Six weeks on from the Manchester terror attack, NHS England has today sent an open letter to GPs across the country with practical advice to help patients who may be suffering ongoing mental health problems following this and other recent traumatic events.

Experts have said that it is around this point that people should be seeking help if they are still experiencing symptoms.

In today’s letter, which has also gone to other healthcare professionals, Dr Arvind Madan, Deputy Medical Director and Director of Primary Care outlined the symptoms to watch out for in the aftermath of a traumatic event, in the weeks after and that if symptoms are severe and continue for more than four weeks, a referral to specialist service may be required.

The open letter comes after the recent terror attacks in Manchester and London and the Grenfell tower block fire.

The letter describes how people with pre-existing mental illness may be destabilised by traumatic events. It also points to evidence-based advice for GPs who are treating patients who have been affected, as follows:

• it is normal to have strong emotional responses to traumatic events;
• it is important to keep communicating with each other, and to use support helplines;
• we all need to make space and time to talk and listen.

As well as outlining important symptoms to watch out for, the letter recognises that children and young people experiencing symptoms which may indicate PTSD might think differently about themselves or other people. They might:

• blame themselves or show lowered self-esteem;
• think that they are a bad person or deserve bad things to happen to them;
• show less trust in other people and be less able to experience a sense of safety;
• experience overwhelming shame, sadness or fear; and/or
• avoid situations where fear could increase their emotional response, that might make them feel more frightened or reminded of the event.

Claire Murdoch, National Clinical Director for Mental Health said: “We must remember that for those people who were affected by these horrific tragedies, the journey is not over and many will continue to face difficulties. From day one of each of these incidents, staff have been working incredibly hard on making sure that mental health support is available for those who need it – we want everyone who has been affected to know that there is always support available and  how and when they should access it.

“We also need to ensure we continue to support our dedicated NHS staff who have showed incredible fortitude and bravery in tending to the sick and injured as each of these terrible events has unfolded.”