Retour d’expérience des attentats du 13 novembre 2015. Prise en charge psychologique hospitalière des impliqués

Abstract

During the events of November 13, 2015 in Paris, a large number of people were involved in the terrorist attacks without being physically wounded. Most of them needed urgent medicopsychological care. To manage this flow of patients, a care set up was put in place at the Hôtel-Dieu hospital. This set up was complementary to that which was provided by the emergency psychological units. It had been used for the first time during the attacks in Paris in January 2015. It allows an immediate availability of premises, while maintaining the circuit of the usual emergencies. It includes an immediate mobilization of psychiatrists, emergency doctors and non-medical staff. A total of 646 people were admitted during the 4 weeks following the attacks, including 424 directly involved (whose lives had been directly threatened or who had been in physical or visual contact with dead people), 67 mourners, and 155 indirectly involved (which were more remote places of attacks). Most of the patients seen in this set up showed severe mental disorders (acute stress disorder, peritraumatic dissociation, repetition syndrome and avoidance behaviours). The main difficulty was to keep this set up on the long run in order to meet the needs of the continuous flow of involved patients over several weeks. Mobilizing the necessary resources mainly psychiatrists and psychologists has also been a challenge. Only a mutual engagement of emergency doctors and hospital psychiatrists allows such a set up.