Proactive psychosocial follow-up of youth exposed to a terrorist attack: longitudinal study linking interviews and register-based data.

Background: Knowledge on efficient approaches to the provision of post-disaster psychosocial care is urgently needed. To prevent unmet healthcare needs, proactive follow-up by municipal contact persons was recommended for survivors of the Utøya youth camp attack in Norway.

Aims: To examine characteristics of the survivors by whether or not they had a contact person in the early (0-5 months), intermediary (5-15 months) and long-term (20-32 months) aftermath of the attack, and to describe the survivors' experiences with the contact person.

Method: We analysed data from three waves of interviews with survivors conducted 4-5, 14-15 and 30-32 months after the attack, as well as register-based data on the use of mental health services from 3 years before until 3 years after the attack.

Results: Survivors with a contact person early post-attack were less likely to receive care from mental health services concurrently or to have anxiety/depression symptoms subsequently compared with survivors without a contact person in the same period. Survivors with a contact person in the intermediary aftermath were more satisfied with the overall help they received, but also more likely to have long-term anxiety/depression symptoms. Survivors with a contact person in the long term were more likely to be financially disadvantaged. Approximately half of the survivors with a contact person found this highly or very highly useful, whereas one-third found it of little use or not at all useful.

Conclusions: The proactive outreach reached survivors across sociodemographic characteristics during the recommended first year of follow-up, which could be conducive to prevention of unmet healthcare needs. Still, there was considerable variation in the perceived usefulness and duration of the follow-up.