The role of flood memory in the impact of repeat flooding on mental health. Jessica Lamond

Transcription

1 The role of flood memory in the impact of repeat flooding on mental health. Jessica Lamond Senior Research Fellow, Centre for Floods Communities and Resilience University of the West of England

2 Content Introduction Findings Implications Rationale Methodology Summary and next steps

3 Working definition of flood memory in the context of the project and this study Memory refers to the differential level of vulnerability (to mental health problems) caused by the antecedent effect of the damage (within the built environment to physical and socio economic aspects) as a result of flooding and the limited window of recovery time between events.

4 Why look at mental health aspects? Consensus that mental health issues are often greater than physical health problems. Experts have called for more research in the field of mental health Understanding the role of memory in mental health issues might help recovery processes Better mental health outcomes could lead to more resilient communities

5 Methods What are the main mental health problems caused by flooding? What factors affect the prevalence and severity of mental health issues in flooded communities How long does the impact of flooding on mental health endure and does the memory of flooding affect mental health issues following flooding.

6 Findings: Spectrum of reactions to trauma asp

7 Findings: main mental health problems (Adapted from Alderman et al). Author Location Study Findings Chae et al (2005) Korea (2002) 3-6 months post flood with control PTSD 39.5% Anxiety 21% Paranjothy et al (2011) England (2007) 3-6 months post flood PTSD 11.9% Anxiety 17.8% Depression 7.7% Mason et al. (2010) England (no date) 6 months post flood PTSD 27.9% Anxiety 24.5% Depression 27.9% Liu et al (2006) Hunan, China (various) 2.5 years post flood PTSD 8.6% Norris et al (2004) Mexico (1999) Longitudinal 6 month reported Assananckomchai et al (2004, 2007) Thailand (2000) Longitudinal 20 weeks reported Heo et al (2008) Korea (2006) 18 months post flood pre flood control PTSD 28% Generic mental health problems 40% PTSD 43.1% Mild depression 53.5%

8 Findings: Generic Health Models Few et al Few, R Health and Climatic hazards: framing social research on vulnerability, response and adaptation. GLOBAL Environmental Change, 17,

9 Findings: Psycho-social dimensions - Tapsell et al Tapsell, S. M., Tunstall, S. M. & Priest, S Developing a conceptual model of flood impacts upon human health. Integrated Flood Risk Analysis and Management Methodologies. FloodSite Report.

10 Findings : factors affecting prevalence Table 1: Factors influencing the likelihood of experiencing mental health disorder after flooding Pre existing conditions Features of the stressor Post event stress and coping strategies event History of psychiatric Severity of exposure Presence of other stressors disorder History of other health Perception of human Lack of resources for recovery related problems control or responsibility for the event Gender General scale of loss of life or massive injury Distress of others, particularly spouse Disaster experience or training Age Ethnicity Socio economic status Dependent children Urban/rural setting Personality factors Level of personal property Living with the threat of constant or growing flood threat Social support Religion Family structure Coping strategies Need for relocation

11 Findings: disaster recovery profiles asp

12 Findings: Duration and memory Most symptoms disappear quite quickly For a minority they last a long time perhaps forever Memory has an impact on symptoms anniversaries can trigger increase in symptoms Weather events can also trigger symptoms

13 Conceptual model development: factors affected by memory Pre existing conditions Features of the stressor event Post event stress and coping History of psychiatric disorder (could be made worse because of lasting impact of previous event) History of other health related problems (could be made worse because of lasting impact of previous event) Disaster experience or training (Could be improved because of previous experience) Level of personal property damage and loss (could be improved by preparedness but otherwise could be cumulative ) Perception of human control or responsibility (Frequent flooding could feel like victimisation but improved preparedness could give feeling of control) strategies Need for relocation (could be improved through better resilient reinstatement) Lack of resources for recovery (May be more prepared but previously held resources could be exhausted) Distress of others, particularly spouse (could be worse through memory of flooding) Social support (may be improved due to past experience or subject to compassion fatigue) Coping strategies (May be enhanced through past experience but may have to be abandoned) Living with the threat of constant or growing flood threat (likely to be made worse by flood memory)

14 Conceptual model Influencing Factor Impact of flood Possible mitigation Pre-existing mental health - Treatment/counselling = Pre-existing physical health - Treatment = Flood Experience + Training and preparedness + + Level of personal loss = Preparedness + Perception of control ~ Information/preparedness ~ Relocation = Resilient reinstatement/ preparedness + Resources ~ Insurance/preparedness + Distress of others - Treatment/counselling = Social support system ~ Coping strategy ~ Reinforce community organisations + Choose appropriate coping strategy + Living with threat - Counselling/preparedness = Potential combined impact

15 Implications Not ready to predict patterns of mental health needs in advance Avoid pathologising normal reactions Repeat flooding can be instrumental in triggering more severe mental health disorders Identify helpful interventions to speed recovery Identify helpful interventions to build adaptive capacity Consider coping styles

16 Summary and next steps Looking through the lens of memory brings new insight for recovery processes Re-examine recent survey findings Survey of frequent flooded communities Discuss findings with health professionals