In the wake of last week鈥檚 terror attacks in Paris, which killed 132 and injured hundreds more, thoughts are turning to the survivors and how to prevent them experiencing long-term health problems. The world鈥檚 top psychiatrists have come up with a five-point plan to help.
Research suggests that between 70 and 90 per cent of people exposed to trauma will cope effectively on their own. However, a small minority will experience increased anxiety, even post-traumatic stress disorder (PTSD).
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鈥淎t this stage, most people are likely to recover quite naturally,鈥� says at University College London, who helped develop a programme to help victims of the 2005 tube attacks in London to recover. 鈥淧eople are very resilient.鈥�
Working out who is likely to suffer most is one of the biggest challenges in this field of research. Culture is thought to play a part. For instance, the Spanish recorded much higher rates of PTSD after the terrorist attacks in Madrid in 2004 than the British did after the suicide bombings in London in 2005, although it鈥檚 not clear why. Levels of alcohol consumption also contribute, since it can mask symptoms of PTSD.
In 2007, the world鈥檚 premier psychologists drew up for helping communities deal with traumatic events.
鈥淚t鈥檚 evidence-inferred, because with massacres and terrorist acts there are no randomised controlled trials to back things up scientifically,鈥� says Brewin. 鈥淏ut there is evidence, and the strategy was put together by the most experienced trauma people in the world,鈥� he says.
The first priority is safety: taking visible steps to make terror attacks, for example, less likely, such as increasing security.
The second is to calm people down. 鈥淧eople generally calm down of their own accord provided they鈥檙e not kept in a state of anxiety by events elsewhere,鈥� says Brewin.
The third, crucial factor is connectivity, the ability to contact friends and family to tell them you are safe. 鈥淎fter the London bombings, everyone was very agitated because they couldn鈥檛 use their mobile phones,鈥� says Brewin.
Fourth is feeling that the community is there to help if needed. 鈥淲hen we had terrorist attacks in Jerusalem, we would give people at the hospital a telephone number to ring if they felt they needed further psychological help,鈥� says of the New York University Medical Center, and a co-author of the 2007 strategy.
The final factor is hope, particularly to repair the 鈥渟hattered world views鈥� that often accompany major terror outrages. Given the right support, what is amazing is that even in the worst conditions, the majority of people don鈥檛 develop debilitating symptoms, says Shalev.
One thing the French authorities should definitely avoid, however, is insisting on early debriefing of the people who witnessed the Paris massacre first-hand, to help them come to terms with their experiences. 鈥淵ou don鈥檛 want to override people鈥檚 own coping systems,鈥� says Brewin.
Although popular more than a decade ago, counselling eve-ryone connected with an event fell out of favour when evidence emerged that it was probably doing more harm than good, he says.
Brewin says that French authorities should follow everyone closely connected with the events and make contact in three months鈥� time. 鈥淎ny that are not recovering on their own can then be offered professional help.鈥�
(Image: Philippe Wojazer/Reuters)
