By Megan Ockert
People in many Flint households have been experiencing worsening of their behavioral health, including trouble concentrating, signs of depression and increased anxiety or stress since the Flint water crisis began, according to a recent survey of 182 randomly selected households conducted by a consortium of local, state and federal health officials.
The survey was carried out as a Community Assessment for Public Health Emergency Response, commonly referred to as CASPER. It was requested by the Michigan Department of Health and Human Services on behalf of the Flint Community Resilience Group, Data & Gap Analysis Workgroup, from the Centers for Disease Control to assist in recovery efforts.
Results of the community assessment were announced in early November.
Young and old alike report depression, anxiety, stress
The CASPER assessment found that 65.6% of surveyed households including adults 21 or older reported at least one or more new or worsening behavioral health concerns since the crisis began.
The study also found that households containing younger family members have been negatively affected, with 54.3% of Flint households with residents younger than 21 reporting they have experienced one or more behavioral health concerns.
The assessment asked Flint residents to answer questions related to their physical and behavioral health and how each has been affected by the water crisis, which had been brewing since the 2014 water changeover but exploded into local and national attention in October, 2015.
On April 25, 2014, the city of Flint changed the municipal water source from the Detroit-supplied Lake Huron water to the Flint River. The switch in the water source resulted in the corrosion of water pipes and leaching of lead and other contaminants into the city’s drinking water. In succeeding months, hundreds of children and adults showed increased levels of lead, a toxin extremely dangerous to humans, in their blood.
Fatigue, nausea, forgetfulness, aches and pains
The surveyors additionally found that nearly half of household representatives reported some physical health concerns. The most common were skin irritation or rashes, which prompted an investigation by the MDHHS in conjunction with the CDC and Agency for Toxic Substances and Disease Registry (ATSDR) in February.
In addition to rashes, residents reported symptoms such as fatigue, nausea, forgetfulness, and muscle aches and pains since the water crisis began.
Surveys were conducted in mid-May. Fifteen teams of two went door-to-door to randomly selected homes throughout Flint. The Centers for Disease Control provided interview teams with a three-hour training before they interviewed 182 households.
As stated on www.cdc.gov, a CASPER is “an epidemiologic technique designed to provide quick and low-cost household-based information about a specific community.”
Major areas of study included self-reported household and individual behavioral health concerns for adults and children since the crisis began; household access to behavioral health services; self-reported physical health concerns; water-related resource needs and barriers to resources; and the effectiveness of the communication from relevant government and community agencies with the community.
Data may help address needs
Patricia Reynolds, an epidemiologist for the Genesee County Health System, stressed the importance of the CASPER assessment. She said, “This survey will help give us a deeper understanding of what the community requires and will help us determine how best to ensure that those needs are fulfilled.”
One tool that the Genesee County Health System made available to Flint residents is MyFlintStrong.com. Announced in August, this interactive website offers a platform for teaching people how to overcome trauma and stress often associated with events like the Flint water crisis.
“What we’ve learned over the years in emergency response and recovery is that all crises are unique yet have common elements—including increased behavioral health needs,” said Dr. Nicole Lurie, assistant secretary for preparedness and response with the U.S. Department of Health and Human Services. Lurie has been the team leader for the federal government’s response to the Flint water crisis.
According to their report, investigators also conducted water-quality tests by taking water samples from 170 homes in Flint where people reported rashes. Investigators were unable to determine if the lead in the water caused the residents to develop rashes.
Rash research findings limited
However, the ATSDR cautions that that there are limitations to their findings because the samples for the survey were all taken at a single time from each household, and water quality and concentration of metals can change over time. It is possible that a substance was present in the water at the time the participants’ rashes began but was no longer in the water at the time of testing.
Director Nick Lyon of the MDHHS said, “We are committed to continuing our efforts to help residents connect with the behavioral and physical health resources that are right for them. With the right support, information, and collaboration, we can continue to improve the short- and long-term health outcomes in Flint.”
Because children are more susceptible than adults to the adverse effects of lead exposure due to hand-to-mouth actions, higher physiological uptake rates, and developing biological systems, particular attention is being placed on their behavioral health services, including prevention screening and early intervention for children and youth. Infant mental health and home-based services are also being offered.
To aid the city of Flint, the MDHHS received a $500,000 emergency response grant from the federal Substance Abuse and Mental Health Services Administration (SAMHSA) that has enabled hiring locally-based outreach workers to provide crisis support for underserved adults via a Mobile Mental Health Unit.
As Genesee Health System supervisor, Elizabeth Burtch stated in an earlier interview with East Village Magazine, the elderly are particularly affected by the water crisis because their limited mobility and isolation can cause them to “miss out” on new developments pertaining to the water crisis and information about available resources.
The funding will also expand current behavioral health services to all affected adults in Flint, and educate Flint residents about services and support available to them as well as where to go to receive those services. In addition, the grant will help employ more personnel to provide services such as lead testing, treatment, and outreach.
To view the full CASPER assessment, visit www.http://www.michigan.gov/flintwater/0,6092,7-345-76930–,00.html. For more information regarding the resources available in Flint, visit www.michigan.gov/flintwater.
“Federal agencies have been working with the state and community to meet these needs” identified in the study, Lurie stated An overview of the federal response to the crisis can be found at https://www.whitehouse.gov/the-press-office/2016/05/03/fact-sheet-federal-support-flint-water-crisis-response-and-recovery.
EVM staff writer Megan Ockert can be reached at firstname.lastname@example.org.