Improving the mental health system for trauma victims in France

El‐Hage, Wissam; Birmes, Philippe; Jehel, Louis; Ferreri, Florian; Benoît, Michel; Vidailhet, Pierre; Prieto, Nathalie; François, Irène; Baubet, Thierry; Vaïva, Guillaume

doi:10.1080/20008198.2019.1617610

Cited by 7 publications

(6 citation statements)

References 8 publications

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“…Health systems are complex and it was beyond the scope of our study to do a complete assessment of the available psychosocial services in each country. More comprehensive data on this are available elsewhere [ 47 , 48 , 94 , 99 , 100 ].…”

Section: Discussionmentioning

confidence: 99%

Psychosocial care responses to terrorist attacks: a country case study of Norway, France and Belgium

Stene

Vuillermoz

Overmeire

et al. 2022

BMC Health Serv Res

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Background The international terrorism threat urges societies to invest in the planning and organization of psychosocial care. With the aim to contribute to cross-national learning, this study describes the content, target populations and providers of psychosocial care to civilians after terrorist attacks in Norway, France and Belgium. Methods We identified and reviewed pre- and post-attack policy documents, guidelines, reports and other relevant grey literature addressing the psychosocial care response to terrorist attacks in Oslo/Utøya, Norway on 22 July 2011; in Paris, France on 13 November 2015; and in Brussels, Belgium on 22 March 2016. Results In Norway, there was a primary care based approach with multidisciplinary crisis teams in the local municipalities. In response to the terrorist attacks, there were proactive follow-up programs within primary care and occupational health services with screenings of target groups throughout a year. In France, there was a national network of specialized emergency psychosocial units primarily consisting of psychiatrists, psychologists and psychiatric nurses organized by the regional health agencies. They provided psychological support the first month including guidance for long-term healthcare, but there were no systematic screening programs after the acute phase. In Belgium, there were psychosocial intervention networks in the local municipalities, yet the acute psychosocial care was coordinated at a federal level. A reception centre was organized to provide acute psychosocial care, but there were no reported public long-term psychosocial care initiatives in response to the attacks. Conclusions Psychosocial care responses, especially long-term follow-up activities, differed substantially between countries. Models for registration of affected individuals, monitoring of their health and continuous evaluation of countries’ psychosocial care provision incorporated in international guidelines may strengthen public health responses to mass-casualty incidents.

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Section: Discussionmentioning

confidence: 99%

Psychosocial care responses to terrorist attacks: a country case study of Norway, France and Belgium

Stene

Vuillermoz

Overmeire

et al. 2022

BMC Health Serv Res

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“…A second recommendation can be made regarding the need of more available centers for victims of traumatic events. France has already integrated such a center for victims of trauma (28), while in the United States there is Project Liberty, a large intervention program established after 9/11 (29). This project has shown to increase service access in vulnerable groups (30).…”

Section: Discussionmentioning

confidence: 99%

Victims of the Terrorist Attacks in Belgium and Professional Mental Health Aid Barriers: A Qualitative Study

et al. 2021

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Introduction: Terrorist attacks can cause short and long-term stress-reactions, anxiety, and depression among those exposed. Sometimes, professional mental health aid, meaning all types of professional psychotherapy, would be appropriate, but victims often delay or never access mental health aid, even up to a decade after the initial event. Little is known about the barriers terrorist-victims encounter when they try to access professional mental health aid.Method: Using a qualitative design, 27 people exposed to the 22/03/2016 terrorist attack in Belgium were interviewed using half-structured, in-depth interviews, on their experiences with professional mental health aid. A reflexive thematic analysis was employed.Results: Five main barriers for professional mental health aid seeking by victims were found. First, their perception of a lack of expertise of mental health aid professionals. Second, the lack of incentives to overcome their uncertainty to contact a professional. Third, social barriers: people did not feel supported by their social network, feared stigma, or trusted that the support of their social network would be enough to get them through any difficulties. Fourth, a lack of mental health literacy, which seems to be needed to recognize the mental health issues they are facing. Finally, there are financial barriers. The cost of therapy is often too high to begin or continue therapy.Conclusions: This study showed that the barriers for seeking professional mental health aid are diverse and not easily overcome. More mental health promotion is needed, so that there is a societal awareness of possible consequences of being exposed to terrorist attacks, which might result in less stigma, and a quicker realization of possible harmful stress reactions due to a disaster.

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“…Participants were enroled from January 2013 to October 2017 from three French regional outpatient services specialising in psychotraumatology in Toulouse, Lille and Tours University Hospitals [ 25 ]. Participants had to have a primary diagnosis of PTSD according to the DSM-IV criteria [ 26 ], with a PTSD Checklist–Specific (PCL-S) score ≥ 45.…”

Section: Methodsmentioning

confidence: 99%

Traumatic memory reactivation with or without propranolol for PTSD and comorbid MD symptoms: a randomised clinical trial

Roullet

Vaïva

Véry

et al. 2021

Neuropsychopharmacol.

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Post-traumatic stress disorder (PTSD) is difficult to treat but one promising strategy is to block memory reconsolidation of the traumatic event. This study aimed to evaluate the efficacy of traumatic memory reactivation under the influence of propranolol, a noradrenergic beta-receptor blocker, in reducing PTSD symptoms as well as comorbid major depression (MD) symptoms. We conducted a double blind, placebo-controlled, randomised clinical trial in 66 adults diagnosed with longstanding PTSD. Propranolol or a placebo was administered 90 min before a brief memory reactivation session, once a week for 6 consecutive weeks. Measures included the SCID PTSD module, the PTSD Check List (PCL-S) and the Beck Depression Inventory-II (BDI-II). PTSD symptoms decreased both in the pre-reactivation propranolol group (39.28%) and the pre-reactivation placebo group (34.48 %). During the 6 treatment sessions, PCL-S and BDI-II scores decreased to similar extent in both groups and there were no treatment differences. During the 3-month follow-up period, there were no treatment effects for the mean PCL-S and BDI-II scores. However, in patients with severe PTSD symptoms (PCL-S ≥ 65) before treatment, PCL-S and BDI-II scores continued to decline 3 months after the end of treatment in the propranolol group while they increased in the placebo group. Repeated traumatic memory reactivation seemed to be effective for PTSD and comorbid MD symptoms. However, the efficacy of propranolol was not greater than that of placebo 1 week post treatment. Furthermore, in this traumatic memory reactivation, PTSD symptom severity at baseline might have influenced the post-treatment effect of propranolol.

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Improving the mental health system for trauma victims in France

Cited by 7 publications

References 8 publications

Psychosocial care responses to terrorist attacks: a country case study of Norway, France and Belgium

Psychosocial care responses to terrorist attacks: a country case study of Norway, France and Belgium

Victims of the Terrorist Attacks in Belgium and Professional Mental Health Aid Barriers: A Qualitative Study

Traumatic memory reactivation with or without propranolol for PTSD and comorbid MD symptoms: a randomised clinical trial

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