National response required for the psychological trauma of Australian bushfires
It is difficult to overestimate the emotional devastation and mental anguish caused by Australia's current bushfire crisis.
As unprecedented events continue across the nation, University of South Australia mental health expert Professor Nicholas Procter says it is essential we recognize that intense, confusing, and frightening emotions are being experienced by many people, both those directly affected and those watching the crisis unfold.
"People and their regions have been significantly impacted—life as people knew it has changed," Prof Procter says.
"Impacts are being felt immediately and for a small number this will continue for many years to come. The loss of life, property, familiar surroundings and estimated loss of millions of animals is devastating.
"It's natural to feel overwhelmed, anxious, frightened, and begin to question why. It's also part of the human condition to re-run what has happened over and over, and to feel uncertain about what the future may hold."
Prof Procter says while such emotions are entirely normal, and adaptive, the severity of the current crisis means communities must be provided with a national, 'trauma informed' crisis response, aimed at ensuring both the victims of the fires and those assisting them—including volunteer firefighters—recognize and respond to the associated mental health challenges.
"The immediate priority is to ensure survival and practical support—safety is essential," he says. "But once evacuations are complete and as news of the fires enters a denouement, the role of executive government will be critical in the weeks, months and years ahead.
"There must be fully integrated knowledge about the implications of trauma and its effects on policies, procedures and practices.
"From an immediate crisis response to sustained ongoing trauma support, the entire system that surrounds individuals and communities, inclusive of the insurance industry and of local, state and federal government, must be geared towards realizing the widespread impact of trauma."
Prof Procter says current evidence and experience highlight the need for service providers to understand the devastating effects of trauma distress, recognize potential paths for recovery, and do all that is possible to actively resist re-traumatization.
"This includes health and human service workers, community and peer workers—anyone with a platform for making sensitive decisions and, where necessary, revisions in how they work. In supporting people following bushfire crisis we should also be asking, 'when it comes to your mental health and wellbeing, what's the ideal scenario?'
"Interactions should be framed by the broad overarching questions, 'what's happened to you?' and 'how has what's happened to you impacted upon your life today?'," Prof Procter says. "This requires a deliberate moving away from the question, 'what's wrong with you?'"
Prof Procter emphasizes a wide range of emotional reactions are normal in situations such as the current bushfire crisis, and he says a national strategy could help people recognize and respond to these emotions in a positive, compassionate manner.
"When our nervous system is overwhelmed by stress, it sets off a range of powerful thoughts and emotions, and they can often come and go in waves," Prof Procter says.
"There may be times when you feel agitated, edgy and anxious, and other times when you feel detached and numb. Shock, fear, sadness, helplessness, even guilt, anger and shame, these are all normal feelings to experience."
Pointing to the frontline experience of rural mental health clinicians in South Australia and others with lived experience of mental health, Prof Procter says the evidence-based, best-practice during times of crisis is to work towards building trust through empathic, honest communication and person-centered approaches.
"Being trauma-informed begins with trauma awareness, involves strengths-based approaches, facilitating choice and remaining flexible through trusting engagement," Prof Procter says.
"Cultural sensitivity is also an essential element. People from culturally and linguistically diverse backgrounds caught up in the bushfire crisis will express trauma experience and injury in ways that are in keeping with their culture.
"For many, trauma-informed practice means portraying genuine 'care,' embracing compassionate support and recovery with dignity, offering practical assistance and maintaining the working relationship through taking the least restrictive pathway."
Nicholas Procter et al. Engaging consumers in the Australian emergency mental health context: a qualitative perspective from clinicians working in the community, Health & Social Care in the Community (2014). DOI: 10.1111/hsc.12156