Academic journal article Advances in Mental Health

A Systematic Approach to Building the Mental Health Response Capacity of Practitioners in a Post-Disaster Context

Academic journal article Advances in Mental Health

A Systematic Approach to Building the Mental Health Response Capacity of Practitioners in a Post-Disaster Context

Article excerpt

In early 2009, Australia experienced one of its most extensive natural disasters during which bushfires devastated large parts of the state of Victoria. As a direct result of the fires, 173 people lost their lives, 51 townships were directly affected, and over 2,000 homes and many businesses and schools were destroyed (Commonwealth of Australia, 2009).

The international research literature demonstrates that disasters of this magnitude can significantly affect the mental health of impacted individuals and communities (Norris, Friedman, & Watson, 2002; Ursano, Fullerton, Weisaeth, & Raphael, 2007). Natural resilience and recovery processes play important roles in mediating the trajectory of individual disaster responses, and the impact of exposure to disasters such as bushfires on mental health can be mild, moderate or severe, short term or enduring and also variable over time (Laugharne, Van de Watt, & Janea, 2011; Van Ommeren, 2006). The World Health Organization (WHO) estimates of the anticipated increase in mental health problems following disaster are summarised in Table 1 (Van Ommeren, 2006).

In view of the anticipated mental health impact of the bushfire disaster, the Australian Government contributed $7.5 million towards the provision of mental health support to fireaffected individuals and communities. Under the Australian Government Mental Health Response to the Victorian Bushfires Measure (the Response), support was delivered through four components, namely: (1) primary mental health care services to support people most impacted by the bushfires; (2) training and support to professionals providing these services; (3) additional telephone-based counselling services to respond to broader levels of distress within the community; and (4) support for affected communities to reconnect and psychologically recover from the impact of the trauma over the long term. All Response components were integrated with the Victorian Government response to the fires.

The training framework

A scoping document devised by an expert reference group in the immediate fire aftermath outlined guiding parameters for the Response. These included a three-level framework which comprised three levels of intervention and care required in the community as well as corresponding training programmes for providers. Table 2 outlines the full suite of training programmes delivered through the Response aimed at building the mental health and psychosocial response capacity of providers at the three levels. Service delivery on the basis of this framework was operationalised through a resource-efficient stepped care model which progresses from the delivery of low-level support to more intensive treatments as the need arises.

Training development was carried out by agencies with expertise in the area of disaster response and trauma recovery and overseen by the Victorian Bushfire Cross-Professional Working Group. This group comprised representatives from both the Australian and Victorian Government health departments and key professional and mental health organisations, including the Australian Psychological Society (APS), the Australian Association of Social Workers, Occupational Therapy Australia, the Royal Australian College of General Practitioners, the Royal Australian and New Zealand College of Psychiatrists (RANZCP), the Austin Hospital and the Australian Centre for Posttraumatic Mental Health (ACPMH).

Nature and scope of training

Level 1 training was based on a community capacity building approach which sought to equip generic community workers and leaders with a better understanding of the disaster recovery context and range of individual disaster responses, and the skills to facilitate self-care, low-level support and access to appropriate levels of care for affected community members (Wade et ah, 2013). Jointly developed by ACPMH and beyondblue: the national depression initiative (and delivered by the latter), Level 1 training was largely consistent with a psychological first aid approach and designed for the support of common distress responses to disaster in the wider community. …

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