A qualitative evaluation of Southwark Council’s public health approach for mitigating the mental health impact of the 2017 London Bridge and Borough Market terror attack

BackgroundOver recent years there have been several major terror attacks in cities across Europe. These attacks result in deaths, physical injuries, and pose long-term threats to mental health and wellbeing of large populations. Although psychologists and psychiatrists have completed important work on mental health responses to disaster exposure including terrorist attacks, the mental health and wellbeing impacts of such attacks have been comparatively less examined in academic literature than the acute health response to physical injuries. This paper reflects on Southwark Council’s pioneering public health response to the June 2017 terror attack at London Bridge and Borough Market. It aims to explore the perceptions of mental health and wellbeing impact of the incident, and evaluate Council led efforts to minimise mental health and wellbeing sequelae following the attack.Methods A rapid qualitative evaluation informed by the logic underpinning Southwark Council’s response was conducted. Nineteen in-depth semi-structured interviews with consenting Southwark Council employees, residents, business owners, and workers from the London Borough of Southwark were conducted. Seven formative interviews were conducted with members of Southwark Council and other individuals directly involved in the planning and/or delivery of the mental health and wellbeing response. Twelve subsequent interviews were then conducted with residents, business owners and council employees to examine the mental health and wellbeing impacts of the attack and the effectiveness of the response. A thematic analysis of transcribed interviews was undertaken. Results The main theme found was that the attack had a wide-reaching negative impact and the main subthemes found that delivering the response was a challenge, that there was multifacted damage botha cross and within communities, and there was limited visibility of the response within the community. As such, when establishing a health and wellbeing response, public health expertise and capacity provides an opportunity to dynamically identify and respond to emerging mental health and wellbeing needs. A comprehensive systematic approach to health needs assessment which draws on knowledge and relationships of key Council workers and community stakeholders is imperative. This improves communication and working relationships between statutory organisations and community stakeholders, and ensures all groups in the community are reached and supported in a manner appropriate for them. It is also critical that mental health needs of Council staff involved in delivering such a response are met. Failure to do this risks extending the negative impacts of such events. Conclusions This article highlights the potential of taking a public health approach in the aftermath of terror attacks. This approach has already influenced the response to the Christchurch mosque shooting in 2019.