Dealing with bushfire trauma and the challenges that lie ahead
Article prepared by Franco Greco – March 2020
The bushfires that raged across Australia from September 2019 – January 2020 were unprecedented in their scale and duration.
Dr Sam Harvey, Chief Psychiatrist, Black Dog Institute states that:
“While the physical effects of these fires are readily captured in images of razed homes and injured wildlife, the mental health impacts are harder to measure.”
Mental health experts are calling for more bushfire aid to go towards long-term psychological support, warning firefighters and other first responders will face significant risks in the years to come.
The Federal Government has already announced $76 million in mental health support, however, experience from previous disasters suggests rushing support too quickly could do more harm than good.
Studies completed after previous large-scale disasters tell us that most people can bounce back from these terrible situations. That is not to say that there will not be a significant amount of distress, worry, tears and sleepless nights along the way. We know that these reactions are very common and understandable. However, these are usually temporary, and most people will be able to adapt.
Sam Harvey made this point on the Radio National AM Program on 22 January 2020¹:
“… we need to allow people to experience and rely on their natural coping mechanism. What we learned from residents impacted by the Black Saturday bushfires, who were followed up four years after the fires … around one in six of still had symptoms suggestive of post traumatic stress disorder (PTSD), with similarly high rates of depression, anxiety and alcohol use problems.”
Dr Rob Gordon² a clinical psychologist and trauma specialist in fires and disaster argues that:
“Poorly managed recovery is often identified as ‘the second disaster’; the unnecessary one. Anecdotal evidence indicates that the quality of a person’s recovery depends more on how well they manage the recovery years than what the event does. To minimise long-term destructive consequences, greater understanding of recovery is needed.”
Dr Sam Harvey outlines on the Black Dog Institute website, that the evidence from Australia and overseas points to four key things in order to plan out a recovery response in order to reduce the mental health impacts of the current crisis:
First, there is ample evidence that immediate debriefing after trauma may not be helpful for everyone and probably harmful.
Dr Rob Gordon would say that we need to meet people where they are at … not everyone will want to examine or talk about trauma.
What is critical in this early response stage is to ensure that people feel safe, can return to their routines, and are not exposed to additional sources of stress. This means the best thing that can happen right now to reduce the mental health impacts of these fires is to ensure that impacted communities have access to shelter, resources, communication, reliable information and hope for the future.
Dr Gordon³ said it was not healthy to remain in the 'heightened state of arousal' people go into to cope with emergencies, for a significant period of time.
"When you're in that mode you are properly attuned to fight a fire ... you're mentally prepared to deal with a physical threat," he said.
"Now the problem is when you're in that state you can't do long-term planning or prioritising or fill out complex forms.
"The longer people stay in that adrenaline mode the more they try to look at very simple, short-term immediate solutions, and they can't get them."
Second, there is overwhelming evidence that social support is a major factor in determining how people respond to trauma.
A delay in being able to connect with loved ones was a major risk factor for mental health problems. Fire affected communities must be given the resources and support to come together in the ways that best fit their existing context, their culture and history.
Third, a disturbing finding from the Black Saturday fires was that despite large support services, one-third of people with significant long-term mental health problems were not receiving any mental health care.
Dr Gordon argues that "The longer people stay in that adrenaline mode the more they try to look at very simple, short-term immediate solutions, and they can't get them."
This results in feelings of anger and hopelessness and can stymie long-term recovery.
"You will totally put everything into the immediate rebuilding and recovery and you will do that at the expense of your relationships, your family life, your social networks and your health," he said.
"That's when two or three years down the track you'll find your marriage is in trouble, your health is deteriorating.... That's the second disaster. Those are irreversible losses."
Dr Gordon said right after a disaster, divorce, suicide and crime rates all decrease, but once the ashes settle, they increase.
"Six months to two years down the track there's a time of real difficulty where everyone is stressed and depressed... you get an increase in divorce rates, suicide, crime etc and then in another year or so it evens out," he said.
We need to ensure that GPs and mental health services have the resources and skills to deal with mental health needs, any barriers to accessing these are reduced.
Finally, special consideration needs to be given to the first responders who are risking their lives to protect communities.
How are we helping to support these communities?
The Recharge Program will continue to provide evidenced based support to fire and drought impacted communities by:
Supporting local events that connect local communities that align with their existing context, their culture and history.
Sponsoring Melbourne Retreats – encouraging more adaptive coping approaches such ‘taking a break’ and ‘time out with their families’ through special experience weekend in Melbourne.
Developing and implementing approaches to enhance communities in drought and fire impacted areas that seek to better align the provision of psychological services.
These activities have been developed in the past learnings to provide relief and respite to those in fire and drought effected communities of regional Victoria at the right time and place.
Find out more
To find out more about the Recharge program, please contact The Royal Agricultural Society of Victoria firstname.lastname@example.org.
I will be regularly posting articles on farmer mental health and wellbeing and looking forward to hearing about your views and any topics you would like me to cover.
Mental Health Support
Franco provides expert mental health advice and services to assist and support fire and drought impacted farmers and their communities in Victoria. He is also Delivered Live’s consulting psychologist on mental health and wellbeing regarding COVID-19.
Franco Greco - Consulting Psychologist - Recharge Program and Delivered Live
Franco is also the Principal Psychologist at Your Psychologist (www.yourpsychologist.net.au) - a unique private practice dedicated to helping professional people improve their life, career and relationships.