Protocol for Identifying and Responding to Emotional Distress During the World Trade Center Health Registry (WTCHR) Baseline Interview
Triplett, S. E. (2005, December). Protocol for Identifying and Responding to Emotional Distress During the World Trade Center Health Registry (WTCHR) Baseline Interview. Presented at American Public Health Association Annual Meeting, Philadelphia, PA.
The WTCHR cohort was designed to follow persons whose health was potentially affected by environmental agents and trauma resulting from the 9/11 attack. 71,437 enrollees completed interviews from four target groups 2-3 years after 9/11: persons south of Chambers Street on 9/11, nearby residents, disaster workers, and school children. Respondents were asked about their 9/11 exposures, physical health, and current symptoms associated with PTSD and serious psychological distress (SPD). A protocol for responding to elevated levels of emotional distress during the interview was implemented. Trained interviewers first identified distress symptoms classifying them as minimal, moderate, or serious. Next, interviewers employed at least one action (e.g., offered a break, stopped an interview, provided referral/made call to the Mental Health Association of New York's LIFENET counseling service). Respondents to PTSD or SPD questions who exceeded a threshold were automatically flagged for referral to LIFENET. Out of 68,556 completed adult interviews, 8,776 (13%) had at least one action taken with 7,902 (12%) referred or connected directly to LIFENET. All 2,964 participants who exhibited emotional distress had an action taken including a LIFENET referral or call. Tower survivors were more likely to have an action taken (787/4,179, 19%) compared to residents (1,565/12,423, 13%) or disaster workers (3,335/30,551, 11%). The protocol for identifying and responding to emotional distress assured a high level of safety for respondents during the interview and can serve as a model for handling sensitive data and fostering collaboration in the aftermath of future disasters.