A study led by researchers at the Medical University of South Carolina five years after the water crisis began in Flint, Michigan, found a continuing “large unmet mental health need.” Dr. Dean Kilpatrick, the study’s principal investigator, said last year’s estimates of PTSD and depression in Flint were significantly higher than those in Michigan, the U.S. and more than 20 countries included in an international study of PTSD and depression.
The resulting Flint research article appears in JAMA Network Open, a peer-reviewed open-access journal published by the American Medical Association. The findings in this article are obvious. One in five Flint residents surveyed, age 18 and older, suffered from major depression in the past year. One in four had PTSD. And one in 10 had both.
“If you still have PTSD or depression five years after something happened, that’s pretty much evidence that you either didn’t get the right treatment or you still need more treatment,” said Kilpatrick, a distinguished university professor in the department in Psychiatry and Behavioral Sciences.
Or any treatment, period. Less than 35% of respondents said they had been offered mental health services related to the water crisis.
The team studying the long-term effects of this crisis included scientists from the departments of Psychiatry and Behavioral Sciences, Microbiology and Immunology, and Public Health Sciences at MUSC along with researchers from Boston University and Dartmouth University.
They surveyed 1,970 people in Flint about the water crisis that began in 2014 when the city switched its water supply from Lake Huron and the Detroit River to the Flint River and did not add corrosion inhibitors to the water. This resulted in lead and iron from old pipes entering the water supply.
People immediately began complaining that the water smelled, tasted and looked bad, but authorities told the public the water was safe to drink for more than a year. Was not.
Doctors have found high levels of lead in children, which can damage the central and peripheral nervous systems, cause learning disabilities, affect growth, damage hearing and affect both the formation of blood cells and the way they work, according to the Environmental Protection Agency.
Researchers have found that polluted water also has a psychological effect. People worry about the effects on their health and the health of family and friends. And they weren’t sure how much lead they might have been exposed to.
“Just the idea that ‘I might have been exposed and I don’t know what the health effects are, but they might be bad and long-term’ — that’s enough to scare people and create mental as well as physical stress.” , Kilpatrick said.
Almost all respondents have taken steps to reduce their risks from contaminated water – almost 80% avoid drinking it – but most are still concerned about the health effects, including long-term effects.
Another key stressor: People lost faith in their leaders. “Government officials were reluctant to acknowledge the fact that they had a widespread problem. And so they assured the people that the water was safe, which actually turns out to be what many government officials tend to do. They often have difficulty initially admitting to themselves that they may have a huge problem on their hands,” Kilpatrick said.
“So they try to deny it as long as possible until they face it. And then they finally announce it. But up until this point, because they’ve been telling people, “You’re safe, don’t worry about it,” for a good, long time, people have a hard time believing them.
Early studies by other researchers during and soon after the onset of the crisis found elevated levels of PTSD, stress, anxiety, and depressive symptoms. Two small studies in 2018 and 2019 found that mental health problems remain.
But researchers in the MUSC-led study wanted more data to see how serious the long-term problems might be. So with funding from the federal Department of Justice’s Office of Victims of Crime to the MUSC-based National Resource Center for Victims of Mass Violence, they set out to assess current psychiatric problems in Flint residents using standardized diagnostic measures. The NMVVRC played a role as the Office for Victims of Crime specifically identified the need for better information about major events, such as the Flint water crisis, that are not mass violence but can lead to criminal charges.
They also looked at how previous exposures to stressful events influenced people’s response to the Flint water crisis. This includes a life-threatening illness, serious accident, previous disaster and/or physical or sexual abuse. The study found that these factors significantly increased the risk of suffering from mental disorders.
“Exposure to traumatic events accumulates over time. So if you’ve had a few of these highly stressful things in the past, that probably makes you react more along the lines of developing PTSD or depression to some new stressor or making those problems worse if you’ve had those problems in the past.” , Kilpatrick said.
People on lower incomes and those without social support were also more likely to experience difficulties, the study found.
The scientists hope their findings will help guide what happens next for the people suffering in Flint. “We’re going to create a basic research program here at MUSC that looks at the effects of cumulative lead exposure, first integrating it with some other research that’s going on. But it appears that cumulative lead exposure affects not only children, in terms of their cortical development, but can also affect adults, especially if the lead stored in the bones begins to be released from the bones and into the rest of the body. It can affect your cortical functioning at that point, possibly leading to early dementia and things like that, and other health issues,” Kilpatrick said.
“Through this Flint study, we got interested in this whole area of integrating measures of cumulative lead exposure into other studies that look at potentially traumatic events that look at your exposure to different kinds of things.” How do all these things interact, perhaps, to make you more likely to have some mental disorders, not to mention some of the cognitive impairments or other health problems?”
He said the survey results also make it clear that local, state and federal governments need to work together to offer more mental health services in Flint.
But he said the researchers also noticed something positive that speaks to the strength of Flint, a city that has been through a lot in recent years and seen people come together. “It’s important to note that not everyone has PTSD or depression, and not everyone still has it. So it shows the resilience of a lot of people in Flint who are able, despite all of these difficulties, to be able to get the help that they need, maybe from other friends, from family, from the community.”