32 REPORTS AND COMMENTS

Australian research into the psychological aspects of disasters

On 16th February 1983, Ash Wednesday, bushfires devastated large areas of the states of Victoria and South Australia causing substantial loss of life and property. This disaster served as the stimulus for the convening of a research meeting on 26th and 27th April 1984 by the Australian Counter Disaster College and some members of the Department of Psychology at La Trobe University. Ironically the College, an educational and training institute situated at Mt. Macedon, is in one of the areas worst affected by the fires.

The topic of the conference was human behaviour in disasters. The intentions of the organizers were to gain an overview of recent Australian disaster research in human behaviour, to provide an opportunity for researchers to make contact and to encourage an exchange of information on methodology and research strategies. It was also hoped that by requesting all participants to present a written paper it would stimulate the documentation of recent research.

While it was recognized that an important concern is to facilitate the application of research findings to disaster planning and post disaster intervention, this was considered beyond the scope of the conference. However, the range of those invited was broadened to encourage the beginnings of this process. The resulting diversity in participants was stimulating but led to some loss of the intended focus on empirical research into behaviour.

Conference participants came from three main groups and the majority presented papers based on research. The first group was of those who had studied the recent bushfires, including some who were new to disaster research. A second group had past experience and a continuing interest in disaster research. The third group included clinical and welfare service administrators. This mixture ensured a wide variety of interests and experience and included most people currently engaged in human behaviour disaster research in Australia.

The opening papers by Raphael and Singh raised important research issues. Raphael emphasized that researchers should be empathetic to the victims and use simple and compassionate measures. To prevent the needless re-examination of issues and to ensure the maximum usefulness of data, she suggested that a unified and co-ordinated methodology and approach to disaster should be developed in Australia. In the discussion which followed, some argued that methodology should be left to the individual researcher and that any other approach would be an inappropriate intrusion into academic freedom. It seems that disaster researchers have the capacity to be as over involved in their work and

proprietorial of their interest as any other disaster worker. This phenomenon can cloud the careful consideration of evidence and restrict the research that is important to those providing clinical and welfare service. Singh when discussing the ethical issues relevant to disaster research emphasized the vulnerability of victims. He suggested that unless researchers are clear about their motives and have weighed the potential costs as well as benefits, they may be no different from the voyeurs who gather at the scene of an accident. He recommended that research should be conducted through clinical and weIfare services and be done by people who have a practical knowledge of crisis and bereavement management. Such channels could serve to ensure genuine informed consent and confidentiality.

The research papers presented covered a wide range of topics which can be organized broadly into three areas. Perhaps the most pragmatic issue, counter disaster management, was approached from a number of perspectives. Price reported a study of preparedness for bushfires which was conducted in an area in South Australia subsequently devastated on Ash Wednesday. Despite the availability of information, most residents were ill-prepared and it seemed that people did not consider appropriate responses because they believed that they would escape unscathed. Blong reported on the prevalence among urban Australians of myths about disasters. Although people viewed its reliability with suspicion, the media served as the primary source of information. This reliance emphasized the need for accurate reporting by the media prior to, during and after a disastrous sequence of events.

Two reports emphasized the importance of canvassing those affected directly, when attempting to assess needs following disaster, independently of professional interests and bias. Berry reported that the relief and welfare effort after the Southland Flood in New Zealand in 1983 was partly developed on the basis of a survey of the victims in the first days of the disaster. Clayer described the preliminary findings of a study that had attempted to contact the 2,261 adults who registered as victims after the bushfires in South Australia. One striking feature was that a proportion of those who had suffered considerably had not received the degree of assistance intended from a specially co-ordinated Bushfire Relief Team. The unit was set up by the South Australian State Government as the major welfare agency to deal with victims. The structure and function of this team was described by its co-ordinator, Grear, who emphasized the efficient and rapid methods used to distribute relief. This approach was developed to minimize the problems that had occurred following similar fires in South Australia three years before. However another report demonstrated the need for an external audit of such disaster agencies. McFarlane and Frost, using a combination of questionnaire and interview, contacted the twenty workers in this team. Their research suggested that the job description of these workers was not specific enough and that this was reflected in the workers’ failure to develop priorities (as required by a crisis intervention model) as to who was most likely to benefit from assistance. The range of skills which these workers described as necessary for the job emphasized how

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REPORTS AND COMMENTS 33

material relief cannot be provided adequately without a detailed understanding of psychological reactions to disaster.

Chamberlain and Leivesley presented a preliminary evaluation of the policies and procedures of disaster welfare services at both Federal and State levels. They emphasized the need for the continuing development and evolution of existing services. Britton further developed this thesis by describing a conceptual framework for attempting to analyze the organizational structure of counter-disaster bodies. One of the most challenging papers was presented by Michaelis who called for the establishment of an international inter-disciplinary disaster research centre. Using the example of the recently completed floodgates at the mouth of the Thames, he indicated how inappropriate decisions are made by experts in one area because of a lack of consultation with experts from seemingly unrelated areas. Planning can be successful only when engineering, managerial, demographic, economic and behavioural aspects of a problem are simultaneously considered. Government disaster bodies often do not have the flexibility to incorporate the wide range of research data available when planning services. Budd emphasized the capacity of individuals to modify the impact of disaster and how this implies that an understanding of human behaviour is essential for adequate disaster management.

The second theme of the workshop focused on the provision of clinical services and related questions about the nature and prevalence of psychological reactions following disaster. The conflict which occurred between the central planning group for mental health services in Victoria and an outreach programme from a metropolitan hospital, described by Grigor and Buckingham, emphasized how mental health professionals need to formulate coherent goals based on an accurate assessment of need. The planners emphasized the current gap between disaster relief policy formation and research and called for a stronger link between researchers and service providers. Jones, Valent and Berah described the strengths and weaknesses of their outreach programme and reported a study of the effects of the experience on the workers in this team. Team members experienced considerable stress during the work in part due to their ill-defined role, but they also gained a great deal at professional and personal levels.

Boman used the case of the Vietnam veterans to emphasize both the morbidity of disaster victims and how myths arise from misinterpreted data. He reported a study of hospitalized veterans which supported the general conclusion that Vietnam veterans are more likely to suffer from post traumatic stress disorders and depressive reactions than matched controls. However, the study detected no greater incidence of violence, alcoholism, drug dependence or criminal offences than in others of their age group.

A study into the effects of the Ash Wednesday tires on thirty-seven firefighters and their spouses by Cook, Wallace and McFarlane suggested that the prevalence of post- traumatic symptoms in the firefighters eleven months later

is significantly influenced by their spouses’ level of morbidity. It seemed that a mismatch between the coping style of the partners ofa marriage was a perpetuating factor of post disaster psychological disorder.

An important step in defining the prevalence of post- disaster non-psychotic psychological disorder has been the use of instruments such as the General Health Questionnaire (GHQ). Fairley presented a relevant study of the adult population of a small Fijian village badly damaged by a cyclone in 1983. Based on a sample of seventy-five subjects and using the GHQ he found that ten weeks after the disaster the population demonstrated twice the normal rate of emotional disturbance but that this rapidly returned to predisaster levels by three months.

Another study, which attempted to define the meaning of a high CHQ score in disaster victims in terms of specific psychiatric disorders was reported by McFarlane and Croft. Following a survey of 469 firefighters, fif ty were chosen and examined using a structured interview. Post-traumatic stress disorders were found in ten of these men and despite frequent presentation to their local doctors, only one had received appropriate treatment. The fact that these interviews took place eight months after the fire indicates that psychiatric morbidity does occur and is often not recognized by medical practitioners.

The need to assess populations for some time after a disaster before reaching conclusions about the prevalence of psychiatric disorder was emphasized by another study conducted by McFarlane of 520 primary school children in South Australia. He found that the prevalence of “cases” defined by Rutter’s Teacher Questionnaire was 296% greater eight months after the fire than two months after it. In these children after eight months, it was not specific losses or exposure, but disturbed family functioning that had the strongest association with symptoms.

The third group of papers reported research which used a disaster as a natural experiment to investigate specific, theoretical issues. Wallace, Cook and Frehse studied the role that social support played in the adjustment of thirty-eight women who had lost their homes. Contrary to hypotheses generated from previous research they found no relationship between locus of control and the utilization or effects of support. Four months after the fires twenty-nine of the women showed non psychotic psychological impairment as scored by the GHQ. Innes and Clarke, on the other hand, found some evidence that perceived social support played a protective role for metropolitan firemen called to assist in fighting the bushfires.

Many of the issues which arose from the opening papers by Raphael, Singh and others throughout the conference were developed in the closing discussion session. It was suggested that multi-disciplinary teams could act to limit the convergence of researchers following a disaster. Grear proposed a number of questions which may provoke answers useful to those involved in disaster management. However, the conference concluded without resolving the question of how to ensure the incorporation of research material into disaster planning.

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Comment

A positive outcome of the conference was that it has promoted the documentation of research into the recent bushfires (all reports will be published in the Proceedings in late 1984). Some interaction between people in this research area had taken place as a result of seminars and public meetings following the fires, but there had been few formal papers presented.

Researchers came from a number of disciplines including psychology, psychiatry, social work and human geography. While representation at the conference was cross- disciplinary. most research was within particular disciplines (collaboration was limited mainly to psychologists and psychiatrists). As a consequence participants had different priorities regarding methodology and statistical treatments. Nevertheless there was evidence that some tools and methodology are commonly accepted and this is an important basis for future cross-disaster comparisons.

A consideration of the material presented at the conference reinforces the observation that there are no coherent theories of disaster response. While the literature is preoccupied with the “stage” model there was little evidence of its importance to Australian researchers. In the past in this country, research has frequently been conducted as “one off‘’ studies by people who then leave the field. Without continuity of researchers who develop some expertise and who have developed a methodology applicable to the next occasion, the same mistakes are repeated by new recruits and disaster research in Australia advances more slowly than it need.

If meetings such as this one can promote contact between the widely scattered researchers of this country and persuade them to continue their interest in the area, it may

encourage longer term studies. Cross-disaster comparisons and longitudinal studies may validate aspects of the stage model or lead to its refinement, and a revised model may in turn provide the foundation for testable theories of disaster response and for the informed application of research findings in the field.

The question of the application of research to the planning and provision of welfare, health and other services in and after disaster requires imaginative collaboration between planners and researchers. To date, disaster planners in Australia have not drawn on research findings to any great degree, relying instead on more easily accessible material. Carefully designed research often takes a long time to collate and analyze and addresses questions which may cut across service boundaries and reach politically unpalatable conclusions. The alternatives are to draw on intradepartmental audits of disaster management which are restricted to coverage, or on reports which are broad in scope but which do not use primary information sources and present superficial conclusions. A formal mechanism is required to ensure a liaison between disaster researchers, planners and managers. Only then will planners have more influence on the questions to be asked and researchers become more appropriately accountable.

A.C. McFarlane Department of Psychiatry Flinders University of South Australia

Meredith Wallace

Peter Cook

Department of Psychology La Trobe University

Sunshine Hospital & Health

St. Albans Services Complex

Disasters/9/1/ 1985