Best practices for managing depression and suicide risk in World Trade Center responders and survivors

A growing body of research supports the association between exposure to the World Trade Center attacks and increased risk of subsequent depression, particularly among individuals who directly witnessed the attacks or participated in the rescue and recovery efforts. Depressive disorders, often comorbid with PTSD and substance use disorders, present an ongoing and substantial health burden for 9/11 responders and survivors. These conditions are associated with an increased risk of suicide mortality, highlighting the importance of screening for depression and suicidal ideation in this population. This paper, part of a series for primary care and other clinicians, offers a brief overview of research on depression in WTC-exposed populations, summarizes critical elements for identifying and managing depression, and offers best practices for suicide prevention.