Responding to mental health needs after terror attacksBMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l4828 (Published 13 August 2019) Cite this as: BMJ 2019;366:l4828
All rapid responses
The natural history of psychological trauma has been presented in a “Snakes & Ladders” model (1).
An easily achievable physiological technique, BabyGaze (2), has been demonstrated to rapidly resolve anxiety and panic. Further, it has been shown that the ‘da Vinci Gaze’ technique (3) helps resolve the mismatch of egocentric experience and allocentric understanding that we believe occurs in trauma. These simple techniques require no specialist knowledge or skills and have been effectively taught to groups of up to 60 in under an hour.
Provision of effective mental health services to affected survivors after a traumatic event is clearly essential. Mental Health First Responders should be equally as available as Medical & Physical First Responders.
A simple orientation and calming approach could be taught to event security staff for use in situations like that in Manchester and, for example, to chaplaincy staff who might have the added advantage of access to familiar local places (e.g. of worship) to be used as Mental Health reception centres.
Given that an event occurred outside BMA House in London, perhaps the BMA might organise a meeting of interested parties there to agree a framework for the immediate mental health response to future attacks, flexible enough to be applied quickly in any location.
1. Dutton P. V. & Ashworth A. J.
The natural history of recovery from psychological trauma: An observational model.
Medical Hypotheses 85 (2015) 588–590; 2015.
2. Ashworth A. J. & Dutton P. V. BabyGaze: A Rapid Neurobiological Intervention for Anxiety, Panic and Anger Int J Psychiatry, 2017 ISSN: 2475-5435; 2017.
3. The Ashworth-Dutton neurobiological model of psychological trauma: including the da Vinci Gaze resolution method. Andrew J Ashworth J Addict Res Ther 2018 Vol 9 DOI 10.4172/2155-6105-C2-038
Competing interests: AJA is a former BMA Councillor and has presented the simple calming techniques described to paying audiences at the Edinburgh Fringe
There is a political bias with regard to the current 'war on terror'.
Any perusal of medical journals - such as the British Journal of Psychiatry - will locate many articles on the mental health of veterans in Afghanistan or Iraq, or of terror victims in the West.
The coverage in the medical literature on the mental illness produced by western attacks in the Middle East and Central Asia is little, or nothing, in comparison. Yet, across a shattered Afghanistan, for example, the fear of unpredictable drone attacks, the night raids on villages, the torture in military bases, must surely be increasing psychosis and depression in a very Third World population.
The implication is that the mental health of Third World peasants matters less than that of the apparently sophisticated citizens of the West.
This article in the BMJ concludes that the problem is 'international', but this is unlikely to mean the imperilled mental health in villages searched through and bombed by western armies.
Politics is always tribal, but medicine that is not universal in spirit is not really medicine at all.
Competing interests: I am an elderly man with Afghan heritage