An evaluative case study of the mental  health and wellbeing response to the Grenfell Tower fire; Lessons for disaster preparedness and management

Background The Grenfell Tower fire, London, in 2017 caused 72 deaths, and mass evacuations. This evaluative case study examines the disaster response, particularly the mental health and wellbeing programme delivered by statutory services, notably the NHS and local government (RBKC). It explores what they did, and how they worked together and with voluntary sector organisations (VSOs) to identify key lessons for the planning of disaster responses. Methods The study focused on the first two years of the response. Data was gathered from publicly available sources and interviews with key informants. Uncertainties and missing information were clarified with organisations. A timeline of the response was created as well as an overview of key lessons for future responses. Results In national guidance RBKC was responsible for co-ordinating the longer-term recovery response. That was difficult because it had lost the trust of the local community. The NHS had to go beyond its assigned role of treatment and advice, which was too narrowly envisaged in national guidance. Both mental health and wellbeing need to be addressed after a disaster. Wellbeing is poorly defined, inadequately measured and rarely researched. Local and national VSOs played a vital role, but our understanding of the details is incomplete, as for most disaster responses. Conclusions Local communities must be fully involved in decisions about recovery programmes. Mental health and wellbeing are not synonymous but closely linked. Far more people will be injured psychologically than physically in a disaster. Large disasters require multi-agency partnerships sharing expertise and resources, rather than tasks being allocated between organisations through commissioning. There is a need to further develop and disseminate evidence-based mental health interventions delivered by non-experts as part of these partnerships. Training needs to teach practical skills as well as awareness. These lessons are also relevant to mainstream mental health services.