Two-thirds of the adults who survived or were affected by the Grenfell fire have shown signs that they require treatment for post-traumatic stress disorder (PTSD), according to an official report.



The document reveals that more than 2,200 people had been screened for PTSD by the end of last month, including those who lost family members, were rescued or who were evacuated from the tower and 67% of adults were assessed as needing treatment.

The findings have raised alarm within the Grenfell response teams because the proportion is so high – typically, the NHS estimates that one in three people experience PTSD when exposed to a traumatic event.

The report says there is also a “significant risk” of secondary trauma, where people are affected by events even though they were not directly exposed to them.

Local health agencies are now “working alongside schools to carry out a ‘screen and treat’ programme for children” who might have been affected, it says.

Though the figures are not definitive and other factors may be at play, the report acknowledges that the “scale of this response is unprecedented for the UK … further research will be required to better understand the implications”.

Natasha Elcock, from the Grenfell United group of survivors and bereaved, said it was not surprising that so many people were experiencing trauma. “It has affected our whole community. It was a hugely traumatic experience, on the night and the days and weeks after,” she said.

The details are set out in a 117-page report prepared for the Royal Borough of Kensington and Chelsea (RBKC) and presented to its leadership team last week. The report, called A Journey of Recovery, sets out many of the difficulties facing the various bodies responding to the fire during a period in which “there has been a collapse of trust in public authorities, particularly the council”.

In the year since the fire claimed 72 lives, local GPs, NHS outreach teams and other mental health services have been undertaking screening programmes to help monitor the mental health of those people potentially affected by the tragedy.

The tests on the adults who survived the fire were considered necessary because of the unique nature of the event and how its effects rippled across the borough. The report says the number of people potentially affected by the tragedy is likely to spread far beyond the immediate survivors and the relatives of those who died.

“Witnessing a disaster unfolding over hours, powerless to help those in the tower, left very deep wounds for many people,” the report says. “The area has many large tower blocks and the fire was seen by many, either from their homes or from the surrounding streets by those who came to try and assist. The shell of the tower remained visible for many months after the fire, a daily reminder to those living and working locally of that night.”

The report says the 67% “rate of screening positive [for PTSD] is higher than found in other post-trauma contexts”.

PTSD can take different forms, and symptoms can include anxiety disorders, nightmares and flashbacks.

The report says: “As well as many local people, many first responders on the scene on the night of the fire will have been significantly at risk of PTSD. Firefighters, NHS staff, police, council staff and many from the community and voluntary sector will have been deeply affected.”

The report says the screening has focused on those most likely to have been affected by the fire. Although a breakdown of the figures is not given, it says the rate among those living nearby who were not evacuated was lower, at between 26% and 48%.

Another contributory factor could be the makeup of the local population, some of whom may have been exposed to trauma before the Grenfell fire. The report notes that many people living in the area around the tower in North Kensington are “people with poor mental health and previous exposure to traumatic events, for example those who are refugees, fleeing violence and persecution, [with a] large number of children and struggling financially.” This could have increased the impact of the disaster on some people, the report says.

“The 67% figure is very high,” said a council source. “We need to interrogate this further. We don’t know how much of this is down to the fire itself or whether the testing has uncovered previously unreported mental problems in the area that have existed for years without anyone realising.”

Dr Jim Bolton, a consultant psychiatrist and member of the Royal College of Psychiatrists, said that typically only a minority of people would become ill after a trauma. “The most common problems will be anxiety and depression and excessive use or alcohol and drugs … only a small minority will have PTSD.”

He said the high level of positive results for the Grenfell screening was unlikely to translate to that many people suffering from the severest forms of PTSD. “The screening does not come up with a diagnosis – it helps to identify people who need help,” he said.

Elcock described how Grenfell United has worked with the local NHS trust to shape the service provided to all those affected by the fire.

“We’ve needed to be creative and help the NHS trust come up with new ways of working, taking into consideration the culture and diversity of our community,” she said. “It’s going to be an effort for years to come as the wellbeing of our community will always be a priority for us.”

In a draft recovery strategy, which was also circulated to the RBKC leadership team last week, the council said it had undertaken a huge amount of work already to support the mental health needs of the community.



But it acknowledged: “There is more work to do … we are committed to ensuring that the urgent and pressing needs of those affected are met effectively in the here and now.”

A spokesperson for RBKC said the council had commissioned a series of emotional health and wellbeing services for those affected by the tragedy. These included enhanced emotional support in local schools, including counselling and art therapy.

• This article was amended on 25 July 2018. Dr Jim Bolton is a consultant psychiatrist, not psychologist as an earlier version said.

