TJackson, Mississippi, This summer’s water crisis is a troubling reminder that some American communities are still failing to provide safe water to their residents. After the primary water treatment plant in Jackson failed, about 180,000 people were left with little or no healthy water. This was reminiscent of the crisis in Flint, Michigan, which rose to widespread public awareness in 2015, when residents learned they had been poisoned for months by drinking water containing bacteria, disinfectant byproducts, and lead.
The crisis is far from a distant memory in Flint. According to a new survey of nearly 2,000 adult community members published in JAMA Network is open On September 20, residents were still grappling with the ongoing mental health effects of the crisis, five years later. After conducting a survey from 2019 to 2020, the researchers estimated that in the year prior to the survey, one in five Flint residents had experienced major depression, while a quarter had PTSD, and one in 10 had both conditions. Those who believed that they or their family had been injured by polluted water were more likely to be affected. The authors note that lead itself can affect mental health, including mood.
Flint residents, who are largely low-income and people of color, were already prone to mental health problems, including due to systemic racism, a lack of quality, affordable housing, and widespread poverty. However, researchers found evidence that the water crisis itself had a lasting effect on mental health. For example, 41% of participants said they felt psychological or emotional problems related to their concerns about water pollution. Flint residents were more than twice as likely to have major depression as the average population in Michigan, the United States, or the world, and were twice as likely to develop PTSD as post-deployment veterans, according to the study.
The way the water crisis unfolded, researchers say, has made Flint residents especially vulnerable to long-term mental health effects. One major problem is that decisions by government officials caused the water crisis in 2014, when they switched the city to untreated water from the Flint River. Even after health care workers sounded alarms about high levels of lead in children’s blood, officials misled the public by insisting the water was safe. says Aaron Rubin, co-author of the new study and a postdoctoral researcher at Duke University and the Medical University of South Carolina.
A lack of resources can also exacerbate anxiety. Lottie Ferguson, Flint’s chief resilience officer, noted that food insecurity has made it difficult for residents to eat a healthy diet rich in foods that mitigate the effects of lead toxicity. Ferguson, who worked in Flint during the crisis and whose children were shot, says she felt for parents who didn’t have the same resources as her family. “It felt even more upset and hurtful for parents who did not have access to resources to secure their children’s future,” she says, adding that she understands why there continues to be a lack of trust in officials in Flint.
The situation is also complicating: the water crisis has continued for a long period of time. Although the water supply was restored to its original source in October 2015, lead levels did not fall below the federal limit until January 2017. This left Flint residents with a constant sense of uncertainty about their health and safety. “It wasn’t like a hurricane came and went, and then you rebuild,” says Lauren Tompkins, former vice president of clinical operations at Genesee Health System, a nonprofit healthcare organization in Flint. She coordinated the emergency mental health resources available to residents in response to the crisis. “It took a huge number of years to fix the pipes. So you are always in this state, for a long period of time, of worry.”
In many ways, the water crisis is far from over. For example, researchers have described a rise in hyperactivity and learning delays among children. Residents still do not know for sure how much they and their families were affected by the polluted water, and whether it caused the health problems they are now suffering from. They also don’t know if new health problems will suddenly appear in the future.
This is similar to what happened after the partial meltdown at the Three Mile Island nuclear plant in Pennsylvania in 1979, says study co-author Dean J. Kilpatrick, MD, a professor of psychiatry at the Medical University of South Carolina, who researches PTSD and traumatic events. Although the locals are not exposed to dangerous levels of radiation, the fear is that it could lead to permanent damage to mental health. “If something is invisible, tasteless, you can’t really tell if you’ve got it or not,” says Kilpatrick. “Even the perception that you might have been exposed to something, by itself, is enough to have a lot of long-term effects on mental health.”
With outside funding and assistance, members of the Flint community expanded their mental health offerings in Flint, during the initial crisis and the years that followed. However, only 34.8% of respondents said they had accessed mental health services for symptoms related to the crisis, even though 79.3% of those who were offered services did. The study authors argue that their findings suggest that the city of Flint still needs a greater mental health response from local, state and federal government. There are also important lessons for other cities experiencing water crises, including Jackson – such as how important it is to provide the public with clear and accurate information.
Overall, says Robin, it’s essential to recognize that crises like what happened in Flint can have a lasting impact on mental health. At Jackson, “We want the community to know we’re thinking of them, and we’re going to think about their mental health,” he says. “Not only is the taps clean once, but it will likely last for years afterward.”
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