BACKGROUND: Two pipe bombs exploded in September 2016 in 2 separate New Jersey (NJ) locations and were linked to domestic terrorism; no physical injuries were sustained. Because the purpose of terrorism is to invoke physical harm and fear, psychological distress after an event can potentially increase mental health visits to local emergency departments (EDs) in the absence of physical injuries. We sought to determine if an increase occurred.
METHODS: Reports of ED chief complaints by patients meeting validated mental health key word groups residing in the same zip codes as the bombings were analyzed. Cases from September 2016 and 2015 were obtained from the NJ Department of Health’s syndromic surveillance system. T-tests were used to compare the same weekend in 2016 to 2015. A moving median and interquartile range (IQR) was calculated for each date in September 2016. Daily observed counts were compared against the expected moving median.
RESULTS: Mental health ED visits increased an average 1.2% (95% confidence interval: 0.17%–2.23%; P =0.031) from 2015 to 2016, of the same weekend. We observed an increase outside the expected IQR 2 days after the first bombing with a count (n = 7) that is 2.3 times higher than the moving median for that day (median = 3). This count is the only statistical outlier in September 2016 (IQR = 2).
CONCLUSIONS: On the basis of the significant t-test and observed increase over the expected median, ED visits for mental health symptoms increased <48 hours after these terrorist events. This finding supports the needs for health departments and hospitals to have adequate mental health preparatory responses and action plans when such events occur.