Post-disaster mental health problems and the utilization of mental health services: a four-year longitudinal comparative study

This study examined mental health problems and mental health services (MHS) utilization after a fireworks disaster among adult survivors and a comparison group. The disaster took place on May 13, 2000, in the city of Enschede, The Netherlands. Victims (N=662) participated in a survey 2-3 weeks (T1), 18 months (T2) and 4 years (T3) post-disaster. The comparison group consisted of non-affected people from another city (N=526). They participated at T2 and T3. Victims used MHS more often than the comparison group in the 12-month period before T2 and T3 (OR 3.9 and 2.4). Victims with severe depression and anxiety symptoms at T2 used MHS more often than participants in the comparison group with these symptoms (OR 2.6 and 2.0). After 4 years, MHS utilization among participants in both groups with anxiety symptoms did not differ, suggesting attenuation of the observed effects. Results suggest that after a disaster survivors with mental health problems are less reluctant to use MHS than under normal circumstances