The role of prevention in technological catastrophe

Abstract

This paper discusses the potential for and problems inherent in the prevention of stress resulting from technological catastrophe. Baum, Fleming, and Davidson's (1983) characterization of technological disaster is reviewed. These accidents, which involve the breakdown or failure of human‐made systems, differ from other types of disaster in their psychological impact. These differences are particularly important in accidents involving hazardous substances including radiation and chemical toxins. The continuing threat of future illness resulting from exposure to radiation and toxins contributes to feelings of uncertainty; and the fact that the accident resulted from a failure of human‐made systems means it is likely to be perceived as a loss rather than a lack of control. Because of their unique features, technological catastrophies are likely to result in long term effects including chronic stress in exposed populations. Because failures of human‐made systems would be prevented if the problem was foreseen and preventable, prevention concerns center around reducing stress where possible. Three domains of prevention activity are described. First, assessments aimed at predicting the stress inducing and reducing impact of intervention strategies can contribute to decisions about how to handle the accident once it has occurred. Second, some of the policy implications of these events are described. Finally, the ethics of stress reducing interventions in settings where a real danger is present are discussed.     

Will the National Disability Insurance Scheme Improve the Lives of those Most in Need? Effective Service Delivery for People with Acquired Brain Injury and other Disabilities in Remote Aboriginal and Torres Strait Islander Communities

The aims of National Disability Insurance Scheme (NDIS) are to provide long‐term, person‐centred care and support to all Australians with a significant and ongoing disability, including individuals with an acquired brain injury (ABI). The scheme has significant potential to provide equitable opportunity of access to health and disability services. Historically, however, service provision in remote and outer regional areas of Australia lags behind more densely populated centres. Aboriginal and Torres Strait Islanders living with disability are already significantly marginalised. Further to this, people with an ABI are very often misunderstood and overlooked by disability services, health professionals and governments, and frequently fall victim to the criminal justice system. This paper provides an overview of the state of ABI disability for Aboriginal and Torres Strait Islanders in remote and outer regional settings, and the present sets of barriers they face to obtaining quality care and effective interventions. A significant opportunity has emerged with the advent of the NDIS but equitable benefit can only be achieved if additional and specialised measures are devised and implemented to appropriately screen for, and assess, incidence of ABI; disability services are appropriately resourced to overcome the pre‐existing disadvantage, and education, training and recruitment of Aboriginal and Torres Strait Islanders with the NDIS is undertaken to lead attitudinal changes in community to disability and health services. This paper concludes with recommendations for the NDIS to meet its laudable objectives.