The Manchester bombing: Providing a rational response

This paper describes the response of the psychological services in one major teaching hospital in Manchester to the Manchester bombing in June 1996. One hundred and two patients attended the hospital on the day of the bombing. A decision was made, not to offer these patients debriefing, but to screen them 8 weeks later and provide psychological treatment for high scorers on the Impact of Events Scale and a modified PTSD symptom measure. Seventy-four patients were sent screening questionnaires and 25 patients returned them. Twelve scored above threshold. Two were children who were referred to local child psychiatry services, two patients declined further help and eight were offered psychological treatment. Two further patients improved before treatment was actually started and one other patient severed all contact with the department. Five patients completed treatment, all showing a good response. Rather than providing all patients with debriefing shortly after the bombing, by screening patients and providing treatment to a small percentage (those who most needed it), relatively scarce psychiatric services were used in an efficient and effective manner. In view of the potential harmful effects of debriefing, this paper provides a model for service intervention following major disasters.