Healthcare to parents of young terrorism survivors: A registry-based study in Norway

Abstract

Objectives: To assess changes in parents' short-term and long-term primary and specialised healthcare consumption following a terrorist attack threatening the lives of their children. Design: Registry-based study comparing parental healthcare service consumption in the 3 years before and the 3 years after a terrorist attack. Setting: The aftermath of the Utøya terrorist attack. The regular, publicly funded, universal healthcare system in Norway. Parents learning of a terrorist attack on their adolescent and young adult child ren. Participants: Mothers (n=226) and fathers (n=141) of a total of 263 survivors of the Utøya terrorist attack (54.6% of all survivors 13-33 years, n=482). Main outcome measures: We report primary and specialised somatic and mental healthcare service consumption in the early (0-6 months) and delayed (>6-36 months) aftermath of the attack, both in terms of frequency of services consumed (assessed by age-adjusted negative binomial hurdle regression) and proportions of mothers and fathers provided for (mean semiannual values). The predisaster and postdisaster rates were compared by rate ratios (RRs), and 95% CI were generated through bootstrap replications. Results: Frequency of primary healthcare service consumption increased significantly in both mothers and fathers in the early aftermath of the attack (mothers: RR=1.97, 95% CI 1.76 to 2.23; fathers: RR=1.73, 95% CI 1.36 to 2.29) and remained significantly elevated throughout the delayed aftermath. In the specialised mental healthcare services, a significant increase in the frequency of service consumption was observed in mothers only (early: RR=7.00, 95% CI 3.86 to 19.02; delayed: RR=3.20, 95% CI 1.49 to 9.49). In specialised somatic healthcare, no significant change was found. Conclusion: Following terrorist attacks, healthcare providers must prepare for increased healthcare needs in survivors and their close family members, such as parents. Needs may present shortly after the attack and require long-term follow-up.