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

Abstract

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.

Healthcare utilization after mass trauma: a register-based study of consultations with primary care and mental health services in survivors of terrorism

“…The utilization of PCP and MHS after terrorist attacks could be different in countries with other health systems and/or different psychosocial care responses to terrorist attacks [ 48 ]. For instance, studies based on self-reported healthcare utilization suggest that the utilization of GPs was less common in survivors of the 13 November attacks in Paris, France than in survivors of the Utøya attack [ 24 – 26 ].…”

The impact of a terrorist attack: Survivors’ health, functioning and need for support following the 2019 Utrecht tram shooting 6 and 18 months post-attack

“…As has been demonstrated in previous research, the organization of care and support after a terrorist attack varies widely between countries (e.g., Stene et al, 2022), not only with regard to the parties involved, but also in the degree to which an outreach approach is used whereby survivors are actively approached to refer to care. International guidelines recommend the monitoring of needs and problems of the survivors of disasters (Inter-Agency Standing Committee (IASC), 2007; Bisson et al, 2010;Te Brake and Dückers, 2013;Juen, 2016; International Committee of the Red Cross (IFRC), 2018; Dückers et al, 2022).…”

Appraising Evidence-Based Mental Health and Psychosocial Support (MHPSS) Guidelines—PART II: A Content Analysis with Implications for Disaster Risk Reduction

“…Disasters and humanitarian crises can have a tremendous impact on the mental health and psychosocial well-being of affected populations [1][2][3][4][5][6][7][8]. To adequately respond to mental health risks and problems, governments and partners at different levels, including governmental and non-governmental organizations and citizens, need to engage and collaborate on behalf of the planning and implementation of mental health and psychosocial support (MHPSS) in different stages of the disaster life cycle [9][10][11][12][13][14][15][16][17]. MHPSS has been defined as "any type of local or outside support that aims to protect or promote psychosocial well-being and/or prevent or treat mental disorder" [18] (p. 1).…”