Mental Health and Social Networks After Disaster

Richard A Bryant; H Colin Gallagher; Lisa Gibbs; Philippa Pattison; Colin MacDougall; Louise Harms; Karen Block; Elyse Baker; Vikki Sinnott; Greg Ireton; John Richardson; David Forbes; Dean Lusher

doi:10.1176/appi.ajp.2016.15111403

Mental Health and Social Networks After Disaster

Am J Psychiatry. 2017 Mar 1;174(3):277-285. doi: 10.1176/appi.ajp.2016.15111403. Epub 2016 Nov 14.

Affiliation

¹ From the School of Psychology, University of New South Wales, Sydney; the Melbourne School of Psychological Sciences, University of Melbourne, Melbourne; the Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; the Office of the Deputy Vice-Chancellor (Education), University of Sydney, Sydney; the Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide; the Department of Social Work, University of Melbourne, Melbourne; the Victorian Department of Health and Human Services, Melbourne; the Centre for Disaster Management and Public Safety, University of Melbourne, Melbourne; Emergency Services, Australian Red Cross, Melbourne; Phoenix Australia-Centre for Posttraumatic Mental Health, University of Melbourne, Melbourne; and the Centre for Transformative Innovation, Swinburne University of Technology, Melbourne.

PMID: 27838935
DOI: 10.1176/appi.ajp.2016.15111403

Abstract

Objective: Although disasters are a major cause of mental health problems and typically affect large numbers of people and communities, little is known about how social structures affect mental health after a disaster. The authors assessed the extent to which mental health outcomes after disaster are associated with social network structures.

Method: In a community-based cohort study of survivors of a major bushfire disaster, participants (N=558) were assessed for probable posttraumatic stress disorder (PTSD) and probable depression. Social networks were assessed by asking participants to nominate people with whom they felt personally close. These nominations were used to construct a social network map that showed each participant's ties to other participants they nominated and also to other participants who nominated them. This map was then analyzed for prevailing patterns of mental health outcomes.

Results: Depression risk was higher for participants who reported fewer social connections, were connected to other depressed people, or were connected to people who had left their community. PTSD risk was higher if fewer people reported being connected with the participant, if those who felt close to the participant had higher levels of property loss, or if the participant was linked to others who were themselves not interconnected. Interestingly, being connected to other people who in turn were reciprocally close to each other was associated with a lower risk of PTSD.

Conclusions: These findings provide the first evidence of disorder-specific patterns in relation to one's social connections after disaster. Depression appears to co-occur in linked individuals, whereas PTSD risk is increased with social fragmentation. These patterns underscore the need to adopt a sociocentric perspective of postdisaster mental health in order to better understand the potential for societal interventions in the wake of disaster.

Keywords: Epidemiology; Models/Theories of Psychiatry; Mood Disorders-Unipolar; Posttraumatic Stress Disorder.

MeSH terms

Adult
Aged
Cohort Studies
Depressive Disorder / diagnosis*
Depressive Disorder / psychology*
Disasters*
Female
Fires*
Humans
Male
Middle Aged
Outcome Assessment, Health Care
Protective Factors
Risk
Social Support*
Stress Disorders, Post-Traumatic / diagnosis*
Stress Disorders, Post-Traumatic / psychology*
Surveys and Questionnaires
Survivors / psychology*
Victoria