Psychological outcomes following the Victorian Black Saturday bushfires

Abstract

Objective: We aimed to map the prevalence and predictors of psychological outcomes in affected communities 3-4 years after the Black Saturday bushfires in the state of Victoria, Australia.Methods: Baseline assessment of a longitudinal cohort study in high-, medium-, and low-affected communities in Victoria. Participants included 1017 residents of high-, medium-, and low-affected fire communities. Participants were surveyed by means of a telephone and web-based interview between December 2011 and January 2013. The survey included measures of fire-related post-traumatic stress disorder (PTSD) and general PTSD from other traumatic events, major depressive episode, alcohol use, and general psychological distress. Results:The majority of respondents in the high-(77.3%), medium-(81.3%), and low-affected (84.9%) communities reported no psychological distress on the K6 screening scale. More participants in the high-affected communities (15.6%) reported probable PTSD linked to the bushfires than medium-(7.2%) and low-affected (1.0%) communities (odds ratio (OR): 4.57, 95% confidence interval (CI): 2.61-8.00, p = 0.000). Similar patterns were observed for depression (12.9%, 8.8%, 6.3%, respectively) (OR: 1.83, 95% CI: 1.17-2.85, p = 0.008) and severe psychological distress (9.8%, 5.0%, 4.9%, respectively) (OR: 2.08, 95% CI: 1.23-3.55, p = 0.007). All communities reported elevated rates of heavy drinking (24.7%, 18.7%, 19.6%, respectively); however, these were higher in the high-affected communities (OR: 1.39, 95% CI: 1.01-1.89, p = 0.04). Severe psychological distress was predicted by fear for one's life in the bushfires, death of someone close to them in the bushfires, and subsequent stressors. One-third of those with severe psychological distress did not receive mental health assistance in the previous month.Conclusions: Several years following the Black Saturday bushfires the majority of affected people demonstrated resilience without indications of psychological distress. A significant minority of people in the high-affected communities reported persistent PTSD, depression, and psychological distress, indicating the need for promotion of the use of health and complementary services, community-based initiatives, and family and other informal supports, to target these persistent problems.

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“…12 The observed low proportion of participants with scores indicating moderate or severe anxiety or depression in the current study is in line with these findings. However, the length of follow-up may have been too short to reflect the full extent of disturbance.…”

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“…A population of children exposed to the Ash Wednesday bushfires has now been followed for 28 years (McFarlane and Van Hooff, 2009). Similar to the study of Bryant et al (2014), this study cautioned against viewing the disaster in isolation from the substantial prevalence of traumatic events that occur within the broader Australian community and background psychological morbidity of the disaster victim. Whilst there appeared to be significant long-term educational and socio-economic disadvantage, the only significant difference in relation to psychiatric disorder when compared to a non-exposed comparison group was a greater prevalence of weather phobia in the bushfire-exposed group arising from the extreme wind conditions on the day of the fire.…”