期刊论文详细信息
BMC Health Services Research
Use of mental health supports by civilians exposed to the November 2015 terrorist attacks in Paris
Thierry Baubet1  Cécile Vuillermoz2  Maude Marillier3  Yvon Motreff4  Philippe Pirard5  Lise Eilin Stene6  Stéphanie Vandentorren7  Gabrielle Rabet8  Antoine Messiah9 
[1] CESP, Inserm, Université Sorbonne Paris Nord, Villetaneuse, France;APHP, Hôpital Avicenne, Bobigny, France;Centre National de Ressources et de Résilience (CN2R), Lille/Paris, France;Department of Social Epidemiology, INSERM, Sorbonne Université, Institut Pierre Louis d’Epidémiologie et de Santé Publique, F75012, Paris, France;Non Communicable Diseases and Trauma Division, Santé Publique France, French National Public Health Agency, F-94415, Saint-Maurice, France;Non Communicable Diseases and Trauma Division, Santé Publique France, French National Public Health Agency, F-94415, Saint-Maurice, France;Department of Social Epidemiology, INSERM, Sorbonne Université, Institut Pierre Louis d’Epidémiologie et de Santé Publique, F75012, Paris, France;Non Communicable Diseases and Trauma Division, Santé Publique France, French National Public Health Agency, F-94415, Saint-Maurice, France;Team MOODS, CESP, Inserm, Université Paris-Saclay, UVSQ, 94807, Villejuif, France;Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway;Scientific and International Division, Santé Publique France (The French Public Health Agency), Saint-Maurice, France;INSERM, Bordeaux Population Health Research Center, UMR 1219, Univ Bordeaux, F-33000, Bordeaux, France;Support, Data Treatment and Analysis Division, Santé Publique France, French National Public Health Agency, Saint-Maurice, France;Team MOODS, CESP, Inserm, Université Paris-Saclay, UVSQ, 94807, Villejuif, France;
关键词: Terrorist attacks;    Mental health services;    Post-traumatic;    Stress disorders;    Health service research;    Disaster medicine;    Psychological first aid;    Mental health outreach;    Health care use;   
DOI  :  10.1186/s12913-020-05785-3
来源: Springer
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【 摘 要 】

BackgroundThe use of mental health supports by populations exposed to terrorist attacks is rarely studied despite their need for psychotrauma care. This article focuses on civilians exposed to the November 2015 terrorist attacks in Paris and describes the different combinations of mental health supports (MHSu) used in the following year according to type of exposure and type of mental health disorder (MHD).MethodsSanté publique France conducted a web-based survey of civilians 8–11 months after their exposure to the November 2015 terrorist attacks in Paris. All 454 respondents met criterion A of the DSM-5 definition of post-traumatic stress disorder (PTSD). MHD (anxiety, depression, PTSD) were assessed using the PCL-5 checklist and the Hospital Anxiety and Depression Scale. MHSu provided were grouped under outreach psychological support, visits for psychological difficulties to a victims’ or victim support association, consultation with a general practitioner (GP), consultation with a psychiatrist or psychologist (specialist), and initiation of regular mental health treatment (RMHT). Chi-squared tests highlighted differences in MHSu use according to type of exposure (directly threatened, witnessed, indirectly exposed) and MHD. Phi coefficients and joint tabulations were employed to analyse combinations of MHSu use.ResultsTwo-thirds of respondents used MHSu in the months following the attacks. Visits to a specialist and RMHT were more frequent than visits to a GP (respectively, 39, 33, 17%). These were the three MHSu most frequently used among people with PTSD (46,46,23%), with depression (52,39,20%), or with both (56,58, 33%). Witnesses with PTSD were more likely not to have RMHT than those directly threatened (respectively, 65,35%). Outreach support (35%) and visiting an association (16%) were both associated with RMHT (Phi = 0.20 and 0.38, respectively). Very few (1%) respondents initiated RMHT directly. Those who indirectly initiated it (32%) had taken one or more intermediate steps. Visiting a specialist, not a GP, was the most frequent of these steps.ConclusionOur results highlight possibilities for greater coordination of mental health care after exposure to terrorist attacks including involving GP for screening and referral, and associations to promote targeted RMHT. They also indicate that greater efforts should be made to follow witnesses.

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CC BY   

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