Mental health and health-related quality of life in victims of the 2013 flood disaster in Germany-A longitudinal study of health-related flood consequences and evaluation of institutionalized low-threshold psycho-social support

Purpose: Climate models predict an increase in frequency and intensity of flood disasters that have the potential to affect human health due to immediate traumatic experiences or long-term secondary stressors. However, only few studies examined the longitudinal course of mental health after floods and those who do lack an inclusion of physical health and evaluation of effective interventions to mitigate adverse health effects. Methods: A longitudinal field study with 3 waves covering a time span of 12 months was conducted in beneficiaries of the Malteser Aid Service (MAS) psycho-social support program after the 2013 flood disaster in Germany. Participants received a self-report questionnaire to inquire mental and physical health parameters. A crosssectional survey in flood-affected but unsupported individuals was conducted as an approximate control group and to specify the characteristics of help seekers to relief organizations. Results: Participants exhibited elevated screening rates of depression (50.3%), post-traumatic stress (35.5%) and reduced physical health-related quality of life (63.1%) with an overall significant improvement of mental health parameters over time. The control group reported lower rates of depression and post-traumatic stress compared to the MAS group. Financial support and supportive counseling were associated with reduced mental health strain and counteracted established vulnerability factors. Conclusion: Selected and targeted psycho-social interventions have the potential to improve mental health and health-related quality of life in flood victims. Results may inform the development of structured education programs for volunteer and professional staff of relief organizations to promote effective psycho-social support measures and improve post-disaster support.