I was just reading a study that came by my desk about the referral rate for psychotherapy (mental illness) of utility workers from the 9/11 disaster, and I must say, pretty piss poor at that, especially in the follow-up of individuals for ongoing counselling to ensure they don't get PTSD. This comes back into a previous topic raised here about the importance of counselling, which is in the best interest of the person/s exposed to trauma.

Some interesting points raised in the study about the kinds of factors that possibly also influence the likelihood of obtaining PTSD, being:

• Predisposing that exist before the illness, eg. age, gender, marital status.
• Social structure, eg. education and race/ethnicity.
• Past illness and beliefts, which directly reflect family characteristics that may impact access to services, eg. health insurance, illness level and individual/family associative problems.

The participants involved within the study where those that deployed during or in the aftermath to secure gas, steam and electricity supplies. Workers were exposed to stressors such as working long hours, witnessing destruction, seeing human remains and working in dangerous circumstances. They where neither trained members of rescue teams nor first responders.

So, the statistics compile as:

• 3500 workers deployed to site
• Less than 2% refused treatment
• 1621 workers were referred for psychotherapy services
• 443 where then excluded from the study for missing data on forms
• 328 participants finally identified for possible PTSD symptoms
  • 157 accepted referral
  • 92 chose to consider
  • 79 chose to decline

From this final selection of workers who displayed possible likelihood of obtaining PTSD, the study could not provide an accurate outcome because of failure to continue treatment, which was fully paid for all workers, which was believed to be caused by several factors, being race/ethnicity, social lifestyle and living conditions.

Basically, from those 328 participants who were picked from the original 3500 workers as having possible PTSD symptoms, only a handful actually followed through to reduce the risk of obtaining PTSD. It is these type studies that demonstrate where symptoms of PTSD fall down, because workers depression, anger, fear of being triggered, etc etc, would have been many of the issues that stopped further treatment, which means many may now have PTSD, which could have been prevented through continuous counselling.