Emotional distress and depression in children and adolescents following Australian bushfire disasters

Given the evidence from epidemiological studies of a substantial unmet child & adolescent mental health service need, it is typical that children with mental health symptoms following a natural disaster are not routinely provided an intervention. However, following a devastating Australian natural disaster the author directed an innovative inter-sectoral response. Proactive, school-based screening for post-disaster mental health sequelae was seen as a way of identifying school-age children with persisting disaster related symptoms. Identified children were offered a targeted mental health intervention. The intervention, a guided trauma workbook for children and group therapy program for adolescents proved to be acceptable to children, parents and teachers as well as being cost effective. Major study investigations included the emotional responses of Primary and High School children, the proportion of children whose responses met case criteria for emotional trauma or depression and the relationship of these symptoms to trauma related events and factors intrinsic to children such as their level of anxiety and perception of disaster related threat. The responses of children of volunteer fire fighters and younger children who attended infant school were also investigated. Given the large sample size (n = 2379 Primary and High School students, n = 310 Infant School students) multivariate analyses were able to control for age and gender and investigate the relative contribution of individual factors versus bushfire-related variables to depressive and emotional trauma symptoms. In Infant School children a novel measure of infant trauma responses, the Early Childhood Trauma Self-Report, a combination of a picture, vignette and brief statements followed by yes/no responses was also trialled. Also the relationship of parent-report of symptoms was compared to child-report. The final analysis chapter reports a replication study following a major bushfire disaster in Canberra, the Australian National Territory. Advances in design included using two new measures of child and adolescent psychopathology: a measure of Post traumatic stress disorder and a general child and adolescent psychopathology screening measure. Changes were also made to improve the disaster related information collected. The thesis concludes with a discussion of research limitations and future research directions in the field of child and adolescent mental health responses to natural disasters.