Although more than one decade has passed since the WTC attack, its lasting effect on the mental health ofthousands of individuals remains constant. Although major efforts were made in the identification and treatment ofmental health problems among adults who were exposed to the WTC attack, other than school programs muchless was done for those children who exposed to this massive traumatic. Given the fact that exposure to traumaearly in life potentially has a significant long-term impact on a person 's life, the need to better understand theservice needs of this population is critical. In response to the program announcement from the National Institute forOccupational Safety and Health (NIOSH), entitled oeCooperative Research Agreements Related to the WorldTrade Center Health Program (U01) ? the proposed study will examine mental health service need and useamong youth who were exposed to the WTC attack during their childhood. Two groups of youth, those who weredirectly exposed to the WTC attack during their childhood and those whose parents were directly exposed to theWTC attack, will be examined. The study will include data from two unique samples: 1) 1,244 youth who wereexposed to the WTC attack during their childhood and participated World Trade Center Health Registry (WTCHR)survey, and 2) 883 youth whose parents were exposed to the WTC attack and who, therefore, were indirectlyexposed to the WTC attack through their parents. The proposed project will assess mental health service need,use and barriers to access to mental health services by identifying factors associated with youth mental healthservice utilization, including predisposing and enabling factors at the individual, family, school and communitylevels, and examine the impacts of parental exposure to the WTC attack, parental psychopathology and parentalhelp seeking behaviors on children 's patterns of mental health service utilization; and develop and test amodel of adolescent mental health service utilization after the WTC attack. It is hoped that the findings from thisproject will provide valuable information to clinicians and policy makers for improving the delivery of mental healthtreatment to those in need, both for this 9/11 population and those exposed to other, subsequent disasters.
The proposed project will examine patterns of mental health service utilization, barriers to mental health treatment services, and factors associated with such use by youth who were exposed, either directly or indirectly, to the WTC attack, an under studied population. The study has a great public health relevance because its findings will provide guidance to the improvement of mental health intervention for these youth and will help in preparedness efforts for future terrorist attacks.