[Evaluation of outpatient treatment units according to the Crime Victims' Regulation Act]. / Evaluation der Traumaambulanzen nach dem Opferentschadigungsgesetz in Nordrhein-Westfalen.

OBJECTIVE: Over the past years, 35 trauma outpatient units have been established in accordance with the Crime Victims' Compensation Act in the federal state of North Rhine-Westphalia (Germany) for both children and adolescents as well as for adults. They are operated by the social welfare authorities and, since 2008, by the regional authorities of Westphalia-Lippe and Rhineland. They enable victims to receive qualified psychotraumatological help within the first few days after suffering violence. Since trauma units have now been set up across most parts of this federal state, the time has come to assess the effectiveness of their acute care provision to victims of violence. METHODS: In 2007, on the order of the Ministry of Labour, Health and Social Affairs of the federal state of North Rhine-Westphalia, trauma outpatient units were subjected to scientific evaluation. In 17 trauma outpatient units, a data assessment protocol was officially implemented that included repeat measurements (immediately before the initial contact, after completion of intervention, at follow-up six months after intervention) of traumatized subjects aged 14 and older. Socio-demographic data were gathered, and the scores of the Impact of Event Scale - Revised (IES-R), the Symptom Checkliste-27 (SCL-27), the simplified Beck Depressions Inventory (BDI-V), the Global Assessment of Functioning Scale (GAF) as well as the Cologne Risk Index (CRI) (expert rating) were collected. RESULTS: Nearly three-fourths (65.9 %) of the traumatic experiences of the 211 patients investigated can be characterized as type-1 traumatisation. 31.8 % of patients were victims of crimes involving violations of the right to sexual self-determination (94.0 % of sexual offences being committed against girls and women). Crimes against physical integrity, which according to crime statistics are the most frequent of crimes against individuals (88.8 %, 34.8 % females), were suffered by 36.0 % of all patients of the trauma outpatient units (63.2 % being females). In 57.1 % of the victims, the interval between the traumatic event and initial intervention was less than a month. In 51.7 % (n = 109), suspicion of PTBS (F43.1) was raised at the initial presentation. The average of all instruments yielded an effect size of d = 1.04 (SD = 0.28) in a pre-post comparison. Pair-wise comparison showed highly significant differences in averages between pre and post (that is, between initial and follow-up measurements) in the sense of marked symptom reduction for all scales. CONCLUSIONS: The services of the trauma outpatient units are utilized in a timely and targeted fashion. The calculated effects show that the trauma outpatient units offer highly effective services to crime victims seeking help there.

European Commission project: European Guideline for Target Group-Oriented Psychosocial Aftercare-Implementation.

After disasters, the individual health and well-being of first responders and affected population are affected for years. Therefore, psychosocial help is needed. Although most victims recover on their own, a minority of survivors, members of rescue teams, or relatives develop long-term, disaster-related psychic disorders, such as post-traumatic stress disorder (PTSD). This subgroup especially should receive timely and appropriate psychosocial help. Many European countries offer post-disaster psychosocial care from a variety of caregivers (i.e., professionals and volunteers, non-governmental organizations, church or commercial organizations). Therefore, European standards for providing post-disaster psychosocial support currently is required. This article describes the project European Guideline for Target Group-Oriented Psychosocial Aftercare-Implementation, supported by the European Commission.