Psychological impacts of the 2019 Quebec floods: findings from a large population-based study

Abstract

Background During Spring 2019, many regions in Quebec (Canada) experienced severe floods. As much as 5,245 households were flooded and 7,452 persons were evacuated, causing extensive material and human damages. A large population-based study was therefore conducted to examine medium-term effects of this natural disaster on health and well-being. Methods Six to eight months post-floods, households located in the flooded zones (in one of the 6 Quebec regions the most severely affected) were randomly invited to participate to a telephone or a web-based survey (response rate=15.3%). Several psychological health outcomes were examined, including psychological distress (based on the 6-item Kessler Scale, score 0-24) and post-traumatic stress (based on the 15-item Impact of Event Scale, score 0-75). These outcomes were compared among 3 levels of exposure using Chi-square test: flooded (floodwater in ≥ 1 liveable room), disrupted (floodwater in non-liveable areas, loss of utilities, loss of access to services, or evacuation), and unaffected. Results Of the 3,437 participating households, 349 (10.2%) were flooded and 1230 (35.8%) were disrupted (but not flooded) during the 2019 floods. A steep gradient was observed for moderate/severe symptoms of post-traumatic stress (score ≥ 26) according to the level of exposure to flooding (unaffected: 3.0%; disrupted: 14.6%; flooded: 44.1%; p < 0.0005). For psychological distress (score ≥ 7), the baseline level (i.e. unaffected group) was 7.3% while it reached 15.0% and 38.4% in the disrupted and the flooded groups, respectively (p < 0.0005). Conclusions This study is among the largest to examine the psychological impacts of flooding. The magnitude of effects observed in flooded households is consistent with the literature and calls for stronger social and economic measures to support flood victims. Such support should help coping with initial stress, but also alleviating secondary stressors classically observed in post-flood settings. Key messages Psychological impacts of floods may persist for several months and may be observed in both flooded and disrupted people. Stronger social and economic measures are needed to better support flood victims, not only in the short but also in the longer term.

Intersectoral approaches: the key to mitigating psychosocial and health consequences of disasters and systemic risks

“…Additionally, with regard to psychosocial interventions that would have been beneficial to the victims, there are, among other things, preventive visits by a front-line worker (firefighter or police officer) accompanied by a social worker during the planning phase (i.e. for social support) in the homes or frequently visited places of flood victims (G en ereux et al, 2020c;Maltais et al, 2022). In order to enable disaster recovery, practitioners should assess community needs early and often; to provide services accessible to the greatest number; work collaboratively and proactively (Norris and Alegria, 2005).…”

“…Indeed, they all have unpredictable sudden onsets, caused fear and uncertainty in the population, resulted in great losses, involved home displacements or confinements and required complex government responses. Profound and extensive psychosocial effects and mental health disorders were also documented following all these events (Agyapong et al, 2018;G en ereux et al, 2020c). Due to their many similarities, lessons learned during the response to these crises must be applied to the research and/or management of future disasters such as the flooding events and vice-versa.…”

“…The recovery phase, especially for psychosocial rehabilitation, may extend into the weeks, months or years following exposure to a disaster (Ehrenreich, 2001;Maltais et al, 2005a, b;Laurendeau et al, 2007;Amaratunga and O'Sullivan, 2006). Quebec generally does well in terms of disaster preparedness and response, but preventive and recovery approaches are more deficient (G en ereux et al, 2020c;Laurendeau et al, 2007;Malenfant, 2013;Maltais, 2015;Leclerc et al, 2020;Brisson and Lessard, 2021). Support for populations at risk of experiencing psychological impacts then depends on local health and social services teams, which may not be sufficient for the task (Brisson and Lessard, 2021), as while for social impacts, no one seems specifically designated to address them in the long term (Marchand et al, 2014).…”

“…More recently, intersectoral studies involving researchers from different backgrounds (medicine, social and natural sciences; see Généreux et al. (2020c)) have been conducted in order to measure the impact on the physical and psychological health of individuals, who have suffered from the recent spring floods (2017 and 2019) which occurred along the Ottawa river and around Montreal areas in Québec.…”

“…Among such studies, over half of the participants directly affected by the floods showed indications for probable mental health disorders, including moderate to severe symptoms of PTSD, anxiety disorder or mood disorder. More specifically, 44.1% of flood victims reported suffering from PTSD symptoms, 21% reported suffering from anxiety disorders and 20% from mood disorders (Généreux et al. , 2020c).…”