Mental Health and Primary Care in a Time of Terrorism: Psychological Impact of Terrorist Attacks

The mobilization of specialized mental health resources to assist victims and their families after the September 11, 2001, terrorist attacks was impressive and unprecedented. Nevertheless, primary-care settings are the first point of contact within the health care system for most people. The purpose of this integrative review of literature is to examine existing research literature regarding the psychological impact of the September 11 terrorist events on adults and children and to identify directions for future research that will guide resource development for health care providers. The review is organized around three themes: (a) prevalence of psychological and somatic symptoms immediately after September 11, (b) trends in symptom reporting over time, and (c) correlates or predictors of psychological symptom severity and resilience. The results of these studies are discussed in relation to those of previous natural disasters and other terrorist attacks. Recommendations for future research and implications for primary-care practice are presented.