The unfolding bushfire crisis could have far-reaching effects on mental health, and is likely to push many people to the point where they need to seek professional help.
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That's the message now coming out from mental health groups, the NSW government and psychologists, who have been urging anyone directly or indirectly affect to reach out early if they are not coping.
Likewise University of Wollongong scientist Dr Natalie Matosin, who researches how extreme trauma can shift the biological makeup of the brain at a molecular or genetic level, said almost everyone was likely to reach "breaking point" at some stage as the traumatic event wears on.
She said the "unprecedented" and "chronic" stress being caused by the bushfires was a risk for many people's mental health, whether they were being directly or indirectly affected by the fires.
For support call:
- Disaster Welfare Assistance Line on 1800 018 444
- NSW Mental Health Line on 1800 011 511
- Lifeline on 131114
- Headspace 1800 650 890
- beyondblue 1300 224 636
- Suicide call back service 1300 659 467
"Generally you feel a stress, you experience that and then when the stress is gone your stress response stops," Dr Matosin said.
"But when people have been extremely stressed for prolonged periods of time, their stress response doesn't turn off and that has detrimental effects on the brain... leading to depression, anxiety and PTSD."
She said it was important to highlight that this was a "normal" response, and urged people to seek help early before long-term problems emerged.
"This is a really traumatic time, and as a community we do have incredible resiliance, but we are also human," she said.
"No matter how resilient people are, everyone has a point where their stress exposure means they will have a mental health reaction.
"It's normal that you will feel affected in some way."
"The crisis isn't over, we're in the middle of it, we're still going to have more hot days and the fires are still going to burn, and the danger is that down the track when the fires stop will be when these prolonged traumatic reactions will be occurring," she said.
"So people may suddenly not be able to bounce back as effectively as they did before because they've been through chronic and traumatic experiences.
"But I don't think people should wait until then to get psychological help, because the science shows that if we can intervene early it increases people's potential to recover."
In a message from NSW Health, the state's chief psychiatrist Dr Murray Wright advised people to look after themselves, family, neighbours and friends and access mental health services if needed.
"Those particularly at risk are the isolated, the elderly, those with pre-existing mental illness and anyone experiencing a recent bereavement," he said.
"Talk to your GP or regular health care provider if you are experiencing these issues.
"We have mental health staff on the ground in bushfire-affected areas to provide advice and pathways to care for those who need specialist assistance."
Private health provider Ramsay has published a number of strategies people can use to help those affected by the fires.
Mental Health Service Line Director Dominique Robert-Hendren said being present with no expectations was a good way to start
"Let the person know you are here for them and ask them how you can help," she said.
"Another way to offer practical support is to assist with chores, cooking, cleaning, and making doctors' appointments and alternative accommodation arrangements."
"You can also offer a listening ear as they may find it helpful to talk about what happened.
"Don't pressure them - let them take things at their own pace. Let the person know that it is okay if they don't want to talk about what happened. You don't have to say too much."
Other tips include
- Make eye contact with the person speaking to you.
- Let them speak freely without interrupting.
- Ask questions to make sure you understand them.
- Do not judge or give uninvited opinions.
- Don't tell them what they should be thinking or how they should be feeling.
- Listen and respect their wishes and offer to check in again.