Psychosocial aid provided to and sought by rescue workers after the March 2016 terrorist attacks in Brussels, Belgium. A qualitative analysis

Abstract

Background During the terrorist attacks of 22/03/2016 in Brussels, Belgium, hundreds of rescue workers were present or came to the sites to give aid to the victims. However, until now, there is little research about these first responders’ own need for aid and support immediately after their work or later, and about how they experienced that aid. Methods Using half-structured interviews, we collected data from 31 first responders including 4 nurses, 5 soldiers, 7 firefighters, 11 airport police officers and 4 Red Cross volunteers. Interviews were transcribed, coded and analyzed by two researchers. Results Generally, debriefings were organized at hoc, informal and at the day of the event. Sometimes, an additional group conversation was organized in the week or weeks later. Further initiative was left to the rescue workers themselves to find psychosocial aid, whether inside or outside their organization. Because of many contextual factors (macho culture, no sense of normality of reactions on traumatic experiences, (lack of) social support, stigma of psychosocial health, lack of understanding of those who did not experience it...) rescue workers (mostly police officers and soldiers) often did not find the necessary psychosocial aid. Some workers simply accepted that they have changed due to the attacks. Those who did search for psychological help, experience several problems: the type of help, the financial costs, a lack of recognition of the psychosocial problems, etc. Conclusions Psychosocial aid of first responders is often too short-term, ad hoc, and poorly prepared and organized. Awareness of adverse changes in health or personality can come long after the debriefing sessions. Furthermore, the quality of the debriefings is not always up to standard. Main message Psychosocial aid must not only be aimed at the short term, and must be better prepared and organized.

Walk the line: a systemic perspective on stress experienced by emergency medical personnel by comparing military and civilian prehospital settings

“…However, both in the literature and in the current interviews, one of the main barriers to seeking support is the fear to be perceived as “weak” and being stigmatized as not being able to perform the job ( 25 , 39 , 72 – 75 ). This attitude may lead to the idea that extremely stressful and untreated potentially traumatizing events are the norm rather than the exception ( 41 , 57 ) and, in extremis, could nurture feelings of indifference and compassion fatigue ( 76 – 78 ). This “big boys don't cry” attitude ( 33 ) was present in some of the current interviews as well.…”

“…According to several authors, the main common goal of using task-oriented coping over emotional-oriented mechanisms is to emotionally disconnect from the patient and its context (33,34,38). However, when this task-oriented approach tips the scale to a general emotional disconnection in the individual, persons with PTSSs may risk not seeking support and/or falling back on macho-culture behavior (33,(39)(40)(41)(42) or a "big boys don't cry" attitude (33).…”