Dr Susie Burke MAPS
Senior Psychologist, Public Interest, Environment
and Disaster Response, National Office

It has been an extraordinary start to the year worldwide, with floods, fires and cyclones occurring almost simultaneously across Australia, followed by a devastating earthquake in New Zealand, and earthquake, tsunami and ensuing nuclear disaster, in Japan. Our hearts go out to the thousands upon thousands of people affected.

As well as the significant impact of a local disaster on the psychosocial wellbeing and mental health of affected individuals and communities, there is also a significant psychosocial impact of multiple disasters on the wider community. There is the accumulative stress for disaster responders and organisations, many of whom have moved from Australia to New Zealand, and now on to Japan, with little respite. There is the impact on humanitarian organisations, like the Red Cross, who are activating hundreds of volunteers to provide immediate assistance for one disaster after another, and needing to care for the wellbeing of staff and volunteers under pressure, as well as the communities they serve. The succession of disasters has an impact on the affected communities as well; as the media and public's attention and sympathy keeps getting diverted to subsequent emergencies, there is a concern that one's own community's distress and need is minimised or forgotten. And last but not least, there is mounting stress and anxiety in the general public about the meaning of these events and the threat they pose to our perceptions of a safe and predictable world.

Promoting recovery at all levels of a community is important in responding to extreme weather events and natural disasters. Following is an update of the work of the APS in responding to natural disasters over the last couple of months.

Training for psychologists

Queensland initiatives

The APS has been collaborating with the Australian Centre for Post-Traumatic Mental Health (ACPMH) and the Queensland authorities to plan and deliver training workshops for mental health professionals across affected regions in Queensland to assist them to provide best practice psychological services for people following disasters. It is very important that the APS works within the coordinated recovery plan within each State or Territory, and we welcome the opportunity to work with the Queensland Government in providing some of the professional training for mental health professionals. At this stage it looks likely that training will be offered in two levels of interventions: Level 2 - Skills for Psychological Recovery (SPR) following disasters, and Level 3 - Psychological treatments for significant mental health issues after disasters. The APS is also seeking to repeat these opportunities in other parts of Australia, and we will be asking for expressions of interest in the near future.

There have been several regional Queensland initiatives by APS psychologists to support members in working with disaster affected communities, and these have been welcomed by members as they wait for additional government-supported training opportunities. For example, the University of Southern Queensland Psychology Department, in association with the APS Toowoomba Branch, launched a wonderful initiative called Water-Wings. This resource provided a meeting and resource point for psychologists to share support and professional consultation around the challenges of disaster assistance. For several weeks they ran weekly informal drop-in meetings, and an electronic discussion list for ongoing peer support. They also ran a series of refresher seminars in psychological first aid, crisis intervention, acute stress disorder and posttraumatic stress disorder.  

Disaster orientation webinar

During February and March, the APS ran several webinars on working effectively with people following disaster. Over 120 members, mainly from Queensland and New South Wales, participated in these two-hour online sessions, which oriented them to working with individuals and communities affected by disasters. These webinars were very enthusiastically received, with members welcoming the effective and efficient way of ‘attending' the webinar, and the content of the sessions.

Collaboration with the Red Cross in Queensland

The APS and Australian Red Cross (ARC) signed an MoU in 2009, agreeing to seek ways of working together in preparing for, and responding to, disasters. The ARC contacted the APS in February asking for psychologist volunteers to support their Personal Support Workers in Northern Queensland. Red Cross Personal Support Workers go out in the field following a disaster to provide psychological first aid to affected people. The Red Cross were seeking psychologists for two roles: (1) peer support for volunteers and staff in the field in cyclone affected areas, and (2) assistance with independent debriefing of volunteers on their return. Red Cross volunteers in Queensland have been constantly deployed since early January with the first floods in Rockhampton, so there has been a huge backlog of volunteers to debrief. Through the APS Disaster Response Network (DRN), and the APS Queensland Branch Chairs, this request was passed on to APS members, and to date, 40 expressions of interest have been received. The Red Cross has been very appreciative of this support. They selected 22 APS volunteers for their database, and have begun processing police checks and contacting those who were available. At the time of writing, four psychologists have been activated (each for about eight days), with two more on their way.

Queensland had an extraordinary summer, with three-quarters of the State eventually declared a disaster zone. The Red Cross has been involved in an enormous operation to provide early support for affected communities, and this is all done largely by volunteers or people on short-term or temporary contracts. The situation in the field has been constantly changing, with emergency response scaling down in some areas, but activated in others as the weather changes. They are also anticipating further severe weather before the end of the wet season. Because of these factors, the Red Cross swings from needing immediate support, followed by lulls in activity, and back again. APS members who have volunteered have been wonderfully understanding of the situation, and we've been enormously appreciative of their offers of time and expertise, as well as their spontaneity, flexibility and patience - essential prerequisites, it seems, to responding to disasters and working with the Red Cross!

The volunteer peer support role

In late February, I went to work with the Red Cross in Brisbane and then up to the cyclone affected areas to see what the Red Cross volunteers are dealing with, and to understand better how the APS can support the ARC in this work. Over a week, I worked with over 50 volunteers, who arrived in groups of 10 to 15 people every couple of days, for four-day activations in Innisfail, Tully, Mission Beach and Cardwell.

In Northern Queensland, Red Cross emergency response volunteers are involved in staffing recovery centres, and providing personal support outreach. Outreach consists of teams of people visiting affected people at their homes or businesses to provide recovery information (e.g., brochures), personal support, referrals to other services, and linking people to key local agencies in their community that can provide ongoing support.

Red Cross volunteers and staff are likely to experience a range of stressors whilst on a Red Cross activation. The psychologist's role is to support them in both the work that they are doing with disaster affected people, as well as their care for themselves. Stressors can include distressing encounters with disaster affected people, logistical frustrations (for example, with travel, accommodation), difficulties with fellow volunteers or staff (like personality clashes or differences of opinion), and unmet expectations of the volunteer role and Red Cross activation.

When I debriefed with the Red Cross staff in Brisbane following the activation, we decided to expand the psychologist peer support role to also include some personal support coaching. Red Cross volunteers who are providing personal support have done at least a one-day training in personal support with the Australian Red Cross. Many have also done other training workshops with the ARC, for example ‘team leader training', or training in logistics, or first aid. Many volunteers have been on multiple activations with the Red Cross, with some having done many already this year. In practice, however, Red Cross volunteers providing personal support have a diverse range of skills and expertise, and divergent understandings of what constitutes personal support. Different volunteers prioritise different personal support tasks. A useful role for the psychologist peer-supporter, therefore, is to provide volunteers with the opportunity to reflect on what they are doing, and even offer some coaching in personal support. This has been done informally one-on-one, or in small groups, even in the car between outreach visits, or more formally in larger groups, perhaps even on special topics. Useful topics include: refresher on basic principles of recovery following disasters, listening skills, handling angry people, handling distressed people, and how to make referrals.

Working with the Red Cross is a tremendous opportunity for APS psychologists to assist with psychosocial recovery following an emergency, to contribute to the community, and to further experience in disaster work. Aside from our professional partnership with the Red Cross, they are always seeking volunteers for their personal support work, particularly now when they are involved in responding to so many disasters simultaneously.

New Zealand earthquake

Our sympathy went again to the people in New Zealand following the shocking earthquake in Christchurch in February. The APS had already been in contact with the New Zealand Psychological Society after the first quake in 2010, and made contact again, reiterating our offer of support and resources. They have found our Disaster Portal very useful, and via the Portal, have distributed materials widely through Red Cross, schools, doctors, preschools, community support groups, hospital staff and visitors, and to psychologists. We will continue to be in touch with them, and offer support as needed.

Japan earthquake and tsunami

Our sympathy also goes to the Japanese people as they cope with an unprecedented earthquake, devastating tsunami and nuclear threat. The scale of the catastrophe they are facing is enormous, and we wish them great strength and fortitude in the coming weeks and months.

Lyn Littlefield, APS Executive Director, was in Tokyo during the massive earthquake in March. She was in Japan to operationalise a recently signed MoU with the Japanese Psychological Society. What gives even greater poignancy to this meeting was Lyn's feedback that, prior to the earthquake, the President of the Japanese Society had expressed particular interest in the APS disaster materials, and Lyn had encouraged him to make the most of them in whatever way would be useful. Lyn has since offered the Japanese Psychological Society our condolences and support, and let them know that we will help them in whatever way they would find useful.

Disaster Portal

Our Disaster Portal (www.psid.org.au) continues to be updated and is well received across Australia and in New Zealand as well. The resources and links in the portal support professionals working with individuals and communities threatened or affected by emergencies and disasters. The site contains resources to help people prepare for disasters, as well as to protect and improve people's mental health and psychosocial wellbeing during and following an emergency.

InPsych April 2011