Psychosocial impacts: resources for mitigation, response and recovery
All disasters - natural or technological - can adversely affect the health and well-being of community members and response workers involved. Because of local and global transformations (climate change, conflicts, migration, urbanization, aging, etc.), these public health impacts are expected to grow over the coming decades. Psychosocial effects refer to the adverse psychological and social outcomes of a disaster or emergency. Because this term encompasses effects at both the individual and community levels, psychosocial effects may include:
- Stress and mental health impacts leading to mental injury or illness (post-traumatic stress disorder, depression, anxiety, etc.), sleep disturbance, disrupted concentration, somatic symptoms, or maladaptive behaviors, such as substance abuse (Goldmann and Galea, 2013);
- Deterioration of family relationships as a result of mental illness or family separations due to death, hospitalization, violence, or evacuations;
- Deterioration of social or cultural supports due to the destruction of community rallying points, events, or significant cultural or heritage sites; and
- The loss of meaningful landscapes and relationships with the physical environment that create a form of distress known as solastalgia, which can deeply impact mental health (Eisenman et al. 2015). This form of psychosocial harm is expected to become more prevalent as climate change broadly alters landscapes and our relationship with them (Hayes et al. 2018).
In contrast to physical health impacts, psychosocial impacts differ in that:
- Effects may peak well after the original incident has occurred, and may persist over the long term;
- Effects may appear to improve and then worsen repeatedly, following a highly non-linear trajectory to recovery (see pg. 5 of Dewolfe, 2000).
- Effects may impact even those with indirect exposure and/or those distant from the disaster site; and
- Some groups, including seniors, children, and Indigenous peoples, are at higher risk of impacts.
Resilient communities are less prone to disturbance and recover more quickly afterward. Community-based approaches for resilience include a variety of pre-disaster individual- and community-level interventions to strengthen individual health and the networks of these healthy humans that make up healthy communities. Similarly, after an event has occurred, it is critical not only to monitor and address individual-level psychological impacts, but also repair the higher level networks that create community wellbeing. The first section of this topic page presents a variety of resources introducing the concepts of community resilience and well-being and the types of interventions that can be use pre- and post disaster to build resilience.
In the event of disaster, it may be useful or necessary to screen the population for psychosocial impacts, whether as part of an immediate needs assessment or prioritization, or as the early stages of long-term psychosocial effects monitoring or research. The second section of this topic page presents a list of tools and other resources to assist in rapidly establishing a study protocol to sample the community, screen for psychosocial effects, and provide immediate assistance if necessary. Resources in support of high-risk populations and first responders are also included. Finally, we have provided some examples of long-term psychosocial monitoring studies from several distinct and highly informative Canadian disaster contexts.
Please see our other Environmental Public Health Emergency Resources
- Extreme heat
- Floods: prevention, preparedness, response and recovery
- Indigenous disaster response
- Oil Spills and Health
- Wildfire smoke and health
- Community impacts of fuel spills: a case study from BC’s northern coast (NCCEH, 2016)
This webinar presented by Chief Councillor Marilynn Slett (Heiltsuk Nation), Linda Pillsworth (First Nations Health Authority), and Dr. Angela Eykelbosh (NCCEH) on the environmental public health response to the impacts of the marine diesel spill that occurred near Bella Bella on October 13, 2016.
- The 2013 Lac-Mégantic tragedy: The public health response then and now (Généreux, 2013)
This webinar (slides only) describes the public health response during and after the Lac Mégantic train derailment tragedy on July 6, 2013. Dr. Généreux’s team retrospectively conducted a comprehensive analysis of direct services provided by her team during the first weeks (i.e. emergency response operations) and months (i.e. recovery operations).
Selected External Resources
Community-based approaches for resilience
- The “Lac-Mégantic tragedy” seen through the lens of the EnRiCH Community Resilience Framework for High-Risk Populations (Généreux et al. 2018)
This article describes the application of the EnRiCH framework in Lac-Mégantic, with the aim of increasing adaptive capacity after having observed moderate to severe psychosocial impacts. After a day of community reflection, a multisectoral “action plan” was developed to increase resilience and promote health. An inventory of 11 other community programs to promote healing and resilience can be found here.
- Community wellbeing: applications for a disaster context (Gibbs et al. 2015)
This article provides an introduction to the concepts of community resilience and wellbeing, as well as an overview of academic methods that have been used to assess community well-being.
- Building Resilient Communities: An Online Training (RAND Corporation, 2013)
This free online course provides an introduction to the concept of community resilience and demonstrates the differences between resilience and emergency preparedness. The course suggests a number of actions that a community (or organization) can take to become more resilient, including asset mapping and supporting behavioural health. For best functionality use Google Chrome.
- Community capacity-building in disaster mental health resilience: a pilot study of an academic/faith partnership model (McCabe et al. 2012)
This article describes a resilience-building project in which academic health professionals came together with urban faith-based organizations to design, implement and evaluate a training program to capacitate lay persons in psychological first aid and disaster preparedness planning. This project demonstrates the value of identifying and developing human assets and networks to prepare for future psychosocial disturbances.
- The Enhancing Resilience and Capacity for Health (EnRICH) Project (Resilience and High-Risk Populations Research Lab, 2011)
This participatory action research project developed a collaborative asset-mapping intervention based on work in five Canadian communities. This is a salutogenic model, meaning that it focuses on developing factors or functional attributes (i.e., assets) that support health, well-being, and coping, rather than simply identifying needs and vulnerabilities (deficits). Instructions for conducting the intervention are found in the EnRICH Community Intervention Manual, which is available in French and English. The genesis of the project and its high-level findings are described in this scientific article.
Tools for addressing immediate mental health needs
- Community Assessment for Public Health Emergency Response (CASPER) Toolkit (Centers for Disease Control and Prevention, (2012)
This toolkit assists practitioners in quickly and cost-effectively designing, conducting, analyzing, and reporting a scientifically rigorous community needs assessment. Although example here focuses on assessing basic necessities, the CASPER methodology can also be targeted toward psychosocial health data. Built-in statistical rigor facilitates further expansion or extension of the study, if needed, at a later date.
- Disaster Psychosocial Program: Helping those impacted by disasters (Provincial Health Services Authority, 2019)
This website describes a BC-based program that offers psychological first aid training to volunteer clinicians, registered therapists, and other mental health professionals and para-professionals. Creating a pool of trained professionals enhances resilience in future events.
See also: For a small fee, the Red Cross also offers an online Psychological First Aid course to professionals and the public in both official languages. The Canadian Mental Health Association has also made this easy-to-understand pocket guide for PFA volunteers.
- Building on the Basics: Planning for Recreation in Emergency Response and Recovery (Government of Alberta, 2017)
This guide demonstrates the importance of recreational opportunities as a psychosocial support for individuals and communities during and after emergencies. It provides recommendations and considerations for integrating recreation services into the emergency response.
- Disaster Behavioral Health Interventions Inventory (Substance Abuse and Mental Health Services Administration, 2015)
This inventory provides rapid overview of the many behaviour health interventions that can be implemented at early, intermediate or later (long-term) stages in the recovery. SAMHSA has numerous other disaster preparedness and emergency response materials, enumerated in this catalogue, which include materials for public health, responders, the general public, and for assisting high-risk populations, like seniors and children.
- Core principles for a community-based approach to supporting child disaster recovery (Gibbs et al. 2014)
This article succinctly outlines some of the key mental health and other issues faced by children and youth impacted by disasters, and works to dispel some of the myths around how children respond to disruption. The authors provide seven key principles for the design of interventions that will best engage children and assist them and their families through recovery.
- Resources for Responding to Emergencies and Disasters (Canadian Psychological Association, nd)
This website provides a number of specific stress management resources (e.g., for wildfires, floods, terrorism, etc) that are aimed directly at the public, as well as resources for public health practitioners working with seniors.
Examples of psychosocial effects studies from Canadian disasters
- Social Reconstruction of the Lac-Mégantic Community Following the Tragedy: Assessment of the First Six Years (CIUSSS de l'Estrie – CHUS, 2019)
This short report summarizes the variety of public health actions taken to understand the impacts of the Lac-Mégantic derailment, and the innovative means taken to promote recovery. Further resources on the community initiatives and public health research include:
- Promising initiatives to mobilize the local community in a post-disaster landscape (CIUSSS de l'Estrie – CHUS, 2019)
- The public health response during and after the Lac-Mégantic train derailment tragedy: a case study (Généreux et al., 2014)
- Monitoring Adverse Psychosocial Outcomes One and Two Years After the Lac-Mégantic Train Derailment Tragedy (Eastern Townships, Quebec, Canada) (Généreux et al., 2019)
- Review and Analysis of the Government of Alberta’s Response to and Recovery from 2013 Floods (MNP LLP, 2015)
This report gives a broad overview of the massive flooding event that affected over 30 communities in southern Alberta in 2013. Through consultation with ministries, municipalities, First Nations, and emergency mangers, the report highlights a number of unmet needs, including failure to adequately integrate or involve psychological and social support resources. For further information see:
- Risk and Protective Factors for Mental Health and Community Cohesion After the 2013 Calgary Flood (Hetherington et al., 2018)
- Responding to Disaster-Related Loss and Grief: Recovering From the 2013 Flood in Southern Alberta, Canada (Fulton and Drolet, 2018)
- Public health surveillance response following the southern Alberta floods, 2013 (Sahni et al., 2016)
- Psychosocial Response and Recovery Evaluation of the RMWB Wildfire 2016 Final Report (Kulig et al. 2017)
This comprehensive evaluation looks at the implementation and effectiveness of the psychosocial supports that were put in place during the Regional Municipality of Wood Buffalo (RMWB) fire in 2016. Additional examples of academic studies looking at psychosocial effects are below:
- Prevalence Rates and Predictors of Generalized Anxiety Disorder Symptoms in Residents of Fort McMurray Six Months After a Wildfire (Agyapong et al., 2018)
- Prevalence Rates and Correlates of Probable Major Depressive Disorder in Residents of Fort McMurray 6 Months After a Wildfire (Agyapong et al., 2019)
- After the Fort McMurray wildfire there are significant increases in mental health symptoms in grade 7–12 students compared to controls (Brown et al., 2019)
This list is not intended to be exhaustive. Omission of a resource does not preclude it from having value.