As the NSW and Queensland flood waters recede and the recent sunny weather continues, those of us not directly affected may be tempted to get on with our lives and hope that flood victims and their communities will get the help they need. But the mental health impacts of flooding are often long lasting. They are complex and not remediable by one size fits all solutions.
With more than 18,000 people evacuated and many towns and communities affected, Red Cross has reported that flood victims are distressed by poor access to mental health services and about the cumulative adverse mental health impacts - first of the drought, then the bushfires and now the floods. NSW Premier Gladys Berejiklian put it succinctly: successive extreme weather events are "pushing communities to breaking point".
There are limits to the resilience of individuals and of communities. This is especially true for those who have experienced significant adversity, depression, anxiety and financial stress even before the floods arrived. The most disadvantaged populations often suffer the most harm from flooding and have fewer resources to help them recover.
The risk to mental health increases once the emergency response has ended and flood victims have to rely on pre-existing support services which are already limited in many rural areas. This gap in recovery can be exacerbated by the stress associated with making insurance claims, having claims rejected or not having insurance, as well as by unemployment or underemployment, financial loss, the loss of home and possessions and difficulty accessing usual educational and social activities.
The more areas (e.g. home, work, suburb) of a person's life that flooding adversely impacts the greater the flood victim's risk of ongoing post-traumatic stress disorder (PTSD) and continuing distress. People who are displaced from their home for more than six months have a high risk of mental health problems.
Small businesses are the backbone of rural communities. Unsurprisingly, business owners whose premises are most severely affected by flooding have the highest rates of depression. The floods can also have a ripple effect on the wider Australian community. Eco-anxiety, a fear about environmental catastrophe provoked by extreme weather events in Australia and globally, is on the increase.
While the degree to which climate change contributed to the recent deluge and associated flooding can be debated, climate science tells us that we are already in the midst of a climate emergency and that we need to prepare for more frequent and more severe weather events. How should our nation respond to the fact that as climate change progresses, droughts, fires and flooding will become more frequent and severe?
Programs need to be implemented to prepare people living in flood or bushfire-prone areas so that they have an emergency response plan and know when to leave. They need to know what the dangers are and to fully understand how fast flood waters and fire can travel and that unprecedented severe weather conditions are increasingly possible. Longer-term support to local businesses and communities is needed to reduce mental health impacts after severe weather events.
Improved access to mental health services is essential. This can be provided in part by telehealth but it is also important to establish local mental health services with expertise in treating PTSD, depression and anxiety related to extreme weather events.
The process for making insurance claims also needs improvement. Disputes over insurance claims and the rejection of insurance claims are strongly associated with an increased risk of depression among flood victims. People need to know what is and is not included in their policy and the process of making claims needs to be more user friendly.
These complex problems cannot be solved if support services are siloed. Collaboration between government-funded, non-government and private sector services is crucial.
Finally, all levels of our society must recognise that there are limits to how much humans can adapt to the changing climate. Every person and community has a breaking point. Australia must participate more fully in the global effort to limit global heating to less than 2 degrees. Science tells us that humans cannot "adapt" biologically to global heating of between 2 and 3 degrees - a level that has the potential to be increasingly disastrous and impossible to reverse.
There is very limited time to act on the climate crisis. Zali Steggall's proposed Climate Change Bill is an opportunity for Australia to stop its legacy of climate hesitancy and legislate net zero emissions by 2050.
Our leaders must support this sensible bill and, by doing so, show the moral courage required to prevent short term political and vested interests stopping them from taking the action that science tells us is needed to avoid a climate catastrophe.
- Robert Llewellyn-Jones is a psychiatrist and member of Doctors for the Environment Australia.