Australian & New Zealand Journal of Psychiatry 2014, Vol. 48(7) 634–643 DOI: 10.1177/0004867414534476 © The Royal Australian and New Zealand College of Psychiatrists 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav anp.sagepub.com Australian & New Zealand Journal of Psychiatry, 48(7) Psychological outcomes following the Victorian Black Saturday bushfires Richard A Bryant 1,8 , Elizabeth Waters 2 , Lisa Gibbs 2 , H Colin Gallagher 3 , Philippa Pattison 3 , Dean Lusher 4 , Colin MacDougall 5 , Louise Harms 6 , Karen Block 2 , Elyse Snowdon 2 , Vikki Sinnott 5 , Greg Ireton 7 , John Richardson 8 and David Forbes 9 Abstract Objective: We aimed to map the prevalence and predictors of psychological outcomes in affected communities 3–4 years after the Black Saturday bushfires in the state of Victoria, Australia. Methods: Baseline assessment of a longitudinal cohort study in high-, medium-, and low-affected communities in Vic- toria. Participants included 1017 residents of high-, medium-, and low-affected fire communities. Participants were surveyed by means of a telephone and web-based interview between December 2011 and January 2013. The survey included measures of fire-related post-traumatic stress disorder (PTSD) and general PTSD from other traumatic events, major depressive episode, alcohol use, and general psychological distress. Results: The majority of respondents in the high- (77.3%), medium- (81.3%), and low-affected (84.9%) communities reported no psychological distress on the K6 screening scale. More participants in the high-affected communities (15.6%) reported probable PTSD linked to the bushfires than medium- (7.2%) and low-affected (1.0%) communities (odds ratio (OR): 4.57, 95% confidence interval (CI): 2.61–8.00, p = 0.000). Similar patterns were observed for depression (12.9%, 8.8%, 6.3%, respectively) (OR: 1.83, 95% CI: 1.17–2.85, p = 0.008) and severe psychological distress (9.8%, 5.0%, 4.9%, respectively) (OR: 2.08, 95% CI: 1.23–3.55, p = 0.007). All communities reported elevated rates of heavy drinking (24.7%, 18.7%, 19.6%, respectively); however, these were higher in the high-affected communities (OR: 1.39, 95% CI: 1.01–1.89, p = 0.04). Severe psychological distress was predicted by fear for one’s life in the bushfires, death of someone close to them in the bushfires, and subsequent stressors. One-third of those with severe psychological distress did not receive mental health assistance in the previous month. Conclusions: Several years following the Black Saturday bushfires the majority of affected people demonstrated resil- ience without indications of psychological distress. A significant minority of people in the high-affected communities reported persistent PTSD, depression, and psychological distress, indicating the need for promotion of the use of health and complementary services, community-based initiatives, and family and other informal supports, to target these per- sistent problems. Keywords Post-traumatic stress disorder, disaster, bushfres, resilience, Black Saturday 1 School of Psychology, University of New South Wales, Sydney, Australia 2 Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Australia 3 School of Psychological Sciences, University of Melbourne, Australia 4 Swinburne Business School, Swinburne University of Technology, Melbourne, Australia 5 Southgate Institute for Health, Society and Equity, Flinders University, Melbourne, Australia 6 Department of Social Work, Department of Health (Victoria), Melbourne, Australia 7 Health and Human Services Emergency Management, Department of Human Services (Victoria), Melbourne, Australia 8 Emergency Services, Australian Red Cross, Melbourne, Australia 9 Australian Centre for Posttraumatic Mental Health, University of Melbourne, Australia Corresponding author: Richard Bryant, School of Psychology, University of New South Wales, NSW 2052, Australia. Email. r.bryant@unsw.edu.au 534476ANP 0 0 10.1177/0004867414534476Australian and New Zealand Journal of PsychiatryBryant et al. research-article 2014 Research Editor’s Choice