Evaluation of mental health outcomes following major incidents
What were we trying to do?
In Manchester, on 22 May 2017, a suicide bomber killed 22 people and himself, physically injuring 239 children and adults. The resilience hub, or ‘hub’ was established to facilitate a screen-and-treat assertive outreach model with public health and clinical components. This was supported by clinical care pathways that were developed for children and young people and adults (public and professionals). The overall aim of this project was to maximise learning from the mental health response to the Manchester Arena attack in 2017.
Why was it important?
The chance of developing post-traumatic stress disorder (PTSD) within one year of a major incident is 33-39% for those physically present, 17-29% for those close to the killed and injured, 5-6% of emergency workers and 4% of recovery workers. Children are particularly vulnerable. The economic burden of mental health care is substantial and evidence of considerable unmet need. A small number of studies had assessed the medium- to long-term trajectories of people’s mental health following a major incident, but few studies had assessed needs beyond 12 months or evaluated factors that influence long term recovery.
This project had direct benefits for Greater Manchester as well as sharing learning nationally and internationally. The COVID pandemic also highlighted interest in research and learning related to major incidents and pandemics.
How did we do it?
Thousands of people engaged with the hub, which facilitated interventions on the basis of need and in line with NICE recommendations. The screening measures were completed when a person registered with the hub, emails were then sent at multiple timepoints (3, 6, 9, 12, 24, 30 and 36 months) inviting people to repeat the measures.
The mental health response to the Manchester Arena attack was assessed by:
1. Enhancing our understanding of the development and expression of distress among participants following the attack through longitudinal follow-up:
- Individuals were identified by both mental health trajectory (resilient, slower recovery, deteriorating/prolonged stress, high stress) and client group (children and young people (under 18 years), adult (over 18 years) or professional (affected in professional capacity rather than as a member of the public).
- Demographic and clinical information was collected from clinical notes, including response to screening questionnaires at multiple time points up to 36 months post event to evaluate longitudinal trajectories of participants’ responses to the arena event.
2. Identifying what psychosocial, contextual factors and post-event experiences of social support have helped or hindered participants’ recovery, including how informal social support processes in participants’ groups and networks may have served to mitigate some of their distress:
- An online survey was done, at 36 months and 48 months, of people who had been in contact with the hub asking them for factors that they thought had helped or hindered their recovery, including the quality of care and service user experience of the hub and other key support.
- Semi-structured qualitative interviews were done to assess the acceptability of the hub and services provided and how multiple group memberships became salient and shaped our expectations of support.
Who did we work with?
Downloadable resources
More information
Programme Manager
Gill Rizzello
gill.rizzello@manchester.ac.uk