Following the terrorist attacks that plunged France into mourning in January 2015, Santé publique France and the Île-de-France Regional Health Agency (ARS) launched an epidemiological study, I.M.P.A.C.T.S¹. This study aims to assess the impact of these events on the mental health of those affected (victims, bereaved family members, responders, and witnesses) and to describe the care and support they received. The preliminary results of this study are being released today ahead of their scheduled publication in late 2016.

I.M.P.A.C.T.S: to better understand and care for those exposed

The survey was initiated following the attacks at Charlie Hebdo, in Montrouge, at Porte de Vincennes, and in Damartin-en-Goële, and took place from June 1 to October 31, 2015. It was conducted by psychologists through interviews with 190 civilians (victims, witnesses, or bereaved individuals) and 232 professionals (firefighters, law enforcement and emergency response personnel, medical-psychological support staff, and volunteer aid workers).

Among the civilian population

Trauma still palpable 6 months later

Preliminary results reveal that the psychological impact remains significant. Thus, six months after the attacks, nearly 4 in 10 people still exhibited at least one mental health disorder: post-traumatic stress (20%); major depression (10%); anxiety disorders (30%). The survey also confirms that the more people were exposed to the attacks (directly or indirectly threatened, having seen/heard the terrorists and/or victims), the more severe the psychological trauma.

Furthermore:

• one-quarter of the people had consulted a doctor for a health problem unrelated to the events and not of a psychological nature;

• one-third of these people were unable to work due to health issues resulting from the events;

• 6% had still not returned to work six months later.

The Importance of Medical and Psychological Care

More than half of those exposed received medical and psychological care or some form of support. Those who received early care experienced half as many symptoms six months later as the others. The study shows that only 4% of civilians directly threatened sought care on their own initiative.

The survey thus highlights the importance of care in preventing mental health impacts. Identifying all victims—whether they were mere witnesses or directly threatened—to offer them medical and psychological support is a major challenge, as these individuals do not spontaneously think to consult a healthcare professional or to talk about it.

Among professionals

Particularly Vulnerable Responders

Faced with this exceptional situation, the mobilization of professionals during the events was particularly intense: on the first day, emergency responders and law enforcement were on the scene for an average of 11 hours, and one-third of professionals responded at multiple sites.

Following the events, the average duration of deployment related to these events was 17 days for emergency responders and 29 days for law enforcement.

Health consequences

Preliminary results reveal that the psychotraumatic impact was less significant among responders than in the civilian population: 3% of responders reported post-traumatic stress disorder, and 14% had at least one anxiety disorder such as anxiety or agoraphobia. It was observed that the psychopathological consequences of the event varied depending on whether or not the individual had received specific training prior to the psychological stress.

Among responders, those in law enforcement were the most exposed to the threat and experienced the greatest loss.

Professionals were heavily engaged with victims in terms of both duration and emotional intensity. The impact on the mental health of professionals was less severe thanks to the training they received and early intervention. The survey results highlight the importance of expanding training in stress management and the consequences of psychological trauma to prevent adverse health effects.

¹Investigation of post-attack traumatic symptoms and therapeutic and support interventions.