John Stancombe

University of Sussex

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Richard Williams

University of South Wales

Alan Barrett

Pennine Care NHS Foundation Trust

Prathiba Chitsabesan

Pennine Care NHS Foundation Trust

Paul French

Manchester Metropolitan University

John Drury

University of Sussex

Hannah Collins

University of Tennessee at Knoxville

Verity Kemp

Royal College of Surgeons of Edinburgh

Suzy Stokes

University of Oxford

Lizzie Lagan

C.L. DUNN

University of Sydney

Cooperative Institutions

University of Manchester

Greater Manchester Mental Health NHS Foundation Trust

Manchester Academic Health Science Centre

Pennine Care NHS Foundation Trust

University of Oxford

Stockport College

University of Liverpool

National Institute for Health Research

Salford Royal NHS Foundation Trust

AstraZeneca (United Kingdom)

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How Emergencies, Incidents, Disasters, and Disease Outbreaks Affect People and Healthcare Practitioners

Cambridge University Press eBooks (2024)

John Stancombe Suzy Stokes Andrew Wood Richard Williams

It is usual for humans to experience distress in the aftermath of emergencies, incidents, disasters, and disease outbreaks (EIDD). The manifestation, severity, and duration of the experiences that constitute distress depend on many intrinsic and extrinsic factors. Recent research has demonstrated that distress may be more ubiquitous than was previously thought, and that some interventions, even if well meaning, may not be helpful. Amelioration for most people comes with timely, proportionate, and targeted support and the passage of time. Validation of people's experiences and minimising the medicalisation of distress are important in helping people to return to ordinary social functioning. This chapter looks at distress related to major events, including the scientific principles, impacts, and implications for intervention. The case study draws on the experience of three members of a pre-hospital team and how a challenging case affected them all.

Affect

10.1017/9781009019330.007

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Citations (1)

People’s experiences of distress and psychosocial care following a terrorist attack: interviews with survivors of the Manchester Arena bombing in 2017

BJPsych Open (2022)

John Stancombe Richard Williams John Drury Hannah Collins Lizzie Lagan

Distress after major incidents is widespread among survivors. The great majority do not meet the criteria for mental health disorders and rely on psychosocial care provided by their informal networks and official response services. There is a need to better understand their experiences of distress and psychosocial care needs.

Thematic Analysis

10.1192/bjo.2022.2

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Citations (24)

Survivors’ experiences of informal social support in coping and recovering after the 2017 Manchester Arena bombing

BJPsych Open (2022)

John Drury John Stancombe Richard Williams Hannah Collins Lizzie Lagan

Much of the psychosocial care people receive after major incidents and disasters is informal and is provided by families, friends, peer groups and wider social networks. Terrorist attacks have increased in recent years. Therefore, there is a need to better understand and facilitate the informal social support given to survivors.

Peer Support

10.1192/bjo.2022.528

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Citations (13)

A Brief Consultation and Advisory Approach for use in Child and Adolescent Mental Health Services: A Pilot Study

Clinical Child Psychology and Psychiatry (2003)

Sam Heywood John Stancombe Eddy Street Helle Mittler C.L. DUNN

In England, the demand for, and access to Child and Adolescent Mental Health Services (CAMHS) have led to endemic and intractable problems: long waiting lists, non-attendance and complaints of inaccessibility from both users and referrers. The dilemma facing CAMHS is how best to respond to rising demand without compromising the quality of specialist secondary care services. As a pilot, we developed an alternative model of service delivery that provided a brief (2+1) consultation. We also created a manual as a guide to this process. This was evaluated with 50 families, who were seen within four weeks of their returned questionnaire. Strengths and Difficulties Questionnaire (SDQ) scores showed that 72% of families improved and 95% of parents were satisfied with the service they received. This approach is brief and empowering, and is sufficient to produce change. Implications for services using this approach would include: (i) informing referrers of the alternative model, (ii) training requirements, (iii) increasing the number of mental health workers so that secondary care services are able to function effectively, and (iv) allowing more specialist services to deal with the more severely disturbed cases.

Attendance

10.1177/13591045030084007

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Citations (22)

Facilitating Psychosocial Care for the Public After Major Incidents and During Pandemics

Cambridge University Press eBooks (2024)

John Stancombe Richard Williams Verity Kemp

This chapter introduces readers to important concepts and practicalities in facilitating, managing, and delivering the wellbeing and psychosocial agendas. It describes the research undertaken by the Social Influences on Recovery Enquiry (SIRE) undertaken in the wake of the Manchester Arena bombing in 2017, and its importance in framing the practical implications for planning and delivering services.

Framing (construction)

Social care

Pandemic

10.1017/9781009019330.030

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Citations (1)

Psychological screening of adults and young people following the Manchester Arena incident

BJPsych Open (2019)

Paul French Alan Barrett Kate Allsopp Richard Williams Chris R. Brewin

Terrorist attacks have increased globally since the late 1990s with clear evidence of psychological distress across both adults and children and young people (CYP). After the Manchester Arena terrorist attack, the Resilience Hub was established to identify people in need of psychological and psychosocial support.To examine the severity of symptoms and impact of the programme.The hub offers outreach, screening, clinical telephone triage and facilitation to access evidenced treatments. People were screened for trauma, depression, generalised anxiety and functioning who registered at 3, 6 and 9 months post-incident. Baseline scores were compared between screening groups (first screen at 3, 6 or 9 months) in each cohort (adult, CYP), and within groups to compare scores at 9 months.There were significant differences in adults' baseline scores across screening groups on trauma, depression, anxiety and functioning. There were significant differences in the baseline scores of CYP across screening groups on trauma, depression, generalised anxiety and separation anxiety. Paired samples t-tests demonstrated significant differences between baseline and follow-up scores on all measures for adults in the 3-month screening group, and only depression and functioning measures for adults in the 6-month screening group. Data about CYP in the 3-month screening group, demonstrated significant differences between baseline and follow-up scores on trauma, generalised anxiety and separation anxiety.These findings suggest people who register earlier are less symptomatic and demonstrate greater improvement across a range of psychological measures. Further longitudinal research is necessary to understand changes over time.None.

Depression

10.1192/bjo.2019.61

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Citations (26)

What Ails Professional Responders, and the Implications for Training and Sustaining Healthcare Practitioners

Cambridge University Press eBooks (2024)

Jennifer Burgess Andrew Wood Suzy Stokes John Stancombe Richard Williams

There is increasing awareness that working within the field of pre-hospital care can have psychosocial effects on clinicians. This chapter describes a systematic review of current knowledge of the psychosocial consequences of working in pre-hospital care. A considerable amount of research has been conducted, examining in particular whether practitioners develop burnout and psychiatric disorders, especially symptoms of post-traumatic stress and post-traumatic stress disorder (PTSD), as a result of their work. However, most studies did not fully assess whether practitioners developed clinically significant symptoms.. Instead, cross-sectional surveys and self-report questionnaires were used, which considerably overestimate the incidence of these problems. Perhaps the high scores on these questionnaires indicate that practitioners who work in pre-hospital care often suffer considerable stress and distress that can be the result of daily organisational and operational hassles, a high volume of work, lack of resources, and, less than has often been thought, attending unusual and high-profile incidents.

Traumatic stress

10.1017/9781009019330.040

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Principles for Intervening with the Wellbeing, Psychosocial, and Mental Health Needs of Mass Casualties

Cambridge University Press eBooks (2024)

Richard Williams John Stancombe Verity Kemp

This chapter draws together key principles that underpin how the responsible authorities should respond to the psychosocial and mental health needs of the public who are affected. It presents an approach that blends psychosocial care with mental healthcare into a comprehensive and inclusive combined cross-agency approach that combines the prominent biomedical and psychosocial conceptual approaches.

Psychosocial Support

10.1017/9781009019330.029

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Citations (0)

Trajectories of distress and recovery, secondary stressors and social cure processes in people who used the resilience hub after the Manchester Arena bombing

BJPsych Open (2023)

John Stancombe Richard Williams John Drury L. Hussey Matthew Gittins

Terrorist incidents lead to a range of mental health outcomes for people affected, sometimes extending years after the event. Secondary stressors can exacerbate them, and social support can provide mitigation and aid recovery. There is a need to better understand distress and mitigating factors among survivors of the Manchester Arena attack in 2017.We explored three questions. First, what experiences of distress did participants report? Second, how might secondary stressors have influenced participants' psychosocial recoveries? Third, what part has social support played in the relationships between distress and participants' recovery trajectories?We conducted a cross-sectional online survey of a convenience sample of survivors of the Manchester Arena bombing (N = 84) in January 2021 (3 years 8 months post-incident), and a longitudinal study of the same participants' scores on mental health measures over 3 years from September 2017.Survivors' mental well-being scores in early 2021 were significantly lower than general population norms. Longitudinal follow-up provided evidence of enduring distress. Secondary stressors, specifically disruptions to close relationships, were associated with greater post-event distress and slower recovery. We found an indirect relationship between identifying with, and receiving support from, others present at the event and mental well-being >3 years later.The Arena attack has had an enduring impact on mental health, even in survivors who had a mild response to the event. The quality of close relationships is pivotal to long-term outcome. Constructive support from family and friends, and people with shared experiences, are key to social cure processes that facilitate coping and recovery.

Stressor

10.1192/bjo.2023.527

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Citations (4)

The Common Ground in the Mental Health Impacts of Emergencies, Incidents, Disasters, Disease Outbreaks, and Conflict, and a Framework for Responding to People’s Needs

Cambridge University Press eBooks (2024)

Richard Williams John Stancombe James Ryan

This chapter introduces themes that recur throughout this book, and reflects on a collection of topics that are covered. One key theme concerns the common areas and differences in people's responses and needs before, during, and after emergencies, incidents, disasters, and disease outbreaks (EIDD). It presents a strategic approach to meeting people's mental health needs. Four areas common to EIDD are identified. First, preparedness before EIDD is critical to shaping how societies, communities, families, and people respond and recover. Second, a wide range of stressors have impacts on people affected by EIDD, and adversity and socioeconomic disadvantage play substantial parts in how people react, cope, and adapt. Third, the impacts of displacement are huge. Fourth, the wellbeing, psychosocial, and mental health agendas of care are extremely important aspects of the care that is required to meet the needs of survivors of EIDD and, often, those of their relatives.

Preparedness

Disadvantage

Stressor

10.1017/9781009019330.014

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Citations (0)