Among 99 direct survivors of the 1995 Oklahoma City bombing, of whom almost 90% were injured, 86% used mental health services at various times over seven years post-disaster. Mental health care was more common among females and those who were injured or had posttraumatic stress disorder (PTSD) or depression. Services varied over time. In the first six months, informal crisis intervention such as participation in support groups, debriefings or sessions with clergy were used by over half. Formal treatment by psychiatrists, other mental health care providers and family doctors began later and usually ended before 7 years. Over three fourths of survivors with psychiatric disorders received help from nonphysician mental health providers. However, only half with bombing-related PTSD or post-bombing depression saw a psychiatrist and only 15% reported taking psychiatric medication for bombing-related problems during the 7 years. While 33% of survivors received care for over a year, only 7% were receiving services at 7 years. Although care decreased over time, this study showed the importance of providing varied services adapted to changing needs.