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Outreach and screening following the 2005 London bombings: usage and outcomes
Open accessAbstract
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. Method: Following 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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Metadata
- Authors
- Brewin, C. R., Fuchkan, N., Huntley, Z., Robertson, M., Thompson, M., Scragg, P., d'Ardenne, P., & Ehlers, A.
- Affiliations
- University College London (GB)
- Camden and Islington NHS Foundation Trust (GB)
- East London NHS Foundation Trust (GB)
- Corresponding author
- Brewin, C. R.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2010-03-09
- Volume
- 40
- Issue
- 12
- Pages
- 2049-2057
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC2964043
- OpenAlex
- W2048941857
- Cited by
- 169
- References
- 35
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 5 · 2022: 9 · 2021: 13 · 2020: 11 · 2019: 12 · 2018: 11 · 2017: 42 · 2016: 5 · 2015: 12 · 2014: 9 · 2013: 9 · 2012: 7
- FWCI
- 7.71
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-sa
- www.cambridge.org/core/terms (unspecified)
- Locations
- Psychological Medicine (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Wellcome Trust (069777)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Sociology and Political Science › Terrorism, Counterterrorism, and Political Violence
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Keywords
- 2005 London bombings, post-traumatic stress disorder, EMDR, mental health outreach, trauma screening, case finding, unmet mental health needs, depression, treatment outcomes, long-term follow-up
- MeSH terms
- Adult, Community-Institutional Relations, Depression, Female, Humans, London, Male, Mass Screening, Mental Health Services, Middle Aged, Primary Health Care, Referral and Consultation, Stress Disorders, Post-Traumatic, Wounds and Injuries, Cohort Studies, Cognitive Behavioral Therapy, Evidence-Based Medicine, Needs Assessment, Terrorism, Eye Movement Desensitization Reprocessing
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