Untrained 9/11 first responders are 5X more likely to have considered suicide

A construction worker bows his head during a moment of silence for the victims of the 9/11 terrorist attacks during the second anniversary of the event at Ground Zero September 11, 2003 in New York City. (Credit: Ezra Shaw/Getty Images)

Untrained first responders who helped after the terrorist attacks on September 11, 2001, are more than five times more likely than traditional first responders to have considered suicide.

Those responders who assisted in recovery efforts include construction workers, clean-up staff, and other untrained nontraditional emergency employees.

In an analysis of more than 30,000 World Trade Center emergency responders, researchers found 12.5% of nontraditional workers—people whose job descriptions don’t include responding to disaster—have expressed suicidal ideation in the years after their work at Ground Zero, compared with 2.2% of police, firefighters, and emergency medical technicians.

The study in the Journal of Affective Disorders is believed to be the first to examine the prevalence and connection of thoughts of suicide in two occupational groups that participated in rescue, recovery, and clean-up efforts following the 9/11 attacks on the World Trade Center.

“Something we’ve learned following the World Trade Center attack is that random people coming in to help is not always a good idea”

“Our findings underscore the continuing burden of suicide ideation in Ground Zero responders, particularly nontraditional responders,” says Iris Udasin, director of the Center of Excellence at Rutgers University for the World Trade Center Medical Monitoring and Treatment Program and a coauthor of the study. “It also provides a more nuanced understanding of the risks associated with responding to disasters without adequate training.”

Standardized surveys administered by the World Trade Center Health Program asked disaster responders how often they are bothered by thoughts of death or of hurting themselves. Researchers used the data to postulate several factors to explain the increased prevalence of suicidal ideation among responders who were inadequately prepared for what they experienced.

Many nontraditional responders were day laborers—young people with limited family support systems—who needed help to navigate these suicidal thoughts.

The study also found that after 9/11, nontraditional responders had fewer opportunities to assume less strenuous work, raising the risk of financial hardship and depression. A police officer who developed asthma from working at Ground Zero, for instance, might be able to shift to desk work, but someone whose job demands physical labor might have a more difficult time adapting to less strenuous activity.

Udasin says another explanation for the discrepancy is that traditional first responders may be reluctant to answer questions about their mental health because of the professional stigma that can arise. Lessons learned from the study should be applied to future disaster responses—from a tsunami in the Philippines to the war in Ukraine, Udasin says.

“Something we’ve learned following the World Trade Center attack is that random people coming in to help is not always a good idea. While we can never anticipate every kind of skill that might be needed at a disaster site, from a mental health perspective it is always better to send in trained people than untrained people.”

The Centers for Disease Control and Prevention’s National Institute of Occupational Safety and Health, a branch of the US Department of Health and Human Services, funded the work. CDC-NIOSH also funds the WTC Health Program at Rutgers, which works to identify and support the thousands of people who responded to the 9/11 terrorist attacks in New York.

Source: Rutgers University