Rafael Castro Delgado
Doctor of Medicine, Full Professor of Emergency Medicine at the University of Oviedo, emergency physician (SAMU-Asturias), researcher at the Asturias Health Research Institute, coordinator of the Pre-hospital Care and Disaster Research Group, and director of the Pre-hospital Care Research Network and advisor to WHO technical working groups related to emergencies and disasters
The train accident in Adamuz does not only have immediate physical consequences; the emotional impact can be profound and long-lasting, affecting not only the direct victims, but also their families, the survivors and, to a lesser extent, the population that regularly uses the high-speed train.
In the case of the relatives of the deceased, grief is often marked by the suddenness of the loss, the uncertainty of the first few hours and, on occasions, by media exposure that is difficult to deal with. All of this can lead to anxiety, depressive symptoms or complicated grief processes, which makes it particularly important to differentiate between the emotional reactions that are to be expected in the face of a traumatic loss and those that require specialised and sustained psychological intervention over time.
Among survivors, even when physical injuries have been minor, it is not uncommon for acute stress reactions, intrusive memories, sleep difficulties or persistent fear related to travel to occur. If these symptoms are not identified and addressed early on, there is a risk that they will develop into post-traumatic stress disorder requiring specific and specialised treatment.
We must not forget the first responders (emergency medical personnel, firefighters, police officers, and volunteers), who may also be emotionally affected by the magnitude of the accident. Direct exposure to traumatic scenes, the pressure to make quick decisions, and the sense of responsibility towards the victims can lead to acute stress, anxiety, or difficulties in processing the experience.
Psychological care and post-intervention support are essential to prevent exhaustion, burnout or symptoms of post-traumatic stress in these professionals, which must be approached from a proactive perspective by those responsible for emergency services, through the implementation of psychological care programmes for professionals.
The impact of the accident also extends to regular high-speed rail users. Following an event of this nature, it is understandable that there may be a temporary loss of confidence and an increase in fear of travelling. In this context, clear, rigorous and transparent institutional communication is key to reducing public alarm and restoring confidence.
Experience in emergency management shows that integrating psychological and psychosocial care in an appropriate manner, both in form and in timing, into the response to such events is essential to alleviate suffering and prevent negative consequences in the medium and long term.