2.5 Considerations in providing disaster mental health and wellbeing support
2.5.1 Psychological impacts of disaster
People show considerable resilience in the face of potentially traumatic events, especially when they are able to meet basic needs, access social supports, and re-establish community networks quickly. In Australia, a major study found that one decade after the 2009 Black Saturday bushfires nearly two-thirds of people felt that they were ‘fully’ or ‘mostly’ recovered.5 Some reported stronger relationships and had experienced a positive transformation in their lives.
However, Australian and international research also shows how disasters and their aftermath can erode mental and emotional health and wellbeing. Short-term distress responses are common, and long-term and severe mental health problems are experienced by a significant minority.6 See Informing the Framework - Supporting Evidence.
For people who already experience mental ill-health (one in five of the Australian population aged 16 years and over), the stress of the disaster and disruption to usual support can lead to a worsening of symptoms. The Framework addresses services and supports for distress, anxiety, and grief, as well as for clinically diagnosable mental illness.
Everyone’s response to traumatic incidents such as a disaster is unique and influenced by their personal history, their context, and the protective factors in their life. Exposure to historical, repeat, and successive trauma events as experienced by refugees, survivors of family violence, and emergency services workers can be particularly challenging. Aboriginal and Torres Strait Islander People may also experience cumulative impacts due to previous exposure to trauma, as well as unique vulnerabilities arising from loss of cultural heritage and social disadvantage.
In short, the Framework addresses the mental health and wellbeing needs of individuals, families and communities who, because of exposure to a hazard with potentially disastrous impacts, are exposed to severe stress and/or who face a crisis outside the bounds of their everyday coping strategies.
2.5.2 Mental health and wellbeing response challenges during disasters
People experiencing crisis situations need the opportunity to access several layers of support, from informal family and community support to more specialised services. Formal services and supports available during and following a disaster are not always planned in advance and well-aligned to community needs. The timeliness of services is critical. Administration and funding processes can mean services are available too late or for too short a period, with people on long waiting lists. Access challenges can arise from poor planning and coordination, inconsistent funding, eligibility barriers, and workforce shortages. Services may not be sufficiently tailored to the local geographic, economic, and social context or the preferences and needs of people affected by the disaster.
For this reason, local services with an existing client base and pre-existing relationships within the service ecosystem are favoured, if available, and assuming a surge in demand can be handled. Both local government staff and other local workers may be dealing personally with the same disaster which can limit their capacity to help others (although their first-hand experiences also allows them to connect strongly with those in need). Proactive outreach is necessary since stigma remains a barrier to people accessing support and treatment for mental ill-health. People may be distressed but reluctant to seek help because of how this may be perceived by friends and workmates, or because they feel others are more deserving. Many people deal first with their and their families’ physical health issues, and for some groups (for example, emergency workers) mental health challenges are commonly uncovered this way. Upskilling community members to identify common stress reactions, signs, and symptoms of mental ill-health is beneficial on an ongoing basis given mental health challenges can emerge a long time after the initial event.
Finally, it is important to minimise the secondary stress that comes from repeated efforts to navigate complicated sources of help. Services that are welcoming, non-judgmental, flexible, and able to connect with an individual’s needs at the right time can be a major boost and help people re-establish a sense of efficacy and control.
2.5.3 Potential disaster-related mental health support needs of specific populations
It is well-known that different population groups are likely to experience disasters differently. This can be for historical, cultural, and social reasons, because they are socially isolated, or alternatively, are better protected by strong social ties, good access to economic resources, and family support. This Framework emphasises flexible, tailored responses at every point of planning, implementation, and delivery to reach all people in need. Research (see Informing the Framework - Supporting Evidence) indicates certain characteristics, context, and experiences may put specific groups at greater risk of experiencing mental ill-health related to a disaster. These include people with:
- • severe or repeated exposure to a disaster and related traumatic events,
- • prior mental ill-health and/or disability,
- • female gender,
- • Aboriginal and Torres Strait Islander People,
- • ethnic minority status,
- • lower socio-economic status, and
- • certain ages (specifically infants, children and young people, and adults of middle age).
All groups need to be carefully included in planning and preparation to make sure effective communication, service capacity, training of recovery personnel, and their specific experience of a disaster event are wellunderstood prior to a disaster and do not become barriers to access and support.