Hidden Costs

By Jim McVeagh 02/01/2012

Talking about the death toll from the February killer quake in Christchurch, Professor Mike Ardagh reckons that there will be a number of others who will have died from the quake who are not yet part of this toll. He is thinking mainly of those who succumbed to complications from their injuries or died as a result of the stress immediately after the quake. He is right, of course.

There is a much bigger (and harder to quantify) hidden cause of both costs and further indirect deaths that Mike has not yet identified. That hidden cause is the vast mental health issues caused by the earthquake. This is not a reflection on Prof. Ardagh who, being an emergency physician, is somewhat focussed on trauma. You see the mental-health ravages of the quake much more clearly down at GP level.

Pharmac reports a 16% increase in scripts for mental-health related drugs, including sedatives and hypnotics (sleeping tablets), over the whole of the country. This is not a trivial amount. We spend around a billion dollars a year in mental health services only – and these are just the direct health costs. Add to this the cost of unemployment, sickness benefits, imprisonment, physical ill health and damaged family structures and you have a potentially very large cost indeed, both in terms of the economy and in terms of society as a whole.

That 16% represents new scripts only. There is no way we can measure accurately how the quake(s) have exacerbated the status of those who already have established mental health problems. Even hospital admissions or suicide rates are only a very blunt indicator (and I don’t have ready access to those stats for the past year). And none of the markers mentioned so far gives us any clue to the level of stress-related illnesses in the more stoic portion of the Canterbury population.

All I can tell you is that I have treated a number of people in Auckland who have moved (mostly permanently) from Christchurch. They are, in general, a mess. Insomnia is rife, depression is common and stress is universal. I have seen a number of people with full-blown Post-Traumatic Stress Disorder. While I acknowledge that the first people to move from Christchurch are likely to be the most affected and that they will be likely to gravitate to the GP for help, the overall look of these poor folk is not good. If the ones still there are even a tenth as bad, they are not going to take the latest string of quakes well. I expect a much larger exodus from Christchurch over the next few months.

We can rebuild the city of Christchurch but, for some, the scars left by the moving ground are not visible and will take much, much longer to heal. I suspect we will continue paying for these quakes long after the city is rebuilt and the debt incurred for the rebuild repaid.