Emergency department mental health presentations in bushfire-, flood-, storm-, drought-, and COVID-19-affected areas: Analysis of growth models between 2017 and 2021

OBJECTIVE: Repeated exposure to adverse events increases the possibility of negative emotional consequences and the development of post-traumatic stress disorders. Communities who have faced several extreme weather events and pandemic-related disruptions may require emergency care for mental health-related reasons to a greater extent than less affected regions. METHODS: This study investigated linear time trends of mental health-related emergency department presentations of adults residing in regions with high, medium, and lesser exposure to fires, floods, storms, droughts, COVID-19 infections and pandemic-related layoffs. Emergency department data were captured from 2017 to 2021. RESULTS: Disaster-affected communities presented to emergency departments at a higher rate well before 'the Black Summer bushfires', possibly due to fewer alternatives to hospital care in regional areas. Exposure to multiple disasters was associated with reduced emergency department presentations for mental health reasons. No increase in presentations was noted during the observation period. CONCLUSIONS: Possible reasons for this pattern relate to community characteristics, including resilience, reappraisal of symptom severity, and a possible service gap for those with less acute mental health problems. IMPLICATIONS FOR PUBLIC HEALTH: Mental health service usage needs to be observed across multiple service areas and on an ongoing basis with the clear intention to explain how disasters shape support needs.