One in four adults surveyed in Flint, Mich., were experiencing post-traumatic stress disorder (PTSD) five years after their community endured a water infrastructure disaster, a new study has found.
The disaster in question, which became known as the Flint water crisis, was a 2014 lead contamination debacle in which the neurotoxicant infected an entire city’s water supply.
Years later, residents were still reeling from the events. While 1 in 4 residents were exhibiting signs of PTSD, 1 in 5 individuals surveyed were suffering from clinical depression, according to the study, published in JAMA Network Open on Tuesday.
“The mental health burden of America’s largest public-works environmental disaster clearly continues for many adults in Flint,” first author Aaron Reuben, a postdoctoral scholar at Duke University, said in a statement.
The Flint water crisis began in April 2014, when the city of Flint’s drinking water source changed from Detroit’s water network to the adjacent Flint River. Because that resource was not properly treated, corrosive river water damaged the city’s pipes — leading to the discharge of lead and other contaminants into Flint’s drinking water system.
The influx of these pollutants caused a situation in which nearly all Flint residents were exposed to unsafe levels of bacteria, disinfection byproducts and lead, which has toxic effects on the nervous system, the study authors noted.
Although Flint returned to Detroit’s water system a year and a half after the problematic switch, the city’s drinking water was not declared lead-free until January of 2017, according to the researchers.
During the crisis, they explained, tens of thousands of children and adults developed high blood-lead levels, increasing their risk for cognitive deficits, mental health problems and other health issues later in life.
“We know that large-scale natural or human-caused disasters can trigger or exacerbate depression and PTSD,” senior author Dean Kilpatrick, a professor of psychiatry at the Medical University of South Carolina, said in a statement.
While clinicians saw clear evidence of increased mental health issues early in the crisis, they were unaware of “the extent to which Flint residents continued to have mental health problems at the clinical diagnosis level five years after the crisis began,” according to Kilpatrick.
To draw their conclusions, the researchers surveyed 1,970 adults from Flint between August 2019 and April 2020, through an external national survey research firm.
The data collected included information on perceived exposure to contaminated water, as well as the development of PTSD and depression in the past year using DSM-5 criteria — the standard classification of disorders published by the American Psychiatric Association.
The survey accounted for potential risk factors for these disorders, including traumatic events, prior physical or sexual assault and low social support, according to the study.
Adults polled also indicated whether they were ever offered or received mental health services.
In total, the researchers determined that 480 people — 24.4 percent — met the criteria for PTSD, while 435 individuals — 22.1 percent — met the criteria for past-year depression.
They also found that 276 respondents — 14 percent — met the criteria for both disorders.
Applying these weighted samples to the general adult population, the scientists estimated that 15,000 individuals may have had PTSD and 13,600 may have had depression, while an estimated 8,600 individuals may have had both PTSD and depression in 2019-2020.
Flint is a predominantly low-income, Black community that already faced challenges prior to the water crisis, including socioeconomic disadvantages, racism and high exposure to potentially traumatic events, Kilpatrick noted.
Meanwhile, participants who said they had endured prior physical or sexual assault were more than six times more likely to have PTSD and more than three times more likely to experience depression than those who lacked such a history, according to the study.
“This highlights the importance of considering the cumulative effects of prior exposure to traumatic events when evaluating the effects of environmental disasters on mental health,” Kilpatrick said.
Despite the prevalence of both PTSD and depression among Flint residents, the researchers expressed concern about a lack of sufficient mental health treatment in the area.
“The vast majority of our respondents were never offered mental health services,” Reuben said.
Only 685 respondents — 34.8 percent — were ever offered such treatment services, and 79.3 percent of those who were offered the services never utilized them, according to the study.
“Now that pipes are being replaced, the time is right to begin a second phase of recovery from the water crisis — one that focuses on providing additional resources to heal psychological wounds,” Reuben added.