” And it was one that lasted for years, Also, since contaminant levels in Flint’s water remained elevated long after the water supply was turned back on (and even once the water became drinkable again, residents were still, understandably, skeptical).
Add in the very real health effects of toxin exposure (in Flint’s case, primarily lead) and the mental health implications of this type of crisis are further magnified. Exposure to lead can not only itself trigger certain psychological problems (such as changes in mood, energy and irritability), but also, its damage to physical health can lead a person to a state of anguish.
“Imagine knowing that you may or may not have consumed something that will kill you, or have these other adverse physical effects, and these effects may show up right away or in 10, 20, or 30 years,” Dr. Kilpatrick says. “You’re going to be stressed.”
How the psychological consequences of environmental crises are unevenly distributed
As with most crises, the people hardest hit by the mental health burden of the Flint water crisis were those in the most vulnerable position to begin with, and with the most limited access to resources. For example, people who believed their or their family’s health was “moderately or severely damaged by the water crisis” were 123% more likely to have depression, 66% more likely to have PTSD, and 106% more % more likely to have both conditions at the same time. the time of the survey. That is, people who suffered physical damage from the water crisis were also more likely to suffer the double whammy of mental health problems.
The study also found that people who felt they couldn’t trust information from city officials about water safety were also more likely to develop depression or post-traumatic stress disorder. And it is likely that many of the people in this group were also people of racial minorities, given the ways that systemic racism has caused and amplified institutional distrust in these groups.
In fact, Flint is a predominantly black community, which made it more susceptible to this crisis. first. Residual effects of racist red-lining practices and residential segregation make Black people more likely to live in low-income neighborhoods plagued by environmental hazards. Let’s just take Jackson, Mississippi, also a predominantly black city where, in this case, city officials failed to invest in an effective water treatment center, so a rain storm easily swept through it last month, leaving residents residents without drinking water for weeks. By the same token, it was a lack of investment by city officials in Flint (to effectively ensure that the Flint River’s water was safe to drink) that endangered the city’s mostly black residents. from the jump.
Going a step further, the study also showed that those in Flint who reported the lowest income, lack of social support, and prior exposure to traumatic events, particularly physical or sexual assault, were also significantly more likely to experience depression and /or PTSD as a result of the water crisis. And this just goes to show how quickly and tragically a crisis like Flint can have the most aggravating effects on the people least equipped to handle them.
What can be done to reduce the psychological burden of environmental disasters
This study is evidence that environmental disasters not only have consequences for physical health; there is also a very real and lasting mental health consequence. And while this certainly underscores the need for investment in infrastructure, particularly in life-saving resources like water and in historically under-resourced areas like Flint, it also demonstrates how important it is for local officials to consider long-term mental health outcomes. term. in developing its response to disasters.
Part of that simply means acknowledging that disaster is, in fact, happening all along. As noted above, Flint residents who did not trust government officials during the water crisis experienced worse mental health consequences than those who did, and much of that mistrust stemmed from the initial response of these officials. to deny, deny, deny. Instead, authorities facing a similar environmental problem “should think to themselves, ‘What if this is really a real crisis?’ And they should avoid blithely telling people, ‘No problem here, nothing to see here,’” says Dr. Kilpatrick, “because if you ruin your credibility early on, you’ll create much more serious problems down the road. ”
At the same time, it is essential that communities expand access to mental health resources in the aftermath of a crisis like the one in Flint. Although Flint city officials launched some new mental health support services in 2016, with the help of federal funding, these initiatives were probably too few too late. Only about 34 percent of those surveyed in the earlier study said they were offered mental health services to help with crisis-related concerns, despite clear survey evidence at the time showing a significant need.
Of Flint residents who were offered mental health support, nearly 80 percent used it (and those who did were significantly less likely to meet criteria for depression at the time of the study). Still, that number isn’t 100 percent, reflecting the additional need to reduce the stigma of accessing mental health care when it’s available, says Dr. Kilpatrick.
City officials can help by normalizing the fact that psychological consequences can and do occur in response to ecological disasters (in the same way as physical ones) and by promoting psychological care early on. This will be especially important for people with preexisting risk factors, such as those who have experienced traumatic events in the past, adds Dr. Kilpatrick: “It’s essential to understand that these things have a cumulative effect on the likelihood that the PTSD develops.” exist and persist.