Assessment of Behavioral Health Concerns in the Community Affected by the Flint Water Crisis — Michigan (USA) 2016

Abstract

The following can be considered to guide recovery efforts in Flint: identifying additional resources for behavioral health interventions and conducting follow-up behavioral health assessments to evaluate changes in behavioral health concerns over time; considering the impact of household economic factors when implementing behavioral health interventions; and ensuring community involvement and engagement in recovery efforts to ease community stress and anxiety. FortenberryGZ, ReynoldsP, BurrerSL, Johnson-LawrenceV, WangA, SchnallA, PullinsP, KieszakS, BayleyegnT, WolkinA. Assessment of behavioral health concerns in the community affected by the Flint water crisis - Michigan (USA) 2016. Prehosp Disaster Med. 2018;33(3):256-265.

Water and mental health

“…Since then, a number of investigative teams have documented a robust relationship between water insecurity and systematically-assessed emotional distress (Cooper, Hutchings, et al, 2019;Harris, Kleiber, Goldin, Darkwah, & Morinville, 2017;Kangmennaang, Bisung, & Elliott, 2020;Thomas & Godfrey, 2018) or symptoms of stress, distress or common mental disorders (Aihara, Shrestha, Kazama, & Nishida, 2015;Aihara, Shrestha, & Sharma, 2016;Boateng et al, 2018;Boateng et al, 2020;Brewis, Choudhary, & Wutich, 2019a, 2019bChindarkar, Chen, & Gurung, 2019;Cooper-Vince et al, 2017Espinosa-Montero et al, 2016;Maxfield, 2020;Mushavi et al, 2020;Shrestha et al, 2018;Slekiene & Mosler, 2019;Snodgrass, Upadhyay, Debnath, & Lacy, 2016;Subbaraman et al, 2012Subbaraman et al, , 2014Tallman, 2016Tallman, , 2019Tsai et al, 2016;Workman & Ureksoy, 2017;Young et al, 2019). Most of these studies have been conducted in lower-income economies, but scholarship based in the United States-in Texas colonias (Jepson, 2014;Jepson & Vandewalle, 2016) and Flint, Michigan (Cuthbertson, Newkirk, Ilardo, Loveridge, & Skidmore, 2016;Fortenberry et al, 2018;Sneed, Dotson, Brewer, Pugh, & Johnson-Lawrence, 2020)-has documented similar associations between water insecurity, emotional distress, and mental ill-health. Together, these studies provide strong evidence of an association, but no clear evidence of causality, between water insecurity and mental ill-health.…”

Psychological consequences of the Flint Water Crisis: A systematic review

“…Decreased trust in officials was also noted by Fortenberry et al (2018), Gray et al (2017), Kruger (2018), Morckel and Terzano (2019) and Singer et al (2017). This decrease in trust may be due to feeling overlooked by decision-makers (Fortenberry et al, 2018). In terms of what could be done to restore trust in the government, Morckel and Terzano’s (2019) participants suggested removing local elected officials, more honesty from elected officials, improving transparency and communication with residents, and fixing the water situation.…”

“…Participants directly affected by the water crisis reported symptoms of poor mental health in general (Kruger et al, 2017b), post-traumatic stress disorder (Kruger et al, 2017a), depression (Fortenberry et al, 2018), anxiety or stress (Fortenberry et al, 2018; Gray et al, 2017; Singer et al, 2017), sleep problems (Fortenberry et al, 2018; Kruger et al, 2018c), fear (Gray et al, 2017), aggressiveness (Fortenberry et al, 2018), trouble concentrating (Fortenberry et al, 2018), emotional outbursts (Fortenberry et al, 2018), decreased appetite (Fortenberry et al, 2018), and exacerbation of pre-existing health conditions (Gray et al, 2017). Cuthbertson et al’s (2016) expert panellists believed the water crisis was increasing stress, anxiety and to a lesser extent depression among Flint’s population, and that residents had been left feeling angry, defeated and on edge.…”

“…Participants cited various sources of uncertainty leading to stress: lack of knowledge about where to find lead testing for children in order to assess the potential impact of the crisis on their children (Cuthbertson et al, 2016); uncertainty of knowing if they had been exposed to lead as well as the unknown severity of effects of lead exposure (Cuthbertson et al, 2016); feeling that the crisis was not over and would never be fixed (Fortenberry et al, 2018; Singer et al, 2017); and uncertainty of the long-term effects of the crisis (Gray et al, 2017; Singer et al, 2017). Sneed et al (2020) found a slight decrease between 2016–2018 in the percentage of participants feeling the crisis would never be fixed; however, this was not statistically significant.…”

Effect of Toxic Metal Binding on Tax-Interacting Protein1 (TIP1): A Protein Related to Brain Diseases

“…Water contamination with lead in 2016 in Flint, Michigan (USA), is a clear example of the effect of toxic metals on public health. [30][31][32] There are numerous reports on the effects of these toxic metals on human health, especially during the gestation period of pregnant women. [33][34][35] Human TIP1 is involved in various signaling pathways controlling key biological processes including regulation of the cerebral concentration of neurotransmitter glutamate, β-catenin-mediated Wnt signaling, Rho-activator Rhotekin, and potassium channel Kir2.3 signaling pathway.…”