Disaster-based trauma support, Australia


The rugged, remote and inhospitable nature of much of the Australian landscape means that when natural disasters strike the effects can be all the more severe.

Most people traumatised by disasters can make a good recovery with the right help. Picture: Daria Ni/Adobe Stock
Most people traumatised by disasters can make a good recovery with the right help. Picture: Daria Ni/Adobe Stock

Cyclones, droughts and forest fires have been a consistent part of the Australian environment for centuries, but the escalation in climate change is making such events more regular and their severity increasingly pronounced. This was most recently seen in the bushfires that raged across large swathes of eastern and southern Australia from September 2019 to January 2020, which claimed the lives of dozens of people and an estimated half a billion animals. Some people lost homes and livelihoods, while whole communities were consumed by the flames that raged across 11 million hectares of Australian land.

The human, animal and environmental toll has been well documented, however, the long-term impact of the bushfires on the mental wellbeing of children and young people is yet to be fully understood and could last for years, experts say.

This is not the first time that Australia has been affected by such a natural disaster and consequently, experts and academics in the country have studied the effect that disaster events can have on children leading to a better understanding of the impact of trauma.

SCALE AND IMPACT

Experience from previous Australian natural disasters suggests that 12 per cent of children and teenagers develop a clinically significant mental health problem as a result.

However, the huge scale of the recent bushfires means that more children are likely to be traumatised according to one expert. This could extend to young people who have experienced smoke pollution or seen media reports of death and destruction.

“With this particular disaster or series of disasters, I would actually expect the percentage to be higher,” Vanessa Cobham, principal research fellow at Brisbane’s Mater Research Institute and a senior clinical psychologist in the child and youth mental health service in Queensland, told the Sydney Morning Herald.

“That’s partly because there has been significant loss of life but also the almost unbelievable extent of this disaster and the huge number of animals that have died.”

Dr Cobham said the right time to intervene was between three and six months after the disaster.

“Within the first month, we would expect that everybody who’s been impacted by this kind of event is going to be distressed – that’s normal, we don’t want to pathologise that,” she said. “Most people are going to make a good natural recovery, with the support of their family and community.”

Aid agency Save the Children Australia, which delivered support for families during the height of the bushfires, has also warned of the traumatising affect they have on children’s emotional wellbeing. Its chief executive Paul Ronalds, says the frightening events can have a “psychological toll [that] can last a very long time if not properly addressed”.

“That’s why supporting children’s mental health needs will be a really important part of the longer-term recovery process,” Ronalds explains.

Save the Children ran three child-friendly spaces in evacuation centres, providing children with a safe place to socialise, play and relax. It has also pledged to support children’s long-term mental health needs. “This is likely to include running a range of activities for children to help them process and express their emotions, deal with the issues they are facing and develop coping mechanisms for the future,” explains Ronalds.

Georgie Harman, chief executive of mental health charity Beyond Blue, says: “It’s very normal to struggle with difficult thoughts and feelings during and after a disaster like this, and these feelings can be intense and confusing.

“These feelings can be at their most severe in the first week after a traumatic event but, in most cases, fade over a month.”

If symptoms persist for longer it may indicate that someone needs professional support, Harman explains.

EFFECTS ON CHILDREN

The Australian Child & Adolescent Trauma, Loss & Grief Network, a government-funded group of medical organisations, in its advice on post-disaster support, explains that in families that have suffered loss as a result of bushfires, children may conceal their emotions or not have their support needs met by other family members also grieving.

“Understanding where a bereaved child’s best supports are and helping them link to these, both in family and school settings, can be helpful,” it states.

Continuity of family life is important even if the family is displaced from its original home, or living in temporary accommodation, because it can “help those affected have some sense of security about everyday living and reassure children and adolescents that the whole world has not collapsed and that there are possibilities for their future”, explains the network.

The advice also highlights the types of concerning behaviour that children affected by bushfires may display. In pre-school children this can include: withdrawal and/or regression, self-soothing, crying, repetitive questions, anger and acting out behaviours, separation-anxiety and attention seeking.

These reactions indicate the child’s need for comforting. Holding, talking gently, recognising a child’s distress, and giving space for them to play are some of the support strategies. Re-establishing family rituals and routines, normal sleep, and comforting for separation distress/anxiety can be helpful to young children, according to the advice.

Primary school children are increasingly familiar with death, but may assume it is to do with killing and badness. It is helpful for children if they can ask questions and receive simple, clear and honest answers. They may feel that it is somehow their fault and need reassurance that it was not.

Withdrawal and internalising behaviours may mean primary age children are seen as not affected and not needing help or support. Acting out behaviours, aggression or conduct difficulties may be seen as “problems” and that the child is uncaring and not affected. It is helpful for children if they are provided with support and the reassurance that they are cared for both physically and emotionally. Children’s play may also reflect their grief and any associated trauma experiences.

For adolescents, thinking processes become much more like those of adults with the capacity to not only understand the nature of death, but that they also could die. Family bonds are still important but peer relationships take on added significance for adolescents.

“Young people in these age groups have very strong peer bonds, and are likely to experience great distress over the deaths of peers,” the network’s guidance states. “They will rely a great deal on group support from school and other peer-based groups, with ritual and expressions though group action, social media, memorial rituals and expression with music.

“Their roller-coaster of emotions may be externalised, may seem demanding and may be perceived as non-supportive by other family members. Alternately, they may be seen as not affected when they appear to be getting on with their lives, which they may struggle with, sometimes experiencing guilt when they do.”

EDUCATIONAL PRACTICE

Emerging Minds develops mental health policy, services, interventions, training, programmes and resources in response to the needs of professionals, children and their families. The organisation now leads the National Workforce Centre for Child Mental Health in Australia, delivered in partnership with a number of health and research bodies. It has put together a resource pack for educators to help them support children after bushfires.

It explains that teachers, continuing to perform their essential role in student learning and wellbeing, are invaluable supporters of children and young people in recovery.

Being prepared for potential disaster can play a part in helping children recover if and when it occurs, it explains. Teachers in bushfire-affected communities are advised to:

  • Focus on establishing and maintaining normal classroom routines
  • Develop new and existing relationships to support connection between both students and staff
  • Provide structured opportunities to talk about the bushfires
  • Provide students with additional notice and reminders of changes to scheduled events
  • Provide spaces and opportunities to focus on emotional expression and regulation skills through mindfulness, circle time or relaxation activities
  • Anticipate situations that may trigger distress, such as hot and windy weather, fog or smoke
  • Monitor students for symptoms of trauma over time
  • Practice self-care and seek support for themselves and their students.

For younger children, talking about the event may be difficult. Some children might respond better to drawing or playing games as a way of communicating. Talking about bushfires:

  • Place rules and time limits around “bushfire talk”
  • Remain calm and optimistic, and convey a clear message that the threat is over
  • Focus on positive coping strategies the student has demonstrated since the traumatic event.

Students who have witnessed the impact of the bushfire crisis on communities, animals and the environment personally or through widespread media coverage are likely to feel distressed. It is important to acknowledge students’ concerns about the bushfire crisis and talk about it. If teachers don’t know the answer to students’ questions, they should use it as an opportunity to explore the answers together. Offer reassurance, avoid distressing media content and explore examples of all the people trying to help and ways that students can make a difference too.

RESPONDING TO NATURAL DISASTERS

ADVICE ON COPING

  • Spend time with people who care
  • Know that recovery times will differ for everyone
  • Find out about the impact of trauma and what to expect
  • Try to keep a routine and return to normal activities as soon as possible
  • Talk about your feelings or what happened when you’re ready
  • Do things that help you relax
  • Set realistic goals
  • Review and reward your progress, even small steps
  • Talk about the ups and downs of recovery


TALKING TO CHILDREN

  • Children’s reactions to trauma may include withdrawal from family, friends and activities, headaches and stomach aches, trouble concentrating or sleeping
  • Tell your child these feelings are normal in the circumstances
  • Take their concerns and feelings seriously
  • Encourage them to speak about their feelings and listen to what they say
  • Try to return to regular routines as soon as possible
  • Allow children to play and enjoy recreational activities

Source: Beyond Blue’s looking after yourself after a disaster fact sheet, 2019

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