Flint adult personalss mad where are you

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Try out PMC Labs and tell us what you think. Learn More. Natural and manmade crises impact community-level behavioral health, including mental health and substance use. This article shares findings from a larger project about community behavioral health, relevant to the ongoing water crisis in Flint, Michigan, using data from a larger study, involving monthly surveys of a panel of key informants from Genesee County.

The data come from open-response questions and are analyzed as qualitative data using grounded theory techniques. Participants thought these mental health issues would affect the entire community but would be worse among low-income, African American populations in the city.

Mental health consequences were related not only to the water contamination but to distrust of public officials who are expected and have the authority to resolve the issues. The mental health effects of this public health crisis are ificant and have received inadequate attention in the literature. Public health response to situations similar to the water issues in Flint should include sustained attention mental health. People who experience shocks from natural or manmade disasters have higher rates of mental illness, including major depression and posttraumatic stress disorder.

While clinically diagnosable mental illnesses may be triggered or influenced by stressful events such as disasters and environmental injustices, we must point out that this differs from the psychological distress individuals may experience in similar or identical situations. Distress is often viewed as a natural reaction to stressful events or life conditions, 11 as a psychosocial response to environmental disasters, based on direct and perceived individual impact and risk to health.

Experiences and interpretations of distress vary by social positionality.

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Soon after the switch in water source, residents voiced their concerns that the water was discolored, had a bad smell and taste, and was causing health problems. State and city officials initially dismissed many of the complaints as inificant.

Even when the water source was switched back to DWSD in October after state officials publicly acknowledged problems with the water, some of those problems persisted. Some physical health impacts have been described by residents and researchers, such as elevated blood lead levels, 13 but the impact of the mental stress associated with the water crisis received substantially less attention to date.

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Flint has long been a site of environmental injustice. In disadvantaged communities, social capital may mediate the negative effects of low income or income inequality on health status. The aim of the project was to create community monitoring or sentinel surveillance systems for mental health and substance use issues, piloting three methods across 17 different communities around the USA.

Partnering communities were selected through an open call for proposals and selected based on demonstrated capacity to successfully complete the project, as well as demographic and geographic diversity. For purposes of the current paper, only the from the Genesee County, Michigan, partnering community, which encompasses the city of Flint, are considered. Genesee County was part of a group of communities testing community monitoring via monthly surveys of a panel of 30 key informants. Panelist expertise included health services, substance use prevention, health-related non-governmental organizations, disability service organizations, schools, and researchers.

Panelists were asked to complete a survey about changes in 30 behavioral health-related issues, including specific mental health and substance use disorders, each month for 1 year. Participants had 1 week to complete each monthly survey, with reminders sent in the middle of the survey period to any participant who had not yet responded.

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The survey asks panelists to identify any new behavioral health issues that were not present in the community before, as well as whether any community events occurred that may have impacted behavioral health.

Responses to these open questions were not required for survey completion. As shown in Fig. Data for this paper come from 12 monthly surveys completed by panelists in Genesee County.

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More specifically, the data come from the open-response questions about what new issues and community events emerged since the survey, as well as open-response comment fields where respondents could mention issues related to a subset of behavioral health problems. The data were analyzed as qualitative comments using grounded theory, including open and focused coding, and concept building techniques such as memoing. Each open-response comment represented one data point for coding.

The open-response comment fields were coded using open coding to determine the most common themes from the data and again using focused coding to refine themes and develop more detailed definitions. Concurrently with coding, memoing aided in drawing connections between themes. All authors reviewed the data, one author completed coding and memoing, and all authors reviewed themes and details for accuracy. Of the completed open-response questions over 12 monthly surveys, were about the contamination of water in Flint The of responses to the open-response questions and the specifically about water varied over the course of the 12 surveys but notably increased starting at survey 6 which was administered in October after Michigan state officials first publicly acknowledged that there was a problem with the water in Flint see Fig.

Four comments referred to the water problems either as disastrous or a disaster, and 58 comments referred to the situation as a crisis. Quotes included from the surveys are followed by the survey date in which those responses were given.

Through the application of grounded theory coding and analysis techniques, the mental health concerns arising most clearly from the data are that the water situation has created and increased stress and anxiety for residents of Flint. From the data, stress is defined as feeling nervous, scared, angry, frustrated, and distrustful, with a lack of confidence in the political system or government.

Many people are very angry, scared, and unsure of the future. Stress was created by the potential and permanent physical health effects of lead exposure, the news coverage finding high levels of lead in the blood of Flint children, and lack of knowledge of where to find lead testing for children. This is causing stress, anxiety, financial hardship, and community unrest. Stress was perceived to increase not only because of the potential physical health effects of lead exposure but also because the solution and course of action were and remain unknown; additionally, panelists noted that residents faced extremely high water bills for unusable water.

Panelists reported that the water issues affected the whole community Flint adult personalss mad where are you would have the greatest impact among African Americans and those of low socioeconomic status in the community. These two groups were identified as those who were disproportionately receiving contaminated water and those who had the least resources to cope with it. Relatedly, panelists identified anxiety and depression as increasing due to the Flint water issues for similar reasons. Panelists expressed that anxiety was elevated among community members because of the uncertainty of knowing whether they had been exposed to lead, and that the effects and severity of lead exposure would be unknown for some time.

Depression was identified as an additional mental health effect of the water problems in Flint, although it was cited much less frequently than anxiety or stress. The mental health effects of the water issues in Flint are perceived to have spillover or ripple effects into other areas of behavioral health, such as abuse and substance use. Other panelists felt the water issues were causing increases in alcohol abuse, illicit drug use, and prescription misuse or abuse. Concerns about the water in Flint are indirectly affecting mental health through the effects of the situation on people living, working, and interacting in the city and county.

It was hard living here with all the negative reporting about crime and the economy. This individual felt that the Flint water issues were the cause of depression, stress, and hopelessness among city residents. Another panelist commented:.

Flint home property values, already down, are now Flint adult personalss mad where are you crisis mode. Several comments indicated a relationship between lack of confidence in government, inability to trust authority figures, and mental health. Many are interpreting the increased attention as an indicator that something much worse is unfolding that they have no power over.

One panelist commented that it was not only a lack of confidence in city and government officials but a sense of abandonment that impacted mental health. Genesee County panelists were in a unique position to assess the mental health impacts of the water issues in Flint and made astute observations about elevated levels of anxiety, stress, and depression among city residents. Panelists indicated that that the water problems were the root of increased stress, anxiety, and depression in Flint. Stress, especially prolonged or chronic stress, has the potential to lead to severe physical health outcomes such as cardiovascular disease, 2425 increased blood pressure, and compromised immune systems.

Both the water contamination and the sense of distrust in government officials appear to have mental health consequences for Flint residents, especially as residents have no control over what flows through water service lines and into their homes. Generally, lower sense of control is associated with greater depressive symptoms 30 ; in the face of disaster, decreased sense of control has been positively associated with acute stress disorder.

Sincethe City of Flint has experienced numerous fiscal challenges, leading to two explicit interventions by state government since the early s. In this sense, the state economic intervention appears to have resulted increased budgetary costs as well as higher human physical and mental health tolls. The health and human services sector came together quickly to provide both information and interventions that address stress, anxiety, depression, and trauma brought about by the water crisis.

At the writing of this paper, the CRG has six active workgroups: 1 planning and coordination, 2 data and gap analysis, 3 psychological first aid, 4 stress management, 5 faith-based groups, and 6 vulnerable and underserved populations. These workgroups meet regularly with the overarching purpose of providing input regarding the needs within the community, assisting with planning, and facilitating service delivery. For example, Psychological First Aid, an evidence-informed approach framed by the listen, protect, and connect approach was implemented with sessions specifically targeting adults and youth.

By mid-April, 11 free-of-cost trainings were held and attended by approximately individuals with an additional eight trainings scheduled between mid-April and mid-July. Crisis counseling sites that connect residents to mental health services were established. The faith-based workgroup developed a presentation template that can be used at awareness summits, community conversations, workshops, and small group discussions to reduce stigma and encourage parishioners to seek mental health services.

The water crisis served to draw professionals and community members together to support the Flint residents who are in need of behavioral health services. The plan addresses short-term, intermediate-term, and long-term goals for each of the aforementioned workgroups.

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Panelists identified several mental health issues that were increasing as the water issues in Flint unfolded. Like the physical health consequences of lead poisoning, the full extent of mental health consequences may not be known for some time. Efforts to provide funding or services for the health consequences of lead and other contaminant exposure would be remiss if they did not include coverage for mental health effects many residents continue to face. Indeed, mental health services should be incorporated as part of the emergency response 34 and carried forward for the next several years.

National Center for Biotechnology InformationU. Journal List J Urban Health v.

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J Urban Health. Published online Nov 2. Courtney A. Author information Copyright and information Disclaimer. Cuthbertson, : ude. Corresponding author. This article has been cited by other articles in PMC. Abstract Natural and manmade crises impact community-level behavioral health, including mental health and substance use. Methods The aim of the project was to create community monitoring or sentinel surveillance systems for mental health and substance use issues, piloting three methods across 17 different communities around the USA.

Open in a separate window. Discussion Genesee County panelists were in a unique position to assess the mental health impacts of the water issues in Flint and made astute observations about elevated levels of anxiety, stress, and depression among city residents. References 1.

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Evans GW, Kantrowitz E. Socioeconomic status and health: the potential role of environmental risk exposure. Annu Rev Public Health. Toxic wastes and race at twenty — Evans GW. The built environment and mental health. Downey L, Van Willigen M. Environmental stressors: the mental health impacts of living near industrial activity.

J Health Soc Behav. Impact of a major disaster on the mental health of a well-studied cohort. JAMA Psychiatr. Posttraumatic stress symptoms in children after hurricane Katrina: predicting the need for mental health services. Am J Orthopsychiatry. The course of mental health disorders after a disaster: predictors and comorbidity.

J Trauma Stress. Neighborhood structural disadvantage, collective efficacy, and self-rated physical health in an urban setting. The geography of mental health and general wellness in Galveston bay after hurricane Ike: a spatial epidemiologic study with longitudinal data. Disast Med Publ Health Preparedness. The mechanisms that associate community social capital with post-disaster mental health: a multilevel model. Soc Sci Med. Horwitz AV. Distinguishing distress from disorder as psychological outcomes of stressful social arrangements.

Psychosocial responses to environmental incidents: a review and proposed typology. J Psychosom Res. Elevated blood lead levels in children associated with the flint drinking water crisis: a spatial analysis of risk and public health response. Am J Public Health. Thompson, B.

Flint adult personalss mad where are you

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