Lessons From Analyzing the Medical Costs of Civilian Terror Victims: Planning Resources Allocation for a New Era of Confrontations

Ellenberg, Eytan; Taragin, Mark I.; Hoffman, Jay R.; Cohen, Osnat; Luft‐Afik, Daniella; Bar-On, Z; Ostfeld, Ishay

doi:10.1111/1468-0009.12299

Cited by 4 publications

(3 citation statements)

References 33 publications

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“…5 Children are particularly at risk. 6 In some analyses, the economic burden of mental healthcare almost equals the medical costs, 7 with evidence of considerable unmet need. 8 The Manchester Arena bombing On 22 May 2017, a suicide bomber detonated an improvised explosive device in the foyer of the Manchester Arena after a concert, killing 22 people and himself, and physically injuring 239 children and adults.…”

Section: Mental Health Impact Of Terrorist Attacksmentioning

confidence: 99%

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Psychological screening of adults and young people following the Manchester Arena incident

et al. 2019

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Background Terrorist attacks have increased globally since the late 1990s with clear evidence of psychological distress across both adults and children and young people (CYP). After the Manchester Arena terrorist attack, the Resilience Hub was established to identify people in need of psychological and psychosocial support. Aims To examine the severity of symptoms and impact of the programme. Method The hub offers outreach, screening, clinical telephone triage and facilitation to access evidenced treatments. People were screened for trauma, depression, generalised anxiety and functioning who registered at 3, 6 and 9 months post-incident. Baseline scores were compared between screening groups (first screen at 3, 6 or 9 months) in each cohort (adult, CYP), and within groups to compare scores at 9 months. Results There were significant differences in adults' baseline scores across screening groups on trauma, depression, anxiety and functioning. There were significant differences in the baseline scores of CYP across screening groups on trauma, depression, generalised anxiety and separation anxiety. Paired samples t-tests demonstrated significant differences between baseline and follow-up scores on all measures for adults in the 3-month screening group, and only depression and functioning measures for adults in the 6-month screening group. Data about CYP in the 3-month screening group, demonstrated significant differences between baseline and follow-up scores on trauma, generalised anxiety and separation anxiety. Conclusions These findings suggest people who register earlier are less symptomatic and demonstrate greater improvement across a range of psychological measures. Further longitudinal research is necessary to understand changes over time. Declaration of interest None.

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Section: Mental Health Impact Of Terrorist Attacksmentioning

confidence: 99%

“…5 Children are particularly at risk. 6 In some analyses, the economic burden of mental healthcare almost equals the medical costs, 7 with evidence of considerable unmet need. 8…”

Section: Mental Health Impact Of Terrorist Attacksmentioning

confidence: 99%

Psychological screening of adults and young people following the Manchester Arena incident

et al. 2019

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“…Children are particularly vulnerable [ 3 , 4 ]. The economic burden of mental health care may equal the medical costs [ 5 ] with considerable unmet need [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

The psychosocial response to a terrorist attack at Manchester Arena, 2017: a process evaluation

et al. 2021

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Background A 2017 terrorist attack in Manchester, UK, affected large numbers of adults and young people. During the response phase (first seven weeks), a multi-sector collaborative co-ordinated a decentralised response. In the subsequent recovery phase they implemented a centralised assertive outreach programme, ‘The Resilience Hub’, to screen and refer those affected. We present a process evaluation conducted after 1 year. Methods Case study, involving a logic modelling approach, aggregate routine data, and semi-structured interviews topic guides based on the Inter-Agency Collaboration Framework and May’s Normalisation Process Theory. Leaders from health, education and voluntary sectors (n = 21) and frontline Resilience Hub workers (n = 6) were sampled for maximum variation or theoretically, then consented and interviewed. Framework analysis of transcripts was undertaken by two researchers. Results Devolved government, a collaborative culture, and existing clinical networks meant that, in the response phase, a collaboration was quickly established between health and education. All but one leader evaluated the response positively, although they were not involved in pre-disaster statutory planning. However, despite overwhelming positive feedback there were clear difficulties. (1) Some voluntary sector colleagues felt that it took some time for them to be involved. (2) Other VCSE organisations were accused of inappropriate, harmful use of early intervention. (3) The health sector were accused of overlooking those below the threshold for clinical treatment. (4) There was a perception that there were barriers to information sharing across organisations, which was particularly evident in relation to attempts to outreach to first responders and other professionals who may have been affected by the incident. (5) Hub workers encountered barriers to referring people who live outside of Greater Manchester. After 1 year of the recovery phase, 877 children and young people and 2375 adults had completed screening via the Resilience Hub, 79% of whom lived outside Greater Manchester. Conclusions The psychosocial response to terrorist attacks and other contingencies should be planned and practiced before the event, including reviews of communications, protocols, data sharing procedures and workforce capacity. Further research is needed to understand how the health and voluntary sectors can best collaborate in the wake of future incidents.

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The October 7, 2023, Attack on Israel Indicates a Change in Trauma Patterns of Terror Victims, due to the Use of Thermobaric Weapons

Ostfeld,

Kachel,

Shafir

et al. 2024

Military Medicine

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Introduction The terror attack on October 7, 2023, in southern Israel resulted in approximately 1,200 civilians and security personnel killed. Of the civilians murdered, approximately 200 men, women, and children were murdered inside their homes, while the remaining casualties were murdered in an open field at a music festival, in their cars, or in the streets of local cities. Materials and Methods Currently, official data have not yet been published regarding the types of injuries suffered by Israeli civilians during the terror attack. However, the massive damage found in buildings infiltrated by the terrorists, weapons found on neutralized terrorists, and the findings of the pathologists tasked with examining and identifying the casualties, as well as preliminary clinical evidence, suggested that many died from hand-held explosive devices or rocket-propelled grenades containing a “thermobaric”-type warhead. Results The use of thermobaric weapons has also been reported from the Russia–Ukraine war, suggesting that these weapons are becoming more common in their use. Thermobaric injuries differ from typical battlefield injuries due to their specific blast characteristics. Considering that thermobaric weapons are relatively cheap to manufacture and highly efficient, it can be assumed that their unique injury patterns will become more common in future battlefields. Conclusions This paper reports on a possible change in the nature of terror and battlefield injuries and alerts emergency organizations and military forces worldwide to prepare for the need of treating more blast injuries, burns, smoke inhalation, and asphyxiation.

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Lessons From Analyzing the Medical Costs of Civilian Terror Victims: Planning Resources Allocation for a New Era of Confrontations

Cited by 4 publications

References 33 publications

Psychological screening of adults and young people following the Manchester Arena incident

Psychological screening of adults and young people following the Manchester Arena incident

The psychosocial response to a terrorist attack at Manchester Arena, 2017: a process evaluation

The October 7, 2023, Attack on Israel Indicates a Change in Trauma Patterns of Terror Victims, due to the Use of Thermobaric Weapons

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