Topic: Disasters, terror and stress management

Post-disaster follow-up of the Utøya survivors. Experiences with measures implemented by public health care services.

Nilsen, L. G., Stene, L. E., Glad, K. A., Hafstad, G. S., & Dyb, G. (2017). Oppfølgingen av de som overlevde på Utøya. Erfaringer med tiltakene fra det offentlige hjelpeapparatet. [Post-disaster follow-up of the Utøya survivors. Experiences with measures implemented by public health care services.] Norwegian only. (Rapport 3/2017).

The purpose of this report was to investigate from a user perspective, what characterizes useful help following larger catastrophes, but also why help offered sometimes is perceived inexpedient, or insufficient.

In this study we have looked at how the survivors of the terror attack on Utøya island, assessed the measures implemented to provide follow-up after the incident. 261 survivors were interviewed in the spring of 2014 about positive and negative experiences with the follow-up they received. This qualitative data material was analyzed using thematic analysis. The help received could be categorized into four main groups: (1) psycho-social support following the model suggested by the Norwegian Directorate of Health; (2) general practitioners (GP), occupational health practitioners, and emergency rooms; (3) psychological health care; and (4) specialized somatic health care.

The proactive outreach recommended by the Directorate of Health, seems to have fulfilled its purpose in the early phase after the terror attack. Many survivors experienced, however, that the services disappeared too quickly. Many found it useful to get a designated contact person in the municipality, but it varied how this person’s role was interpreted locally. When it came to the GPs, it was emphasized positively that the helper was someone who already knew the survivor. Some experienced, however, that their GP did not realize the gravity of their situation, or lacked necessary experience. In this report, psychological health care includes both primary and specialized care. Many different treatment methods were utilized when working with the survivors, but some of them reported the treatment to be less useful because the purpose of the treatment method was not well communicated to them. Some reported that their need for help surfaced months or even years after the attack. At that point, entering the health care system could be challenging. Many were satisfied with the specialized somatic health care, mainly because the health care professionals appeared competent, whereas dissatisfaction usually resulted from a bad relation with the health care provider.
Helpers with necessary professional competence and an understanding of the situation were essential for satisfaction. Additionally, it was perceived to be important that information about purpose and content of the follow-up was well communicated. Many experienced that the follow-up did not last long enough and was not sufficiently proactive.