Mental health service use and outcomes after the Enschede fireworks disaster: A naturalistic follow-up study

Description

Objective: This study documented the number of people seeking help for mental health problems after a fireworks disaster in Enschede, the Netherlands. It describes their diagnostic characteristics, interventions provided, and their results.

Methods: Researchers coded data from intakes and medical charts of all patients who sought help (N=1,659) and entered treatment (N=663) at a disaster relief service between May 13, 2000 (day of the disaster), and June 1, 2004. Patients who received more than eight treatment sessions (N=394) and were in treatment one year after the disaster were interviewed with the Composite International Diagnostic Interview (CIDI) (N=228, response rate, 58%) and other questionnaires (N=271, response rate, 69%).

Results: In the population probably exposed, the cumulative referral-incidence for disaster-related mental health problems over four years was approximately 10%; in terms of referrals to the mental health facility over five years, the proportion of disaster-related referrals was 5.7%. Among adults, posttraumatic stress disorder (PTSD) was the most common clinical diagnosis (53%, chart sample). However, depression was the most common CIDI diagnosis (58%, CIDI interview sample). The recovery rate was about 50% on the basis of clinical judgment (chart sample), between 69% and 76% on the basis of "healthy" scores on symptoms, and between 39% and 60% in social and physical functioning (interview sample).

Conclusions: Apart from persons seeking support during the first weeks postdisaster, the largest influx occurred after about one year and was limited in size. Clinicians in specialized services should be aware that conditions other than PTSD, such as depression, anxiety, substance abuse, and somatoform disorders, are also quite common after disasters. (Psychiatric Services 61:1138—1143, 2010) 
 
On the afternoon of May 13, 2000, a fireworks deposit situated in a residential area exploded, killing 22 people and injuring about 1,000 in the center of Enschede, a town in the east of the Netherlands. As a result approximately 1,500 houses were damaged, of which 498 had to be demolished, leading to displacement of 4,163 inhabitants (1). An estimated 17,000 individuals were probably exposed in one way or another to this disaster (1). The event was immediately declared a national disaster. In response, a nationwide support effort was launched and funds were allocated for research to document health consequences of this disaster. As a result, data about health, well-being, and medical service use have been systematically collected since the early days after this event (2,3,4,5).

In contrast to the wealth of publications about the epidemiology of mental health problems after a disaster (6,7), there are only few studies that describe help-seeking behavior for these problems in a population stricken by disaster, or the outcomes of interventions. In this article we present the results of a chart study and interviews in early and later phases of treatment of adults who sought help from mental health services for disaster-related problems. The aim of the study was to evaluate mental health service delivery to persons affected by the fireworks disaster in Enschede during the period from May 2000 to May 2005. This study documented the number of people seeking help for disaster-related psychological problems, their sociodemographic and diagnostic characteristics, the interventions that they received, and some results of these interventions. To our knowledge this is the first systematic investigation of all adults seeking specialized mental health care in a disaster-stricken area.

Format

Journal

Language

English

Author(s)

Eric O. Noorthoorn
Johan M. Havenaar
Hein A. de Haan
Yanda R. van Rood
Willy-Anne van Stiphout

Original Work Citation

Noorthoorn, E. O., Havenaar, J. M., de Haan, H. A., van Rood, Y. R., & van Stiphout, W.-A. (2010). Mental health service use and outcomes after the Enschede fireworks disaster: A naturalistic follow-up study. Psychiatric Services, 61(11), 1138-1143. doi:10.1176/appi.ps.61.11.1138

Collection

Citation

“Mental health service use and outcomes after the Enschede fireworks disaster: A naturalistic follow-up study,” Francine Shapiro Library, accessed January 16, 2021, https://emdria.omeka.net/items/show/21989.

Output Formats