Trauma and Major Incidents: psychological support following Grenfell Tower

Transcription

1 Trauma and Major Incidents: psychological support following Grenfell Tower BACP 17 April 2018 Anne Scoging Head of Psychological Health London Fire Brigade

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3 Grenfell Tower Designed 1967 Built storeys Brutalist architecture Refurbished further flats added

4 Description and location Grenfell Tower, Lancaster West Estate, London, W11 1TG 24 storey residential building Ground floor crèche, nursery, youth club 129 one and two bedroom flats London Borough of Kensington and Chelsea

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6 An unprecedented incident..

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9 Number of persons rescued 65 people rescued by crews using both Standard Duration and Extended Duration breathing apparatus Extremely difficult and arduous conditions

10 Resources used >200 firefighters and officers during response phase 40 pumping appliances 7 Command Units 14 Fire Rescue Units 4 Aerials 3 Urban Search and Rescue (USAR) modules 50 specialist USAR firefighters and specially trained search dogs In total, almost 1000 personnel attended Grenfell Tower up to STOP message

11 Duration of incident Stop message was sent on 27 June 2017 at 1345 hours 13 days, 12 hours and 51 minutes after the initial call LFB Fire Investigation and Fire Engineering team members remained on scene assisting MPS investigation

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17 LFB s psychological response C&W Unprecedented incident Initial overwhelm No template Limited resources Meeting immediate need Brigade expectations Time line..

18 June 14 03:20 Call to duty counsellor Attendance at Control Control Officers seen at end of shift Support, psychoeducation, further help Impact on Control personnel Mobilisation of SCs to Paddington Welfare Centre

19 June 15 09:00 Welfare centre set up at Paddington 4 SCs in attendance Red Watch personnel seen plus some senior officers officers >200 Support, listening, trauma psychoeducation self-monitoring, how/ where to seek help C&W contact, risk assessment, referrals, notes database Impact

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21 June 16 / 17 C&W given 986 names of attenders How do we meet this scale of need? Massive volunteer response Psych. support plan MI Policy? NICE watchful waiting? CISD model? Combination?

22 Grenfell psychological support plan Immediately after shift: RW, COs seen by SCs 1-7 days after incident: all attenders contacted by telephone by SCs following C&W standard protocol Station (welfare) debriefs by operational managers Information: on intranet Coping with a potentially traumatic incident 28 day checks th July and 6-9 th August attendees visit welfare centres and talk individually to counsellors. IESr implemented Watch visits by T&W FRS trauma support staff 3 month and 6 month outreach checks to watches / SOs IESr; intranet info. Pre-interviews: IESr checks Ongoing: C&W receives counselling referrals, advice requests, station visits

23 June Priorities: Station debriefs C&W calls Red Watch Blue Watch Control Officers Senior Officers, Specialists e.g. USAR Command Units

24 Who Critical Incident When Operational managers Station debrief Immediately after ACS ACS PCIC Normalisation Psycho-education Risk Assessment Watchful waiting 1-5 days No Risk NFA Medium Risk Follow up High Risk ACS appt. Counselling Intervention 30+ days

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26 Upset by it all and feeling emotional, not sleeping so well I m having moments of what if, could I have saved more people? exhausted, seeing flashbacks of casualties faces whenever I pass a tower block feeling very numb and detached, don t quite know how to access my feelings very concerned about some of my watch I m OK, it s our job. I m not having any problems

27 July and Aug 6-9 Welfare centres visited by priority watches Staffed by HR and 64 volunteer counsellors Personnel seen individually by counsellors IESr / counsellor notes / referrals to C&W? 387 RW 214 BW 17 Control 17 Specialists 64 Tel follow ups made by C&W counsellors Support & counselling offered

28 Feeling very frustrated and angry about how things were handled no feedback " I just need a sit down with someone to talk it through unable to process Grenfell yet as too many personal issues going on..sleeping well with no more nightmares or waking up shouting aware that these feelings have recently come to the surface due to the news, social media and on going investigation I worry about how this might affect me as other experiences / incidents accumulate at times

29 Aug - Sept 15 sessions delivered.by T&W FRS TS volunteers Watches opted in. Mixed Watches & teams, people who attended as well as people who had not. Control, all on duty for incident. Sessions based on CISD Laura Lawrence Welfare Manager

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31 Sept 14 (3 mo) / Dec 14 (6mo) 3 mo IESr forms sent to watches via LMs and e-iesr to Senior Officers 192 forms returned 17 high scores >33 followed up 6 mo IESr forms sent 283 (to date) forms returned 27 scores >33

32 Counselling referrals 134 Grenfell-related counselling clients at C&W 116 self-referrals: intervention points / client referral Firefighters Charity / NHS / 3 rd sector Presentations at C&W: Post CI psychoeducation, normal processing Grenfell triggering need to resolve other personal PIs <28 days ASR > 28d single trauma PTSD (rare) >28d multiple incidents complex trauma (common)

33 Complicating factors for recovery Specific nature: threat to self, loss of life, guilt, anger, frustration Ongoing Constant triggers Media coverage; positive and negative Social media Commemorative vents Interviews; MPS, AI Public enquiry

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39 Organisational considerations Landscape has changed Organisational grief, anger and frustration Pride vs loss of life / price paid by LFB personnel Fix it now vs acceptance of complexity of trauma and time needed to heal Constant and ongoing scrutiny: press, legal processes

40 Organisational PTG? Shoots of Post Traumatic Growth? Awareness of trauma, ASR, PTSD Concern and care for watches MH Senior Officers; awareness of more needed 5 new FTE posts in C&W Wellbeing + Counselling & Trauma Service Dealing with PTE / trauma training Peer support system planned

41 Learnings How can a counselling team prepare for the unprecedented? Balance between invasion, monitoring and assistance Avoidance cannot be underestimated Peer support system Differing needs e.g. Senior Officers Anger and frustrations remain, targets? Impact on counselling team: burnout, 2ndary PTSD Evaluation of interventions; University of Reading This is a long haul

42 Thank you Operational colleagues HR colleagues All Volunteer counsellors C&W team Christine Hopfgarten Angela Gaffney Sam Kindred Gareth Brooks Lester Chern Natalie McCandless Ann Brimelow Ray Howell Ros Sewell

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