Skip to main content Accessibility help
×
Home
Hostname: page-component-59b7f5684b-hd9dq Total loading time: 0.508 Render date: 2022-10-04T11:24:25.956Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "displayNetworkTab": true, "displayNetworkMapGraph": true, "useSa": true } hasContentIssue true

Extending the Role of Primary Care Agencies in Mental Health Responses to Disaster

Published online by Cambridge University Press:  08 April 2013

Lennart Reifels*
Affiliation:
Centre for Health Policy, Programs and Economics, Melbourne School of Population and Global Health, The University of Melbourne, Australia.
Bridget Bassilios
Affiliation:
Centre for Health Policy, Programs and Economics, Melbourne School of Population and Global Health, The University of Melbourne, Australia.
Jane Pirkis
Affiliation:
Centre for Health Policy, Programs and Economics, Melbourne School of Population and Global Health, The University of Melbourne, Australia.
*
Address correspondence and reprint requests to Lennart Reifels, Dipl-Psych, Centre for Health Policy, Programs and Economics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia (e-mail l.reifels@unimelb.edu.au).
Rights & Permissions[Opens in a new window]

Abstract

Type
Letters to the Editor
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2013 

Natural disasters increasingly affect individuals, resulting in a greater need for health care services. We believe that it is time to review the traditional roles of different elements of the health system and extend the capacity of agencies that provide mental health services. Primary care systems have been recognized as vital components of disaster mental health responses,Reference Lima, Santacruz and Lozano1 but the role of primary care services after disasters has traditionally been defined in comparatively narrow terms, mostly through family physicians, in mental health screening, treatment, and referral.Reference Stein and Myers2-Reference Forbes, Creamer and Phelps4

We conducted a pilot evaluation of the Australian government's mental health response to Australia's largest wildfire disaster, the Victorian Black Saturday Bushfires of 2009, which highlighted the extended scope for primary care involvement in community disaster recovery.Reference Reifels, Bassilios and Pirkis5 As part of the response, 5 federally funded and regionally operating primary care agencies, called divisions of general practice (or divisions), provided targeted community initiatives to aid the psychological recovery of affected communities. These initiatives were capacity-building and mental health promotion. With limited prior disaster experience, these divisions have played a traditional role centered on family physician workforce support; primary care integration; and provision or facilitation of illness prevention, health promotion, and primary mental health care programs.

The summative pilot evaluation examined the provision of these initiatives in terms of their nature and scope; levels of uptake; benefits; disadvantages; and issues associated with them. Data sources included 5 division program reports and interviews with 9 key informants involved in the wildfire response, which were analyzed through descriptive and thematic analyses.

Following community stakeholder consultations, the divisions provided 35 initiatives that included locally targeted community events (eg, health and well-being nights), mental health and resilience training for community leaders and health professionals, provision of service information, support programs for farming families and frontline recovery workers, and replacement funding for school staff. The divisions either directly provided and facilitated the programs or subcontracted them to external providers. More than 7000 community members participated in the various initiatives.

Although limited in scope, program evaluation data indicated that the initiatives were overwhelmingly positively received by and conducive to the recovery of participants. Benefits to the participant included normalization of disaster reactions, increased mental health awareness, reduced barriers in access to care, breaks from disaster immersion, and opportunities for people and communities to reconnect. Minor disadvantages included limited after-hours access to training and availability of replacement teachers in rural areas.

Postdisaster challenges affecting the provision of initiatives included destroyed infrastructure, community rifts, multiple competing priorities, heightened sensitivities during anniversary periods, fatigue among local agency staff, delayed availability of funding, variable division community profiles, and delivery timelines of greater than 1 year postdisaster.

A strong partnership approach facilitated service provision, as did community engagement and consultation, flexible funding parameters, tailoring of initiatives to local needs, use of existing allied health and drought workers, and integration with local area and disaster-response structures.

The findings of the evaluation highlight the important multiple roles that primary care agencies can play in facilitating community recovery from disaster. These roles include provider, broker, facilitator of mental health capacity-building initiatives, and the mitigation of existing barriers in access to care.6 The profile, preparedness, and capacity of these agencies to provide disaster recovery services may need to be strengthened further to increase the timeliness and efficiency of responses to future disasters. The integration of climate-related primary care response capacities is potentially a key consideration for future disaster planning.

Acknowledgments

This work was supported by the Australian Government Department of Health and Ageing.

References

1.Lima, BR, Santacruz, H, Lozano, J, etal. Planning for health/mental health integration in emergencies. In: Lystad M, ed. Mental Health Response to Mass Emergencies: Theory and Practice. New York: Brunner/Mazel; 1988:371-393.Google Scholar
2.Stein, BD, Myers, D. Emotional sequelae of disasters: a primary care physician's guide. J Am Med Women's Assoc. 1999;54:60-64.Google ScholarPubMed
3.Freedy, JR, Simpson, WM. Disaster-related physical and mental health: a role for the family physician. Am Fam Physician. 2007;15:841-846.Google Scholar
4.Forbes, D, Creamer, MC, Phelps, AJ, etal. Treating adults with acute stress disorder and post-traumatic stress disorder in general practice: a clinical update. Med J Aust. 2007;187:120-123.Google ScholarPubMed
5.Reifels, L, Bassilios, B, Pirkis, J. Evaluation of the Australian Federal Government Mental Health Response to the Victorian Bushfires. Melbourne, Australia: Centre for Health Policy, Programs and Economics, Melbourne School of Population Health, The University of Melbourne; 2010.Google Scholar
6.World Health Organization, World Organization of Family Doctors. Integrating Mental Health into Primary Care: A Global Perspective. Geneva, Switzerland: World Health Organization; 2008.Google Scholar
You have Access

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Extending the Role of Primary Care Agencies in Mental Health Responses to Disaster
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Extending the Role of Primary Care Agencies in Mental Health Responses to Disaster
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Extending the Role of Primary Care Agencies in Mental Health Responses to Disaster
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *