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Outreach and screening following the 2005 London bombings: usage and outcomes.

Brewin CR, Fuchkan N, Huntley Z, Robertson M, Thompson M, Scragg P, d'Ardenne P, Ehlers A - Psychol Med (2010)

Bottom Line: This article reports the usage, diagnoses and outcomes associated with the 2-year Trauma Response Programme (TRP) for those affected by the 2005 London bombings.MethodFollowing a systematic and coordinated programme of outreach, the contact details of 910 people were obtained by the TRP.Individuals judged to need treatment (n=217) received trauma-focused cognitive-behaviour therapy (TF-CBT) or eye movement desensitization and reprocessing (EMDR).Case finding relied primarily on outreach rather than standard referral pathways such as primary care.

View Article: PubMed Central - PubMed

Affiliation: Clinical, Educational and Health Psychology, University College London, UK. c.brewin@ucl.ac.uk

ABSTRACT

Background: Little is known about how to remedy the unmet mental health needs associated with major terrorist attacks, or what outcomes are achievable with evidence-based treatment. This article reports the usage, diagnoses and outcomes associated with the 2-year Trauma Response Programme (TRP) for those affected by the 2005 London bombings.MethodFollowing a systematic and coordinated programme of outreach, the contact details of 910 people were obtained by the TRP. Of these, 596 completed a screening instrument that included the Trauma Screening Questionnaire (TSQ) and items assessing other negative responses. Those scoring ≥6 on the TSQ, or endorsing other negative responses, received a detailed clinical assessment. Individuals judged to need treatment (n=217) received trauma-focused cognitive-behaviour therapy (TF-CBT) or eye movement desensitization and reprocessing (EMDR). Symptom levels were assessed pre- and post-treatment with validated self-report measures of post-traumatic stress disorder (PTSD) and depression, and 66 were followed up at 1 year.

Results: Case finding relied primarily on outreach rather than standard referral pathways such as primary care. The effect sizes achieved for treatment of DSM-IV PTSD exceeded those usually found in randomized controlled trials (RCTs) and gains were well maintained an average of 1 year later.

Conclusions: Outreach with screening, linked to the provision of evidence-based treatment, seems to be a viable method of identifying and meeting mental health needs following a terrorist attack. Given the failure of normal care pathways, it is a potentially important approach that merits further evaluation.

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Related in: MedlinePlus

Flow of participants through screening and treatment.
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fig001: Flow of participants through screening and treatment.

Mentions: Figure 1 provides a flow diagram that illustrates how individuals involved in the bombings whose identity became known to the programme progressed through screening, assessment and treatment. The programme obtained contact information and sent screening materials to 910 adults, mostly within the first 6 months. Only 4.3% of these contacts were as a result of GP referrals. Contact information came mainly from lists of survivors held by NHS hospitals and clinics (41.7%), from police witness lists (12.0%), from other organizations involved in the response to the bombings such as the 7 July Assistance Centre and the Red Cross (27.1%), and from occupational health departments (4.8%). In addition, individuals self-referred (5.8%) or referred relatives and friends (3.3%) as a result of seeing information in the mass media.


Outreach and screening following the 2005 London bombings: usage and outcomes.

Brewin CR, Fuchkan N, Huntley Z, Robertson M, Thompson M, Scragg P, d'Ardenne P, Ehlers A - Psychol Med (2010)

Flow of participants through screening and treatment.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2964043&req=5

fig001: Flow of participants through screening and treatment.
Mentions: Figure 1 provides a flow diagram that illustrates how individuals involved in the bombings whose identity became known to the programme progressed through screening, assessment and treatment. The programme obtained contact information and sent screening materials to 910 adults, mostly within the first 6 months. Only 4.3% of these contacts were as a result of GP referrals. Contact information came mainly from lists of survivors held by NHS hospitals and clinics (41.7%), from police witness lists (12.0%), from other organizations involved in the response to the bombings such as the 7 July Assistance Centre and the Red Cross (27.1%), and from occupational health departments (4.8%). In addition, individuals self-referred (5.8%) or referred relatives and friends (3.3%) as a result of seeing information in the mass media.

Bottom Line: This article reports the usage, diagnoses and outcomes associated with the 2-year Trauma Response Programme (TRP) for those affected by the 2005 London bombings.MethodFollowing a systematic and coordinated programme of outreach, the contact details of 910 people were obtained by the TRP.Individuals judged to need treatment (n=217) received trauma-focused cognitive-behaviour therapy (TF-CBT) or eye movement desensitization and reprocessing (EMDR).Case finding relied primarily on outreach rather than standard referral pathways such as primary care.

View Article: PubMed Central - PubMed

Affiliation: Clinical, Educational and Health Psychology, University College London, UK. c.brewin@ucl.ac.uk

ABSTRACT

Background: Little is known about how to remedy the unmet mental health needs associated with major terrorist attacks, or what outcomes are achievable with evidence-based treatment. This article reports the usage, diagnoses and outcomes associated with the 2-year Trauma Response Programme (TRP) for those affected by the 2005 London bombings.MethodFollowing a systematic and coordinated programme of outreach, the contact details of 910 people were obtained by the TRP. Of these, 596 completed a screening instrument that included the Trauma Screening Questionnaire (TSQ) and items assessing other negative responses. Those scoring ≥6 on the TSQ, or endorsing other negative responses, received a detailed clinical assessment. Individuals judged to need treatment (n=217) received trauma-focused cognitive-behaviour therapy (TF-CBT) or eye movement desensitization and reprocessing (EMDR). Symptom levels were assessed pre- and post-treatment with validated self-report measures of post-traumatic stress disorder (PTSD) and depression, and 66 were followed up at 1 year.

Results: Case finding relied primarily on outreach rather than standard referral pathways such as primary care. The effect sizes achieved for treatment of DSM-IV PTSD exceeded those usually found in randomized controlled trials (RCTs) and gains were well maintained an average of 1 year later.

Conclusions: Outreach with screening, linked to the provision of evidence-based treatment, seems to be a viable method of identifying and meeting mental health needs following a terrorist attack. Given the failure of normal care pathways, it is a potentially important approach that merits further evaluation.

Show MeSH
Related in: MedlinePlus