Dr Rob Gordon has been treating the survivors and conducting weekly community meetings in towns affected by the bushfires.
He says those who survived the fires have described towering walls of flame and a roar which sounded like jumbo jets as blazes swept across Victoria a year ago, killing 173 people.
On Sunday dozens of ceremonies were held across Victoria to mark the anniversary.
Dr Gordon says the violent nature of Black Saturday compared to other natural disasters has led to a much higher incidence of post-traumatic stress among survivors.
“Post-traumatic stress is a significant problem because this fire was so horrific, so violent, so sudden, so destructive,” he said.
“Normally in disasters, post-traumatic stress affects about 10 per cent of people involved, people who have their lives directly threatened or who see terrible things, but you know most people can evacuate.
“[From Black Saturday] it’s been much higher. I would expect it to be possibly in the order of about 30 per cent of people that were involved directly in the fire would have some kind of traumatic stress.”
As well as post-traumatic stress, more survivors are expected to develop depression and anxiety in the coming year.
But Dr Gordon says less than half of those who need help dealing with mental health issues will actually seek it.
“There’ll be a small number of people who probably during the year start to present with depression, anxiety states. They might have been actually coping and they had a bit of a problem beforehand and now it’s all got out of control,” he said.
“We normally estimate that probably somewhere between 10 and 20 per cent of the population would benefit from some kind of mental health assistance and probably less than half of that are actually getting it.”
ELEMENT OF DISRUPTION
The death toll in some of the small communities affected by the bushfires was staggering. Strathewen had a population of just a couple of hundred people when the bushfires swept through, killing 27 people.
Dr Gordon says this toll on whole communities has magnified the trauma for those trying to recover.
“The element of disruption – because what we have to think about for a natural disaster is everybody in the community is affected and every aspect of life is affected,” he said.
He says for most people it will take at least five years to recover emotionally from the disaster. But he says some survivors will never get over the experience.
“Most people recover well and there’s a sizeable number of people who, 10 years down the track, will say “I think I’m a better person for that experience’,” he said.
“There’ll be another group of people whose lives will never quite get back on track, who will carry bitterness, resentment, a sense of hurt and so on.
“One of the problems is people just put their heads down and go hell for leather to try and deal with everything, but they can’t get through it in time and then they totally exhaust themselves and we’ve seen several peaks of people hitting the wall,” he said.
“What’s actually happening at the moment in the lead-up to the anniversary is people going back to their blocks, thinking up until now they’ve been pretty motivated and focused on rebuilding,” he said.
“But when they get up there they look around, they feel the hot weather and they see that most of their neighbours aren’t there, some maybe have died. A lot of the place is destroyed and the bush is destroyed and they say: ‘Is this still the place I want to be? I’m not so sure.’
“And so case managers are saying to us that a lot of people are suddenly very uncertain about the plan they had.”
Meanwhile, Dr Gordon says the children that survived the firestorm have displayed a complex range of coping issues.
He says the recovery of many younger children will depend on their parents, while many older children have taken on much of the burden.
“There’s a large group of kids who are having trouble with the academic side of things, just can’t cope with it,” he said .
“So there’s been a major issue with teenagers not attending school in some areas. It’s just too hard to concentrate. They’ve got to distract themselves with other things.”
Many of the communities affected by the Black Saturday bushfires hosted community picnics or memorials on Sunday as a way of healing and moving forward.
But Dr Gordon says just getting through the day will be all that some can cope with when it comes to marking the anniversary.