Psychological outcomes following the Victorian Black Saturday bushfires.
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.
School of Psychology, University of New South Wales, Sydney, Australia Emergency Services, Australian Red Cross, Melbourne, Australia r.bryant@unsw.edu.au.
Richard A
RA
Bryant
Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Australia.
Elizabeth
E
Waters
Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Australia.
Lisa
L
Gibbs
School of Psychological Sciences, University of Melbourne, Australia.
H Colin
HC
Gallagher
School of Psychological Sciences, University of Melbourne, Australia.
Philippa
P
Pattison
Swinburne Business School, Swinburne University of Technology, Melbourne, Australia.
Dean
D
Lusher
Southgate Institute for Health, Society and Equity, Flinders University, Melbourne, Australia.
Colin
C
MacDougall
Department of Social Work, Department of Health (Victoria), Melbourne, Australia.
Louise
L
Harms
Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Australia.
Karen
K
Block
Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Australia.
Elyse
E
Snowdon
Southgate Institute for Health, Society and Equity, Flinders University, Melbourne, Australia.
Vikki
V
Sinnott
Health and Human Services Emergency Management, Department of Human Services (Victoria), Melbourne, Australia.
Greg
G
Ireton
Emergency Services, Australian Red Cross, Melbourne, Australia.
John
J
Richardson
Australian Centre for Posttraumatic Mental Health, University of Melbourne, Australia.
David
D
Forbes
D000428:Alcohol Drinking / Q000453:epidemiology; D000437:Alcoholism / Q000453:epidemiology / Q000209:etiology; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000209:etiology; D004190:Disasters; D005260:Female; D005390:Fires; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D015995:Prevalence; D055500:Resilience, Psychological; D012737:Sex Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology; D014739:Victoria / Q000453:epidemiology
Black Saturday; Post-traumatic stress disorder; bushfires; disaster; resilience