Dataset Information

Mental health service use by cleanup workers in the aftermath of the Deepwater Horizon oil spill.

ABSTRACT: High rates of mental health (MH) problems have been documented among disaster relief workers. However, few workers utilize MH services, and predictors of service use among this group remain unexplored. The purpose of this study was to explore associations between predisposing, illness-related, and enabling factors from Andersen's behavioral model of treatment-seeking and patterns of service use among participants who completed at least one full day of cleanup work after the Deepwater Horizon oil spill and participated in home visits for the NIEHS GuLF STUDY (N = 8931). Workers reported on MH symptoms and whether they had used counseling or medication for MH problems since the oil spill. Hierarchical logistic regression models explored associations between predictors and counseling and medication use in the full sample, and type of use (counseling only, medication only, both) among participants who used either service. Analyses were replicated for subsamples of participants with and without symptom inventory scores suggestive of probable post-disaster mental illness. Having a pre-spill MH diagnosis, pre-spill service use, more severe post-spill MH symptoms, and healthcare coverage were positively associated with counseling and medication use in the full sample. Among participants who used either service, non-Hispanic Black race, pre-spill counseling, lower depression, and not identifying a personal doctor or healthcare provider were predictive of counseling only, whereas older age, female gender and pre-spill medication were predictive of medication only. The results were generally consistent among participants with and without probable post-disaster mental illness. The results suggest variability in which factors within Andersen's behavioral model are predictive of different patterns of service use among disaster relief workers.

SUBMITTER: Lowe SR

PROVIDER: S-EPMC4363993 | biostudies-literature | 2015 Apr

REPOSITORIES: biostudies-literature

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Mental health service use by cleanup workers in the aftermath of the Deepwater Horizon oil spill.

Lowe Sarah R SR Kwok Richard K RK Payne Julianne J Engel Lawrence S LS Galea Sandro S Sandler Dale P DP

Social science & medicine (1982) 20150212

High rates of mental health (MH) problems have been documented among disaster relief workers. However, few workers utilize MH services, and predictors of service use among this group remain unexplored. The purpose of this study was to explore associations between predisposing, illness-related, and enabling factors from Andersen's behavioral model of treatment-seeking and patterns of service use among participants who completed at least one full day of cleanup work after the Deepwater Horizon oil ...[more]

PMID: 25697635

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Project description:The Deepwater Horizon oil spill affected hundreds of kilometers of coastal wetland shorelines, including salt marshes with persistent heavy oiling that required intensive shoreline "cleanup" treatment. Oiled marsh treatment involves a delicate balance among: removing oil, speeding the degradation of remaining oil, protecting wildlife, fostering habitat recovery, and not causing further ecological damage with treatment. To examine the effectiveness and ecological effects of treatment during the emergency response, oiling characteristics and ecological parameters were compared over two years among heavily oiled test plots subject to: manual treatment, mechanical treatment, natural recovery (no treatment, oiled control), as well as adjacent reference conditions. An additional experiment compared areas with and without vegetation planting following treatment. Negative effects of persistent heavy oiling on marsh vegetation, intertidal invertebrates, and shoreline erosion were observed. In areas without treatment, oiling conditions and negative effects for most marsh parameters did not considerably improve over two years. Both manual and mechanical treatment were effective at improving oiling conditions and vegetation characteristics, beginning the recovery process, though recovery was not complete by two years. Mechanical treatment had additional negative effects of mixing oil into the marsh soils and further accelerating erosion. Manual treatment appeared to strike the right balance between improving oiling and habitat conditions while not causing additional detrimental effects. However, even with these improvements, marsh periwinkle snails showed minimal signs of recovery through two years, suggesting that some ecosystem components may lag vegetation recovery. Planting following treatment quickened vegetation recovery and reduced shoreline erosion. Faced with comparable marsh oiling in the future, we would recommend manual treatment followed by planting. We caution against the use of intensive treatment methods with lesser marsh oiling. Oiled controls (no treatment "set-asides") are essential for judging marsh treatment effectiveness and ecological effects; we recommend their use when applying intensive treatment methods.

Dataset Information

Mental health service use by cleanup workers in the aftermath of the Deepwater Horizon oil spill.

Publications

Mental health service use by cleanup workers in the aftermath of the Deepwater Horizon oil spill.

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