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We report on an unexpected phenomenon following the Herald of Free Enterprise disaster. A series of cross-channel ferry workers referred by their GPs to the Folkestone Mental Health Team, during the three years after the disaster, presented with post-traumatic stress disorder, despite having no direct contact with the disaster as survivors, bereaved relatives or helpers. A retrospective case study is described of 14 ferry crew members presenting with PTSD. Thirteen completed the GHQ60. Evidence is presented of severe functional impairment in this group. It is argued that these subjects are indirect victims of the Herald of Free Enterprise disaster. Ways in which the 'ripples outward' of a major marine accident might extend to such peripheral victims are discussed.
Dixon et al. (Tue,) studied this question.