Rates of PTSD and depression in East Palestine are similar to those found in Flint after water crisis, study shows

You hear a lot of talk these days about post traumatic stress disorder and depression in East Palestine, Ohio, and the surrounding communities. Residents say they’re still struggling with the psychological effects of that 2023 toxic train derailment.

A new study sheds some light on the subject, but we don’t yet know the details because the study is still in peer review. The study’s lead author, however, said the results are similar to those found in a study conducted in Flint, Michigan, a few years ago.

We first heard about the Flint study a few months ago, during one of attorney Kristina Baehr’s presentations in Columbiana, Ohio. She discussed a case she’d recently tried in Hawaii that involved contaminated water. All 17 representative families in that case were diagnosed with PTSD, she said. She cited a study conducted after a water contamination crisis in Flint. That study, Baehr said, revealed the community suffered PTSD at a greater level than soldiers who’d been in combat

“I’m not diminishing the PTSD that comes from combat,” Baehr told those gathered. “But that’s what the medical literature showed.”

We made a note of Baehr’s comment, then checked on the Flint study she mentioned. It was led by researchers at the Medical University of South Carolina and published in the JAMA Network Open, a peer-reviewed journal published by the American Medical Association.

The Flint results indeed revealed high rates of both PTSD and depression among adults living in the city five years after the crisis.

The environmental disaster in Flint began in 2014, when officials changed the source of the city’s water supply in an effort to save money. Soon after the change, residents began complaining about the taste and smell of water pouring from their spigots. Some residents got sick; 12 died. Tests revealed the water contained high levels of lead and other contaminants.

Like the East Palestine train derailment, the Flint water crisis was a human-made catastrophe that ruptured people’s trust in the safety of their homes and in the public institutions charged with protecting citizens. Both disasters left residents wondering whether they and their children would suffer health effects for the rest of their lives.

The Flint study found that, five years after the crisis’s beginnings, a quarter of residents reported experiencing PTSD. One in five met the criteria for depression. One in 10 suffered from both PTSD and depression. The study does show that the prevalence of PTSD among Flint residents is greater than among veterans after deployment.

We had some questions, so we sent an email to the Flint study’s lead author, Aaron Reuben, a postdoctoral scholar in neuropsychology and environmental health at Duke University. Our timing was good, Reuben wrote in his response. He and other researchers recently completed study of the communities affected by the East Palestine derailment. They’ve submitted the study for publication. “Would you like to speak to an author of that study?” he asked.

A week later, we were on a video call with Cameron Pugach, a doctoral candidate in clinical psychology at University of North Carolina-Greensboro and a clinical psychology predoctoral intern at the Medical University of South Carolina.

Pugach said he could not yet discuss details of the study because it is still in peer review. But he did indicate results are similar to those from the Flint survey.

“What I can say is we did find elevations in the rates of these problems — PTSD and depression — that are in line with previous studies that have found elevated rates of these things following other human-caused technological disasters,” he said.

The East Palestine train derailment created a lot of uncertainty for people over a wide area, Pugach noted. Residents continue to voice concerns about the short- and long-term health risks of chemical exposure.

“A disaster like the train derailment constitutes as a potentially traumatic event, which in the diagnostic system we use in psychology is defined as exposure to actual or threatened death, serious injury or sexual violence,” Pugach said. “And we know that potentially traumatic events confer risk for psychiatric disorders such as post traumatic stress disorder and major depressive disorder.”

We asked Pugach about the comment made by Baehr — that the levels of PTSD exceed those of soldiers who’d experienced combat. How could that be? Perhaps, we suggested, we’re misunderstanding PTSD. We asked Pugach to help us out.

“To give a little background on PTSD,” he said, “this is something that’s been historically studied in the context of war and combat exposure. Since those initial studies, we now know that this reaction can follow a wide range of different potentially traumatic events. So not only combat exposure but things like sexual or physical assault, transportation accidents. It’s also been linked to human-caused technological disasters, which is where the Flint study fits in.”

Pugach and his colleagues examined the levels of PTSD and depression in the nine months following the derailment. They surveyed adults who lived within a 65-mile radius of East Palestine at the time of the disaster. Why the 65-mile radius? Pugach said the initial geographical radius was 25 miles, but that proved too small to reach the goal of capturing a 1,000-person sample, so the radius was expanded.

A report by the National Atmospheric Deposition Program found that the chemicals unleashed by the derailment impacted an area stretching from the Midwest, through the Northeastern United States and into Canada, and as far south as North Carolina, Pugach noted. That tracks with alarms raised by toxicologist George Thompson, whose research shows the toxic fallout from the train crash could cover more than 126,000 square miles.

Participants in the study included their ZIP codes in their responses, which will help researchers understand the effects of proximity on the rates of PTSD and depression, Pugach said.

What exactly is PTSD? The manual professionals utilize for assessing and diagnosing mental disorders, called the DSM-5, lists 20 symptoms. These include re-experiencing a traumatic event through nightmares or flashbacks, hypervigilance, sleeping problems and feeling unsafe or threatened.

People who experience a traumatic event often have trouble with memory and concentration, and they deal with an increase in negative emotions such as fear, sadness, guilt, shame, disgust, as well as negative beliefs about themselves and other people. They can see the world as an unjust and untrustworthy place.

Research shows that women are generally more at risk than men for developing PTSD. Perceptions play a role, too. In Flint, those who believe their health was harmed by exposure to contaminated water, and who were skeptical of the information they were hearing from public officials, were more likely to suffer from psychiatric disorders.

Mental health services can help residents, but, in Flint, about three-quarters of residents were never offered such services. When services were made available, they proved popular. About 80% of residents who were offered mental health services after the onset of the water crisis took advantage of them, “and those who did so were significantly less likely to meet criteria for presumptive depression,” the Flint report reads.

A Norfolk Southern spokesperson said the company has agreed to provide mental health services for the communities around East Palestine as part of a settlement the railroad reached last year with the EPA and the Department of Justice. Here’s what the company said that it would provide:

• A Community Health Program: Pending final court approval, this program will provide medical exams and mental health services for the community and first responders for up to 20 years. Norfolk Southern said this is a $25 million commitment.
• A Community Resiliency Center: Norfolk Southern will provide $649,000 for an Ohio-run Community Resiliency Center to address mental health issues.
• Clinical Counseling: The company will provide $1.8 million in funding for the operation of an East Palestine clinical counseling and wellness practice, designed to support the mental well-being of local residents.  In addition, Norfolk Southern will provide monthly funding to help cover derailment-related mental health visits for area residents.