Wednesday, July 13, 2005

Stand down the counsellors

There was a letter in The Times this morning demanding that all everyone caught in the bombings in London last week, "including those involved indirectly and even people who experienced 'near misses'," should be offered counselling.

A few years ago there was a widespread belief that this sort of psychological first aid could prevent the development of serious post-traumatic symptoms. The trouble is that as the evidence base grew it became clear that this mass therapising was useless and could even be counter-productive.

Certainly, many people found the process intrusive. I knew a woman whose husband worked for a building society and was caught in an armed hold-up of one of its branches. She said that the general view among the staff was that the counselling was more upsetting than the original incident.

An article on the Spiked website gives a more informed view of what should be done for the psychological welfare of people who were caught in last Thursday's events. It is written by Simon Wessely, who is professor of psychiatry at the Institute of Psychiatry, King's College London, and director of the King's Centre for Military Health Research.

He says:

what people need in these first few days is the support of their family and friends, as well as practical assistance with information, finance, travel and, sadly for many, the business of organising funerals. The best immediate mental health interventions are practical, not emotional.

Many of those who are now in distress and despair will heal with time. But we know that some will not, and that some will develop serious psychological illnesses such as depression or post-traumatic stress disorder. The only way to prevent those disorders from developing was by not getting on the doomed trains - but such disorders can be treated. The Camden and Islington Mental Health Trust has been designated to organise help for individuals, and to ensure that those who do need proper psychological treatment in the coming months will receive it. But now is not the time, and counselling is not the answer.

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