Developing the role of public health in responding to mental health and wellbeing needs after mass casualty incidents: experience at London Bridge and Borough Market, June, 2017

Abstract Background On Saturday, June 3, 2017, a terrorist attack at London Bridge and Borough Market in the London borough of Southwark resulted in the death of 11 individuals, including the three perpetrators. 48 people were injured. A mental health and wellbeing subgroup of the Humanitarian Assistance Steering Group was immediately formed, co-chaired by the Director of Public Health, to assess and respond to the mental health and wellbeing needs of those affected by the attack. We report on key aspects of this response. Methods The public health response was developed at pace amid a dynamic operational environment. Drawing on the evidence base and professional opinion, the public health team led and coordinated a comprehensive needs assessment to assess and anticipate the mental health and wellbeing needs of the groups affected. A gap analysis then identified whether services were available locally to meet identified needs, and what further support was required. Development of the needs assessment and gap analysis was informed by rapid literature review that focused on deriving learning from previous similar events. Operational and clinical academic expertise was utilised from partners within and outside the organisation. Findings Public health assisted with three key aspects of the response: development and delivery of appropriate, effective, and timely interventions to address mental health and wellbeing needs based on psychosocial support; development of evidence-based messaging to the public and health-care providers; and documented learning throughout to contribute to the evidence-base and improve management of future events. Further work by an independent research team to evaluate the mental health and wellbeing response is underway. Early findings suggest that a more comprehensive approach to identifying the full breadth of community needs would have been useful. Although the response addressed the needs of groups with established representation, other groups did not receive proactive advice and support. More focus is also needed on addressing the wellbeing needs of council staff. Interpretation Public health leadership can strengthen a local humanitarian response by providing system leadership and coordination, engaging expertise and drawing on the evidence-base to support decision making, and facilitating evaluation strategies to derive learning from the process. Funding None.