background So far very few studies have compared the use of the Mental Health Services (mhs) by inhabitants directly affected by the disaster and by those not directly affected and hardly any attention has been given to the link between the mhs and the psychological problems.
aim To investigate whether those directly affected by the Enschede fireworks disaster (in May 2000) have more psychological problems and make more use of the mhs than a comparative group of persons not directly affected by the disaster; also to analyse the link between the use of the mhs and psychological problems 2 to 3 weeks after and/or 18 months after the disaster in inhabitants who were directly affected.
method A longitudinal comparative health study was instituted directly after the fireworks disaster. For this article we analysed the data of the directly affected inhabitants who had completed a questionnaire 2 to 3 weeks and/or 18 months after the disaster (n = 1116) and we analysed similar data obtained from the comparative group of inhabitants not directly affected (n = 609)
results Directly affected inhabitants had more psychological problems 18 months after the disaster and made more use of the mhs (31%) than did the comparative group (9%) 6 to 18 months after the disaster. Affected inhabitants with psychological problems according to the Symptom Checklist-90, Impact of Event scale and the Self-Rating Scale for Post-traumatic Stress Disorder on the occasion of the first and/or second measurement made more frequent use of the mhs, more often considered seeking help and still had more frequent contact with the mhs than did affected inhabitants without psychological problems. Of the affected inhabitants who, according to the Self-Rating Scale, satisfied the criteria for post-traumatic stress disorder (19.6%) 18 months after the disaster, 45.8% were still in contact with the mhs.
conclusion In the 6 to 18 month period after the disaster those affected by the disaster used the mhs 3 times more often. The mhs succeeded in making contact with many affected inhabitants who had psychological problems. A minority of persons with psychological problems is still in contact with mhs. Ethnic minorities used the mhs just as often as affected inhabitants of Dutch origin.