NHS England has produced this guidance which is aimed at anyone exposed to the incident at Manchester Arena that took place on 22 May 2017. The emotional effects will be felt by survivors, bereaved families, friends, emergency services, health care workers and the general public. If you witnessed or lost someone in the attack you will most certainly have a strong reaction. Reactions are likely to be strongest in those closest to the incident, who directly witnessed the aftermath and who were involved in the immediate care of victims.

Common reactions to traumatic events
The following responses are normal and to be expected in the first few weeks:

Emotional reactions such as feeling afraid, sad, horrified, helpless, overwhelmed, angry, confused, numb or disorientated
Distressing thoughts and images that just pop into your head
Nightmares
Disturbed sleep or insomnia
Feeling anxious
Low mood

These responses are a normal part of recovery and are the mind’s mechanisms of trying to make sense and come to terms with what happened. They should subside over time.
What can people do to cope?
The most helpful way of coping with an event like this is to be with people you feel close to and normally spend time with.
If it helps, talk to someone you feel comfortable with (friends, family, co-workers) about how you are feeling.
Talk at your own pace and as much as you feel it’s useful.
Be willing to listen to others who may need to talk about how they feel.
Take time to grieve and cry if you need to. Letting feelings out is helpful in the long run.
Ask for emotional and practical support from friends, family members, your community or religious centre.
Try to return to everyday routines and habits. They can be comforting and help you feel less out of sorts. Look after yourself: eat and sleep well, exercise and relax.
Try to spend some time doing something that feels good and that you enjoy.
Be understanding about yourself.

How can children be helped to cope?
Let them know that you understand their feelings.
Give them the opportunity to talk, if and when they want to.
Respect their pace.
Reassure them that they are safe.
Keep to usual routines.
Keep them from seeing too much of the frightening pictures of the event.

When should a person seek more help?
In the early stages, psychological professional help is not usually necessary or recommended. Many people recover naturally from these events. However, some people may need additional support to help them cope. For example, young children, people who have had other traumatic events happen to them and people with previous mental health difficulties may be more vulnerable.

If about a month after the event anyone is still experiencing the following difficulties, it is a good idea to seek help:
Feeling upset and fearful most of the time
Acting very differently to before the trauma
Not being able to work or look after the home and family
Having deteriorating relationship difficulties
Using drugs or drinking too much
Feeling very jumpy
Still not being able to stop thinking about the incidents
Still not being able to enjoy life at all

You can access help by:
Speaking to your local GP
Accessing your local NHS psychological therapies service:
– West Cheshire: 01244 397 764
– Eastern Cheshire: 01625 469 955
– South Cheshire / Vale Royal: 01606 555 260
– Wirral: 0151 649 1859
– Liverpool: http://www.merseycare.nhs.uk/ / 0151 250 3000
– Halton: http://www.nwbh.nhs.uk
– St Helens: http://www.lancashirecare.nhs.uk/mindsmatter
– South Sefton: http://www.merseycare.nhs.uk/ / 0151 250 3000
– Southport and Formby: http://www.merseycare.nhs.uk/ / 0151 250 3000
– Warrington: http://www.warringtoniapt.org.uk/ / 01925 401 720
– Knowsley: http://www.nwbh.nhs.uk
Samaritans (116 123) operates a 24-hour service available every day of the year
Childline (0800 1111) runs a helpline for children and young people in the UK. Calls are free and the number won’t show up on your phone bill
PAPYRUS (0800 068 41 41) is a voluntary organisation supporting teenagers and young adults who are feeling suicidal
The Sanctuary (0300 003 7029) operates a 24-hour service available every day of the year, for people who are struggling to cope – experiencing depression, anxiety, panic attacks or in crisis