PSYCHIATRIC SERVICES ♦ ps.psychiatryonline.org ♦ September 2006 Vol. 57 No. 9
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disruption of daily routine, and in-
creases in the prevalence of mental
disorders (1). After the attacks, the
New York State Office of Mental
Health (NYOMH) and the New York
City Department of Health and Men-
tal Hygiene (DOHMH) alerted the
public to the availability of counseling
and referral services through LifeNet,
a preexisting toll-free, 24-hour men-
tal health hotline that offered multi-
lingual services. These media an-
nouncements began within 24 hours
of the attacks (2). This initial response
was followed by the establishment of
Project Liberty, a federally funded
program that provided free, anony-
mous crisis counseling and public ed-
ucation services to people affected by
Project Liberty was designed to de-
liver effective, community-based crisis
counseling services in the five bor-
oughs of New York City and in ten sur-
rounding counties. Funded by two
grants totaling slightly over $155 mil-
lion by the Federal Emergency Man-
agement Agency (FEMA), Project
Liberty was administered by NYOMH.
In conjunction with local mental
health departments, NYOMH mobi-
lized a network of providers to deliv-
er crisis counseling services to the
affected populations on an ongoing
he attacks on the World Trade
Center on September 11,
2001, resulted in loss of life,
Impact of a Media Campaign for
Disaster Mental Health Counseling
in Post–September 11 New York
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Dr. Frank is affiliated with the Department of Health Care Policy, Harvard Medical
School, Boston. Ms. Pindyck is with the University of Massachusetts Medical School,
Worcester. Ms. Donahue, Ms. Pease, Mr. Foster, and Mr. Felton are with the Center for
Information Technology and Evaluation Research, New York State Office of Mental
Health, Albany. Dr. Essock is with the Department of Psychiatry, Division of Health
Services Research, Mount Sinai School of Medicine, New York City, and with the Men-
tal Illness Research, Education, and Clinical Center, James J. Peters Veterans Affairs
Medical Center, the Bronx. Send correspondence to Dr. Essock, Department of Psychi-
atry, Mount Sinai School of Medicine, 1 Gustave L. Levy Place, Box 1230, New York,
NY 10029-6574 (e-mail: firstname.lastname@example.org). This report from Project Liberty is
part of a special issue of Psychiatric Services commemorating the five-year anniversary
of the September 11, 2001, attacks. Susan M. Essock, Ph.D., served as guest editor.
Objective: After the September 11, 2001, terrorist attacks on the World
Trade Center, the New York State Office of Mental Health (NYOMH)
initiated a three-phase multifaceted, multilingual media campaign that
advertised the availability of counseling services. This study evaluated
the association between patterns of spending within this campaign and
the volume of calls received and referred to a counseling program.
Methods: Spending on television, radio, print, and other advertising
was examined, as was the corresponding volume of calls to the NetLife
hotline seeking referrals to counseling services. Results: From Septem-
ber 2001 to December 2002, $9.38 million was spent on Project Liber-
ty media campaigns. Call volumes increased during months when total
monthly expenditures peaked. Initially, flyers, billboards, and other
material items accounted for most monthly expenses. Over time,
spending for television and radio advertisements increased, whereas
other advertising declined. Temporal patterns show that in periods af-
ter an increase in media spending, call volumes increased independ-
ently of other sentinel events such as the one-year anniversary of the
attacks. Conclusions: Sustained advertising through multiple media
outlets appeared to be effective in encouraging individuals to seek
mental health services. (Psychiatric Services 57:1304–1308, 2006)