Abstract
Background Globally, flooding is one of the severe consequences of climate change, which is exacerbated by urbanization and inadequate infrastructure. In Trinidad and Tobago, floods affect a sizable proportion of the population and pose a major public health hazard. Aim This study assessed the psychosocial impact of flooding on adult residents in flood-prone areas of Trinidad and Tobago, focusing on the prevalence of mental health conditions such as depression, anxiety, stress, and post-traumatic stress disorder (PTSD), along with identifying associated factors and predictors of psychological distress. Methods Convenience sampling was used to collect data from 215 adult household residents in four selected flood-prone areas in Trinidad and Tobago over 12 weeks, from January 2024 to March 2024. The inclusion criteria were being at least 18 years of age, having resided in their area for at least two consecutive years prior to the start date of the study, and having experienced at least one severe flood in the two years prior to the start date. The data collection instrument was a questionnaire, which was chosen to ensure broad accessibility and ease of data collection in the selected flood-prone areas. The variables measured included selected sociodemographic characteristics, household medical history, and flood characteristics. The 36 items also included the following: (1) the Patient Health Questionnaire-2, (2) the Generalized Anxiety Disorder 2-item, (3) the Perceived Stress Scale 4, and (4) the Posttraumatic Stress Disorder Checklist. In this study, the nature of flooding was categorized ordinally as none, mild, moderate, and severe, in keeping with the flood classifications in Queensland in 2020. Descriptive and inferential statistical methods were used for data analysis. Results Of the 215 residents, 154 (71.6%) met the eligibility criteria and were invited to complete the online questionnaire. Participants were primarily female (n = 162, or 75.3%), predominantly Indo-Trinbagonians (n = 136, or 63.3%), and had a university or college education (n = 129, or 60%). Among the victims, 127 (82.5%) needed to be evacuated. More than four-fifths (82.5%) of those who experienced flooding were classified as having moderate-to-severe stress, with "Age group" being a key predictor; slightly over half (53.2%) experienced no depression, and 56.5% experienced no anxiety. The reported psychological symptoms included mild depression (34.4%), mild anxiety (36.4%), and mild PTSD (38.3%). The differences between or among mean psychological symptom scores were not significant for any sociodemographic variable. However, "Need to evacuate," "Age group," "Flood duration," and "Flood severity" were associated with at least one of anxiety, PTSD, and stress (p < 0.05). Ordinal logistic regression showed that (1) "Need to evacuate" was a predictor of anxiety, (2) "Flood severity" and "Need to evacuate" were predictors of PTSD, and (3) "Age group" was the only predictor of stress. These findings suggest that evacuation may serve as a critical stressor leading to higher anxiety and PTSD symptoms. Conclusion Flood victims experienced significant psychosocial problems with stress, followed by PTSD as the most common disorder. Implementing targeted psychological support and community preparedness programs could mitigate the psychosocial effects of flooding. Follow-up studies with broader populations are needed to help assist in further subgroup analysis.