Mental health service use after the Van Earthquake: evidence from a quasi-experimental difference-in-differences study

This study examines the long-run effects of disaster exposure on mental health service utilization using quasi-experimental difference-in-differences and event-study design. Using nationally representative Türkiye Health Survey data (2008-2022), we analyze changes in mental health service use following the 2011 Van earthquake. We document a delayed but sustained increase in utilization of approximately 3-4% points, peaking in 2016-2019 and attenuating by 2022. Heterogeneity analyses show larger responses among men and single individuals, while utilization among women remains comparatively lower. Robustness checks, including alternative control groups and wild-cluster bootstrap inference, support the validity of the empirical design. The findings highlight that post-disaster mental health service use may evolve gradually over time, underscoring the importance of long-term recovery planning in middle-income, high-seismic-risk settings.