Responding to mental health needs after terror attacks

Serious problems identified after the 2005 London bombings still remain, argue Kate Allsopp and colleagues Mental health responses for people caught up in terror attacks are often inadequate. Internationally, existing services repeatedly fail to identify those with short and long term needs, resulting in an increased prevalence of post-traumatic stress disorder, depression, and anxiety disorders compared with the general population.1 Health services should plan for short and longer term psychosocial care and mental health treatment for the substantial minority who need interventions.2 But the UK has been slow to learn. Many shortcomings in the response to the 2005 London bombings remained at the time of the 2017 Manchester Arena bombing, despite proposals for a new approach. Here, we discuss how services have evolved since 2005 and what still needs to be done. The demographics of the affected population are central to the design of any mental health response (box 1). The organisational challenges include specifying a responsible lead and chain of command; obtaining funding; providing reassurance, guidance, and messaging on trauma responses aimed at health services, other organisations, and the public; and identifying those affected and creating information handling arrangements that are flexible but compliant with data protection legislation. Coordination of a cross-agency response, involving health services, the third sector, and voluntary organisations is necessary to identify people who may develop mental health needs, arrange equitable access to evidence based care, and monitor use and outcomes. Box 1 ### Matching the mental health response to the population affected by mass casualty incidentsRETURN TO TEXT