Improving mental health following compound disasters in Australia: A RCT of the Skills for Life Adjustment and Resilience (SOLAR) program

Alexandra Howard, Cowlishaw, Gibson, Alexander, O'Donnell

Number

20

Assigned to session

Keywords

Crisis, disaster or pandemic related
Public health, prevention, early interventions
(Sub)clinical interventions or treatment (innovations)

Abstract

The mental health impacts of surviving climate change related disasters are significant. However, access to mental health services are often limited by the availability of trained clinicians. Building local capability for the mental health response is often promoted however  lack of evidence-based programs is problematic. This study investigates the impacts of using trained community members to deliver the Skills for Life Adjustment and Resilience program (SOLAR) on those impacted by compound disasters (drought, wildfires, COVID lockdowns) in a number of rural Australian communities.

Method: Thirty-six local community members were trained to deliver SOLAR, a 5-session skills-based, trauma-informed brief program. Sixty-six people with distress and impairment were randomised into the SOLAR program or a Self-Help condition (weekly emails with self-help information) and assessed pre, post and two months following intervention.

Results: Analysis of covariance (ANCOVA) analyses revealed that participants in the SOLAR condition experienced greater decreases in mental health symptomatology (for both psychological distress and PTSD symptom severity) between pre- and post-intervention (T1 to T2) relative to the Self-Help condition, while controlling for scores at intake. However, this was not maintained at follow-up. Moderate to large effect size improvements in SOLAR condition at post-treatment dropped to small effect sizes at follow-up.

While SOLAR was effective in improving posttraumatic stress symptoms, depression, and anxiety after delivery, the effects decreased by follow-up. Given the ongoing stressors in the community following compounding disasters and COVID, booster sessions may be useful. Training local community members to deliver the SOLAR program is safe, acceptable and feasible.

Authors

Alexandra Howard

Cowlishaw

Gibson

Alexander

O'Donnell