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PTSD risk could be worse in urban areas

Story by Adam Ebel

Post Traumatic Stress Disorder is usually associated with events, such as war or tragedies.

Specifically, it is an overactive adrenal response which is thought to cause neurophysiological changes within the hypothalamic-pituitary-axis.

These reactions can be tied either to a single set of extreme circumstances or a sustained stressful environment.

The latter is showing up in dense urban areas.

According to a survey of 8,000 residents from inner-city Chicago, Los Angeles and Washington D.C., conducted by Kerry Ressler of Emory University, a little over 32 percent had symptoms of PTSD, reaching rates higher than United States war veterans.

Although overall crime rates in America have been dropping to record lows over the last two decades, some low-income areas haven’t improved since the 1980s, some even seeing a rise in crime.

In these environments, theorizes Ressler, PTSD can not only be a symptom of local violence but a contributing cause to systemic and cyclic poverty and crime.

A person with PTSD is not only less likely to find regular income, but he or she is also unlikely to feel comfortable or safe in regular environments.

Many focuses for community development ranging from education to public-work projects are based on the assertion that their beneficiary’s mental health is also stable.

PTSD has been shown to reduce working memory, increase impulsivity and lower test scores in areas affected.

PTSD also causes social isolation and mistrust of others, factors that play into community “failure.”

Children are especially vulnerable to more permanent effects from these factors.

“Living in a low-income area would certainly induce stress that would be hard for a person who didn’t grow up in a setting like that to understand,” said first-year political science major Collin Stevens.

Critics of these studies point out that most of the population surveyed was through public institutions such as courts and emergency rooms, which provide a selection bias for the data.

Furthermore, they would point out that the survey did not discriminate between those who just had symptoms of PTSD, and those who had been fully diagnosed, whereas screening for veterans often uses very strict conservative parameters to define and diagnose PTSD, as each diagnosis is a financial obligation for the military.

Most agree that mental health care in America needs substantial review.

“I don’t think we need to improve mental health services just in high-crime areas,” said Liz Kuker, a junior psychology and sociology student. “But across the board. I think our health care system is really lacking in providing services for the mentally ill.”

The United States healthcare system has been criticized on a multitude of fronts, one of which is failing to adequately diagnose and provide for the mentally ill.

This is especially evident in low-income areas, many of which fall in federally designated Mental Health Professional Shortage Areas.

For lower-income neighborhoods that have access to mental health professionals, nearly half of the diagnosed population responded that they could not afford to seek treatment for their illness, according to a survey conducted the Henry J. Kaiser Family Foundation.

Furthermore, most subsidies and aid provided for low-income families with mental health issues are for prescription drugs, rather than the primary treatment for PTSD, psychotherapy.

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