Table 5 Information identified about the psychosocial care response, Brussels 22 March 2016 attacks, Belgium. Acute = first hours/days after attacks. Medium/long-term = weeks/months/years after the attacks

Acute

Victims, their families and witnesses.

The Federal Administration for Public Health (FOD Healthcare), the centre for crisis psychology of the federal service of defense, the services of the municipalities, with assistance from the local police services, and victim support organizations. The Red Cross and companies struck by the attack (e.g., the airport) were also important in the organization and provision of psychosocial care.

In the acute phase, the psychosocial assistance network of the local municipality was called for. This network was composed of different local services and was in charge of the psychosocial care in reception centres for non-injured victims and relatives of the victims organized at the municipal level. The psychosocial assistance was categorized into basic assistance (including sheltering if needed), information, emotional and social support, practical help and healthcare in case of health problems. The federal services for public health should appoint a psychosocial manager to coordinate the psychosocial care response. In case of large-scale events, specialized assistance above local level should be provided on, e.g., collection and treatment of information (concerning victims) in a central information point, acute psychosocial care, phone lines for affected people and relatives, collaboration and information exchange with the Disaster Victim Identification team of the federal police and eventual support in the reception structures. From 2 p.m. on the day of the Brussels attacks, a reception centre for the close ones of victims was opened at a military hospital. Representatives from the medical services, the police, the defense and the legal authorities were present at the centre. During the acute phase, the main coordination of the psychosocial care was at the federal level. The Red Cross assisted with the organization. There is a psychosocial intervention plan which has two phases: an acute phase and a long-term phase. A part of this plan is that the centre for crisis psychology of the federal service of defense gives psychosocial support during crisis.

[56, 71]

Acute

General population.

Cities and municipalities.

On a local level, the cities and municipalities were responsible for providing support. This could for example be to set up a centre for first psychosocial aid, in cooperation with the police.

[56]

Long-term

Victims and families.

Community level (there are in total four, each with own government: one in Brussels, as well as a French-speaking, a Dutch-speaking and a German-speaking).

In the long-term, the responsibility for the psychosocial care after the attacks was transferred from the federal level to the communities. The public health department of the federal public services was responsible for the organization of an adequate transfer toward the local communities that were competent to ensure necessary support during the post-acute phase. A lack of long-term psychosocial follow-up was reported, due to lack of communication between the federal and the local authorities, resulting in no overlap between acute and long-term help.

[72, 73]