Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

Brief Reports   |    
Use of Mental Health Services by Children and Adolescents Six Months After the World Trade Center Attack
Ana Soledade Graeff-Martins, M.D.; Christina W. Hoven, Dr.P.H.; Ping Wu, Ph.D.; Fan Bin, M.D.; Cristiane S. Duarte, Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201200586
View Author and Article Information

Dr. Graeff-Martins is with the Department of Psychiatry, Universidade de Sao Paulo, Sao Paulo, Brazil (e-mail: anasoledade10@terra.com.br). Dr. Hoven, Dr. Bin, and Dr. Duarte are with the Department of Child and Adolescent Psychiatry, Columbia University and New York State Psychiatric Institute, New York City. Dr. Wu is with the Center for Scientific Review, National Institutes of Health, Bethesda, Maryland.

Copyright © 2014 by the American Psychiatric Association


Objective  The authors describe use of mental health services among children and adolescents after the September 11, 2001, attack on the World Trade Center.

Methods  Six months after the attack, sixth- through 12th-graders (N=6,986) who were representative of the student population were asked about their use of mental health services to talk about the attack as well as their exposure to the attack, symptoms of posttraumatic stress and major depressive disorders, and any conversations about the attack with a parent, teacher, or religious leader.

Results  Eighteen percent had used mental health services. Using in-school services was associated with conversation with a teacher about the attack. Using services outside school was associated with direct exposure to the attack, previous trauma exposure, probable psychiatric diagnosis, and conversation with a teacher or religious leader about the attack.

Conclusions  Teachers and religious leaders can function as gatekeepers to identify children in need following a disaster.

Abstract Teaser
Figures in this Article

Your Session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Anchor for Jump
Table 1Factors associated with use of mental health services by children and adolescents after the World Trade Center attack, by location of servicesa
Table Footer Note

a No use of services is the reference group. Models were adjusted by sociodemographic characteristics.



Beaton  RD;  Murphy  SA;  Houston  JB  et al:  The role of public health in mental and behavioral health in children and families following disasters.  Journal of Public Health Management and Practice 15:E1–E11, 2009
[CrossRef] | [PubMed]
Pfefferbaum  B;  Pfefferbaum  RL;  Gurwitch  RH  et al:  Children’s response to terrorism: a critical review of the literature.  Current Psychiatry Reports 5:95–100, 2003
[CrossRef] | [PubMed]
Fairbrother  G;  Stuber  J;  Galea  S  et al:  Unmet need for counseling services by children in New York City after the September 11th attacks on the World Trade Center: implications for pediatricians.  Pediatrics 113:1367–1374, 2004
[CrossRef] | [PubMed]
Hoven  CW;  Duarte  CS;  Lucas  CP  et al:  Psychopathology among New York City public school children 6 months after September 11.  Archives of General Psychiatry 62:545–552, 2005
[CrossRef] | [PubMed]
Stuber  J;  Fairbrother  G;  Galea  S  et al:  Determinants of counseling for children in Manhattan after the September 11 attacks.  Psychiatric Services 53:815–822, 2002
[CrossRef] | [PubMed]
Ford  T:  Practitioner review: how can epidemiology help us plan and deliver effective child and adolescent mental health services? Journal of Child Psychology and Psychiatry, and Allied Disciplines 49:900–914, 2008
[CrossRef] | [PubMed]
Burns  BJ;  Costello  EJ;  Angold  A  et al:  Children’s mental health service use across service sectors.  Health Affairs 14:147–159, 1995
[CrossRef] | [PubMed]
Lucas  CP;  Zhang  H;  Fisher  PW  et al:  The DISC Predictive Scales (DPS): efficiently screening for diagnoses.  Journal of the American Academy of Child and Adolescent Psychiatry 40:443–449, 2001
[CrossRef] | [PubMed]
Donahue  SA;  Lanzara  CB;  Felton  CJ  et al:  Project Liberty: New York’s crisis counseling program created in the aftermath of September 11, 2001.  Psychiatric Services 57:1253–1258, 2006
[CrossRef] | [PubMed]
Covell  NH;  Allen  G;  Essock  SM  et al:  Service utilization and event reaction patterns among children who received Project Liberty counseling services.  Psychiatric Services 57:1277–1282, 2006
[CrossRef] | [PubMed]
Merikangas  KR;  He  JP;  Burstein  M  et al:  Service utilization for lifetime mental disorders in US adolescents: results of the National Comorbidity Survey–Adolescent Supplement (NCS-A).  Journal of the American Academy of Child and Adolescent Psychiatry 50:32–45, 2011
[CrossRef] | [PubMed]
Canino  G;  Shrout  PE;  Alegría  M  et al:  Methodological challenges in assessing children’s mental health services utilization.  Mental Health Services Research 4:97–107, 2002
[CrossRef] | [PubMed]
Pfefferbaum  RL;  Fairbrother  G;  Brandt  EN  Jr  et al:  Teachers in the aftermath of terrorism: a case study of one New York City school.  Family and Community Health 27:250–259, 2004
Wang  PS;  Berglund  PA;  Kessler  RC:  Patterns and correlates of contacting clergy for mental disorders in the United States.  Health Services Research 38:647–673, 2003
[CrossRef] | [PubMed]
Patel  V;  Flisher  AJ;  Hetrick  S  et al:  Mental health of young people: a global public-health challenge.  Lancet 369:1302–1313, 2007
[CrossRef] | [PubMed]
References Container

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe

Related Content
Dulcan's Textbook of Child and Adolescent Psychiatry > Chapter 61.  >
Dulcan's Textbook of Child and Adolescent Psychiatry > Chapter 8.  >
Dulcan's Textbook of Child and Adolescent Psychiatry > Chapter 22.  >
Dulcan's Textbook of Child and Adolescent Psychiatry > Chapter 22.  >
Dulcan's Textbook of Child and Adolescent Psychiatry > Chapter 33.  >
Topic Collections
Psychiatric News
APA Guidelines
PubMed Articles