UNDERSTANDING TERROR AND VIOLENCE IN THE LIVES OF CHILDREN AND ADOLESCENTS Early outreach to survivors of the shootings in Norway

Background: Under-treatment and unmet needs among survivors have been documented years after terror attacks. Improved early and proactive outreach strategies, including targeted interventions for individuals in need, are required. After the terrorist attacks in Norway on 22 July 2011, a national, proactive outreach strategy was developed and implemented to help those who were directly affected. Objective: The aims of this study were threefold: (1) to investigate whether the survivors at the island of Utøya had received proactive outreach from the municipalities, (2) to examine the relationships between received health services and the survivors ’ level of exposure and post-trauma health problems, and (3) to explore the level of unmet needs among survivors 5 months post-terror. Method: Three hundred and twenty five survivors (M age19.4, SD4.6, 47.1 % females, response rate 66%) of the 2011 massacre on Utøya Island, Norway, were interviewed face-to-face 45 months post-terror. The survivors were asked if they had received proactive outreach from their municipality, and what type of health services they had received. Survivors ’ level of peri-trauma exposure, loss and injury, posttraumatic stress reactions, symptoms of anxiety and depression, somatic health problems, and sick leave, were assessed. Results: Most participants (87%) reported that they had received early and proactive outreach, and most (84%) had a contact person. In addition a majority of the survivors has received support from their genera