School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
BMC Psychol. 2021 Feb 2;9(1):22. doi: 10.1186/s40359-021-00527-4.
A 2017 terrorist attack in Manchester, UK, affected large numbers of adults and young people. During the response phase (first seven weeks), a multi-sector collaborative co-ordinated a decentralised response. In the subsequent recovery phase they implemented a centralised assertive outreach programme, 'The Resilience Hub', to screen and refer those affected. We present a process evaluation conducted after 1 year.
Case study, involving a logic modelling approach, aggregate routine data, and semi-structured interviews topic guides based on the Inter-Agency Collaboration Framework and May's Normalisation Process Theory. Leaders from health, education and voluntary sectors (n = 21) and frontline Resilience Hub workers (n = 6) were sampled for maximum variation or theoretically, then consented and interviewed. Framework analysis of transcripts was undertaken by two researchers.
Devolved government, a collaborative culture, and existing clinical networks meant that, in the response phase, a collaboration was quickly established between health and education. All but one leader evaluated the response positively, although they were not involved in pre-disaster statutory planning. However, despite overwhelming positive feedback there were clear difficulties. (1) Some voluntary sector colleagues felt that it took some time for them to be involved. (2) Other VCSE organisations were accused of inappropriate, harmful use of early intervention. (3) The health sector were accused of overlooking those below the threshold for clinical treatment. (4) There was a perception that there were barriers to information sharing across organisations, which was particularly evident in relation to attempts to outreach to first responders and other professionals who may have been affected by the incident. (5) Hub workers encountered barriers to referring people who live outside of Greater Manchester. After 1 year of the recovery phase, 877 children and young people and 2375 adults had completed screening via the Resilience Hub, 79% of whom lived outside Greater Manchester.
The psychosocial response to terrorist attacks and other contingencies should be planned and practiced before the event, including reviews of communications, protocols, data sharing procedures and workforce capacity. Further research is needed to understand how the health and voluntary sectors can best collaborate in the wake of future incidents.
2017 年，英国曼彻斯特发生了一起恐怖袭击事件，影响了大量成年人和年轻人。在应对阶段（最初的七周），多部门协作协调了分散的应对措施。在随后的恢复阶段，他们实施了一个集中的果断外展计划，即“韧性中心”，对受影响的人进行筛查和转介。我们呈现了在 1 年后进行的过程评估。
案例研究，采用逻辑建模方法、汇总常规数据和基于机构间协作框架和 May 的正常化过程理论的半结构化访谈指南。从卫生、教育和志愿部门（n=21）和一线韧性中心工作人员（n=6）中抽取具有最大变化或理论代表性的领导者进行同意和访谈。两名研究人员对转录本进行了框架分析。
权力下放的政府、协作文化和现有的临床网络意味着，在应对阶段，卫生和教育之间很快建立了合作。除了一位领导者外，所有领导者都对应对措施给予了积极评价，尽管他们没有参与灾难前的法定规划。然而，尽管得到了压倒性的积极反馈，但仍存在明显的困难。（1）一些志愿部门的同事认为，他们需要一些时间才能参与其中。（2）其他志愿和社区部门组织被指责不恰当地、有害地利用早期干预。（3）卫生部门被指责忽视了那些低于临床治疗门槛的人。（4）有人认为，各组织之间存在信息共享的障碍，这在试图接触第一反应者和其他可能受到事件影响的专业人员方面尤为明显。（5）中心工作人员在转介居住在大曼彻斯特以外的人方面遇到了障碍。在恢复阶段 1 年后，已有 877 名儿童和青少年以及 2375 名成年人通过韧性中心完成了筛查，其中 79%的人居住在大曼彻斯特以外的地区。
应在事件发生之前计划和演练恐怖袭击和其他突发事件的心理社会应对措施，包括审查沟通、协议、数据共享程序和劳动力能力。需要进一步研究以了解卫生和志愿部门如何在未来事件发生后最好地合作。
