Counselling Not Helpful In The Immediate Aftermath Of A Disaster

Main Category: Psychology / Psychiatry
Also Included In: Mental Health
Article Date: 20 Jun 2007 - 7:00 PDT

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Mental health professionals should stay away during the immediate aftermath of a terrorist atrocity or environmental disaster. Forcing counselling on trauma victims not only prevents them from talking to their family and friends but could increase the risk of their developing post-traumatic stress disorder (PTSD). "It's not just about us talking to them," said Professor Simon Wessely, director of the King's Centre of Military Health Research at the Institute of Psychiatry and King's College, London. "We don't think about people talking to each other. When they do, this prevents panic and mobilises social support."

Speaking to the annual meeting today, Prof Wessely said it was a myth that most people panick after a disaster. Many involved in the bombings in London on 7 July 2005 kept calm and helped each other and there was an overwhelming sense of unity.

Prof Wessely and colleagues conducted a survey of 1,000 of ordinary Londoners immediately after the bombings. It showed that those who failed to get through to their loved ones in the immediate aftermath were the most distressed.

Most showed remarkable resilience. Only a quarter reported feeling upset when something remind them of what had happened; 8 per cent had repeated disturbing memories or thoughts, 4 per cent had difficulty concentrating and the same number had difficulty falling asleep. A third felt "fairly safe" on the tube, In a follow-up survey six months later, Prof Wessely found that 74 per cent said the bombings made no difference to their using the tube. Some 22 per cent said they used the tube less often - though the numbers using the tube have increased.

Psychological debriefing, with those involved in the disaster describing the incident and their reactions to it, did not work, said Prof Wessely, and could increase the risk of post traumatic stress disorder. What people who had been involved in traumatic incidents wanted was practical help, to be able to talk to family and friends, and information on how to get home, he said.

"We should not waste money on useless treatment for people who do not want it. We don't have to bear down on people asking, 'how was it for you?'. It interferes with natural recovery processes and impedes people talking to who they want, when they want"

Immediately after the July 7 bombings, 76 per cent of Londoners contacted their family and friends and only 1 per cent sought professional help.,. Soldiers returning from war zones wanted to talk to their peers, family and friends, not mental health professionals.

In a study of 12,200 UK service personnel coming back from Bosnia, only 15 per cent wanted to talk to manager and 1 per cent wanted to talk to a psychiatrist. Six months after the London bombings, those who were most distressed were those who were unable to contact their family and friends.

The Royal College Of Psychiatrists Annual Meeting
Edinburgh International Conference Centre
19-22 June 2007
www.rcpsych.ac.uk

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