Hugh Colin Gallagher

Beyond Bushfires: Community, Resilience and Recovery - a longitudinal mixed method study of the medium to long term impacts of bushfires on mental health and social connectedness.

BackgroundNatural disasters represent an increasing threat both in terms of incidence and severity as a result of climate change. Although much is known about individual responses to disasters, much less is known about the social and contextual response and how this interacts with individual trajectories in terms of mental health, wellbeing and social connectedness. The 2009 bushfires in Victoria, Australia caused much loss of life, property destruction, and community disturbance. In order to progress future preparedness, response and recovery, it is crucial to measure and understand the impact of disasters at both individual and community levels.Methods/designThis study aims to profile the range of mental health, wellbeing and social impacts of the Victorian 2009 bushfires over time using multiple methodologies and involving multiple community partners. A diversity of communities including bushfire affected and unaffected will be involved in the study and will include current and former residents (at the time of the Feb 2009 fires). Participants will be surveyed in 2012, 2014 and, funding permitting, in 2016 to map the predictors and outcomes of mental health, wellbeing and social functioning. Ongoing community visits, as well as interviews and focus group discussions in 2013 and 2014, will provide both contextual information and evidence of changing individual and community experiences in the medium to long term post disaster. The study will include adults, adolescents and children over the age of 5.DiscussionConducting the study over five years and focussing on the role of social networks will provide new insights into the interplay between individual and community factors and their influence on recovery from natural disaster over time. The study findings will thereby expand understanding of long term disaster recovery needs for individuals and communities.

Where do we start? A proposed post-disaster intervention framework for children and young people

The impact of disasters on the mental health, well-being and social inclusion of children and young people is well established. However, there is very limited evidence about effective community-based interventions to support positive outcomes. In this paper, we review the empirical and theoretical evidence and propose a conceptual framework to guide longer term community-based interventions, modified from an already developed multidimensional framework for refugee integration. We demonstrate its relevance, with some adjustments, through alignment with the disaster literature, particularly as it relates to children and young people. We also pilot the framework by applying it to an analysis of the services and initiatives delivered to support children and young people following the 2009 Victorian bushfires in Australia. The results suggested a concentration of funding on individually oriented, mental health programmes targeting secondary school-aged students. This may indicate under-resourcing of initiatives for younger children. There also appeared to be very limited inclusion of programmes aiming to re-establish a sense of safety and stability. Despite recognition of the important role of schools in supporting children and young people post-disaster, the analysis of initiatives indicated there was limited external funding support for school-based programmes. There were promising indications of programmes providing opportunities for children and young people to develop citizenship in the post-disaster recovery context, and scope for this to be extended to preparedness and response roles.

Heavy Drinkers — Their Prevalence, Attitudes and Characteristics

Heavy drinkers were defined as those admitting to drinking six or more drinks every day or most days. This pattern of alcohol consumption which is equivalent to 80 or more grams of ethanol per day, puts them at ‘high risk’ of physical and / or psychosocial complications. Eleven percent of 23,673 males and 1% of 19,803 females who had a Medicheck screening were heavy drinkers. The most frequent reasons given for heavy drinking were relaxation, social contact and enjoyment of the taste. Most heavy drinkers felt that they drank more than was good for them but did not consider themselves to be ‘sick’ people in need of treatment. Heavy drinkers had a higher prevalence of psychosocial problems than moderate or light drinkers.

Ethical Use and Impact of Participatory Approaches to Research in Post-Disaster Environments: An Australian Bushfire Case Study

This paper presents a case study of Beyond Bushfires, a large, multisite, mixed method study of the psychosocial impacts of major bushfires in Victoria, Australia. A participatory approach was employed throughout the study which was led by a team of academic investigators in partnership with service providers and government representatives and used on-site visits and multiple methods of communication with communities across the state to inform decision-making throughout the study. The ethics and impacts of conducting and adapting the approach within a post-disaster context will be discussed in reference to theories and models of participatory health research. The challenges of balancing local interests with state-wide implications will also be explored in the description of the methods of engagement and the study processes and outcomes. Beyond Bushfires demonstrates the feasibility of incorporating participatory methods in large, post-disaster research studies and achieving rigorous findings and multilevel impacts, while recognising the potential for some of the empowering aspects of the participatory experience to be reduced by the scaled-up approach.

Longitudinal study of changing psychological outcomes following the Victorian Black Saturday bushfires

Objectives: To map the changing prevalence and predictors of psychological outcomes in affected communities 5 years following the Black Saturday bushfires in Victoria. Method: Follow-up assessment of longitudinal cohort study in high, medium and non-affected communities in Victoria, Australia. Participants included 1017 respondents (Wave 1) interviewed via telephone and web-based survey between December 2011 and January 2013, and 735 (76.1%) eligible participants were retested between July and November 2014 (Wave 2). The survey included measures of fire-related and subsequent stressful events, probable posttraumatic stress disorder, major depressive episode, alcohol use and severe distress. Results: There were reduced rates of fire-related posttraumatic stress disorder (8.7% vs 12.1%), general posttraumatic stress disorder (14.7% vs 18.2%), major depressive episode (9.0% vs 10.9%) and serious mental illness (5.4% vs 7.8%). Rates of resilience increased over time (81.8% vs 77.1%), and problem alcohol use remained high across Wave 1 (22.1%) and Wave 2 (21.4%). The most robust predictor of later development of fire-related posttraumatic stress disorder (odds ratio: 2.11; 95% confidence interval: [1.22, 3.65]), general posttraumatic stress disorder (odds ratio: 3.15; 95% confidence interval: [1.98, 5.02]), major depressive episode (odds ratio: 2.86; 95% confidence interval: [1.74, 4.70]), serious mental illness (odds ratio: 2.67; 95% confidence interval: [0.57, 1.72]) or diminished resilience (odds ratio: 2.01; 95% confidence interval: [1.32, 3.05]) was extent of recent life stressors. Conclusion: Although rates of mental health problems diminished over time, they remained higher than national levels. Findings suggest that policy-makers need to recognize that the mental health consequences of disasters can persist for many years after the event and need to allocate resources towards those who are most at risk as a result of substantive losses and ongoing life stressors.

Post-bushfire relocation decision-making and personal wellbeing: A case study from Victoria, Australia

Bringing together 26 case studies from six continents, this volume provides a unique resource which discusses, in considerable depth, the multifaceted matrix of natural and human-made disasters.