Long-Term Mental Health Care Utilization Among Direct Survivors of Terrorism in Oklahoma City

What is it about?

Among 99 direct survivors of the 1995 Oklahoma City bombing, of whom almost 90% were injured, 86% used mental health services at various times over seven years post-disaster. Mental health care was more common among females and those who were injured or had posttraumatic stress disorder (PTSD) or depression. Services varied over time. In the first six months, informal crisis intervention such as participation in support groups, debriefings or sessions with clergy were used by over half. Formal treatment by psychiatrists, other mental health care providers and family doctors began later and usually ended before 7 years. Over three fourths of survivors with psychiatric disorders received help from nonphysician mental health providers. However, only half with bombing-related PTSD or post-bombing depression saw a psychiatrist and only 15% reported taking psychiatric medication for bombing-related problems during the 7 years. While 33% of survivors received care for over a year, only 7% were receiving services at 7 years. Although care decreased over time, this study showed the importance of providing varied services adapted to changing needs.

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Why is it important?

Results point to the need to identify those who need formal mental health care due to their mental distress and to address these problems with the appropriate treatments over time and according to needs. Females, those who are injured or who have PTSD or depression should be carefully assessed. Disaster relief efforts should plan for providing mental health service beyond the 12 to 18 months traditionally supported by federal assistance programs.

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