Intended for healthcare professionals


Different kinds of major incident require different mental health responses

BMJ 2018; 360 doi: (Published 16 March 2018) Cite this as: BMJ 2018;360:k1144
  1. John Green, clinical director1,
  2. Olivia Spivack, assistant psychologist1,
  3. Zahra Khaki, assistant psychologis1,
  4. t,
  5. James O’Donnell, head of outreach1,
  6. Alastair Bailey, clinical lead for trauma1
  1. 1Grenfell Health and Wellbeing Response, Central and North West London NHS Foundation Trust, London, UK
  1. Correspondence to: J Green{at}

Centred events such as Grenfell Tower are particularly challenging for local services

The psychological effect of major incidents on those involved, witnesses, and local communities is often substantial.1 Many people develop post-traumatic stress disorder (PTSD) and other trauma spectrum psychological disorders, and the prevalence of other common mental health problems also rises.1 PTSD and other mental health sequelae impair social and occupational functioning,2 affecting not only the individual but potentially the wider community.

The National Institute for Health and Care Excellence (NICE) recommends consideration of a screen and treat approach to major incidents,3 such as took place after the 2005 London bombings.4 Screen and treat requires identification of those affected by a major incident and assessment for PTSD and other psychological sequelae. Evidence based interventions, such as trauma therapies,5 are then provided for those in need. Individuals are often reluctant to seek help for mental health …

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