title: Post-disaster service provision following proactive identification of children with emotional distress and depression.
abstract: OBJECTIVE
  Proactive, school-based psychological testing for emotional distress and depression was employed 6 months after a bushfire disaster. The service provision aim was to provide children with the greatest emotional distress the relatively limited therapeutic resources available in the post-disaster environment. Specific hypotheses were tested: that the prevalence of emotional distress and depression would be elevated 6 months post disaster; that emotional distress would be correlated with traumatic events; and that depression would be related to experiences of loss.
  
  
  METHODS
  Six months after a bushfire disaster grade 4, 5, and 6 students (n = 601) participated in screening using a test battery measuring emotional distress, depressive symptoms and trait anxiety.
  
  
  RESULTS
  Twelve percent (n = 72) of children experienced severe emotional distress 6 months after the bushfire. Rates of depression were similar to rates in non-traumatised child community samples. Multivariate analysis suggested that emotional distress was significantly associated with trait anxiety, evacuation experience, the perception that parents may have died during the bushfire, and depressive symptoms. Depressive symptoms were associated with total distress score, trait anxiety and perception of threat to the parents.
  
  
  CONCLUSIONS
  Substantial mental health morbidity was identified 6 months after a bushfire disaster. The usefulness of post-disaster service provision influenced by proactive screening is discussed and reasons for further research highlighted.
authors.affiliation: Department of Paediatrics, University of Western Australia, Perth, Australia. brettm@ichr.uwa.edu.au
authors.forename: B M
authors.initials: BM
authors.lastname: McDermott
authors.forename: L J
authors.initials: LJ
authors.lastname: Palmer
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D002648:Child; D002667:Child Reactive Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D003863:Depression / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D005260:Female; D005390:Fires; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008403:Mass Screening; D009517:New South Wales; D010555:Personality Inventory; D011613:Psychotherapy; D012572:School Health Services; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy