Interpersonal violence and mental health outcomes following disaster

Robyn Molyneaux; Lisa Gibbs; Richard A Bryant; Cathy Humphreys; Kelsey Hegarty; Connie Kellett; H Colin Gallagher; Karen Block; Louise Harms; John F Richardson; Nathan Alkemade; David Forbes

doi:10.1192/bjo.2019.82

Interpersonal violence and mental health outcomes following disaster

BJPsych Open. 2019 Dec 4;6(1):e1. doi: 10.1192/bjo.2019.82.

Authors

Affiliations

¹ Research Fellow, Child and Community Wellbeing Unit, Centre for Health Equity, University of Melbourne, Australia.
² Director, Child and Community Wellbeing Unit, Centre for Health Equity, University of Melbourne; and Academic Lead, Community Resilience & Public Health, Centre for Disaster Management and Public Safety, University of Melbourne, Australia.
³ Scientia Professor and NHMRC Senior Principal Research Fellow, School of Psychology, University of New South Wales, Australia.
⁴ Professor of Social Work, Department of Social Work, University of Melbourne, Australia.
⁵ Professor, Centre for Family Violence Prevention, Department of General Practice, The University of Melbourne and The Royal Women's Hospital, Australia.
⁶ Family Violence Principal Practitioner, Department of Social Work, University of Melbourne; and Victorian Department of Justice and Community Safety, Australia.
⁷ Postdoctoral Researcher, Centre for Transformative Innovation, Faculty of Business and Law, Swinburne University of Technology, Australia.
⁸ Associate Director, Child and Community Wellbeing Unit, Centre for Health Equity, University of Melbourne, Australia.
⁹ Chair and Head, Department of Social Work, University of Melbourne, Australia.
¹⁰ National Resilience Adviser, Emergency Services, Australian Red Cross, Melbourne, Australia.
¹¹ Phoenix Australia: Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne; and Senior Clinical Psychologist, Monash Health, Australia.
¹² Director, Phoenix Australia: Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Australia.

Abstract

Background: Disasters pose a documented risk to mental health, with a range of peri- and post-disaster factors (both pre-existing and disaster-precipitated) linked to adverse outcomes. Among these, increasing empirical attention is being paid to the relation between disasters and violence.

Aims: This study examined self-reported experiences of assault or violence victimisation among communities affected by high, medium, and low disaster severity following the 2009 bushfires in Victoria, Australia. The association between violence, mental health outcomes and alcohol misuse was also investigated.

Method: Participants were 1016 adults from high-, medium- and low-affected communities, 3-4 years after an Australian bushfire disaster. Rates of reported violence were compared by areas of bushfire-affectedness. Logistic regression models were applied separately to men and women to assess the experience of violence in predicting general and fire-related post-traumatic stress disorder, depression and alcohol misuse.

Results: Reports of experiencing violence were significantly higher among high bushfire-affected compared with low bushfire-affected regions. Analyses indicated the significant relationship between disaster-affectedness and violence was observed for women only, with rates of 1.0, 0 and 7.4% in low, medium and high bushfire-affected areas, respectively. Among women living in high bushfire-affected areas, negative change to income was associated with an increased likelihood of experiencing violence (odds ratio, 4.68). For women, post-disaster violence was associated with more severe post-traumatic stress disorder and depression symptoms.

Conclusions: Women residing within high bushfire-affected communities experienced the highest levels of violence. These post-disaster experiences of violence are associated with post-disaster changes to income and with post-traumatic stress disorder and depression symptoms among women. These findings have critical implications for the assessment of, and interventions for, women experiencing or at risk of violence post-disaster.

Keywords: Post-traumatic stress disorder; trauma; violence.