Houses in Lismore stand without walls, shop windows are shattered or boarded up, and families are sleeping in caravans and tents one year after historic floods decimated the northern NSW region.
Many residents are waiting for insurance assessments or payouts before they can rebuild their lives, adding to the emotional toll of surviving floods that swept through thousands of homes.
Lismore resident Ella Buckland, a campaign manager at Australian Parents for Climate Action, said the community is tired.
"Everyone is coming to terms with the fact that, for the foreseeable future, the town is not in any way the same," Ms Buckland told AAP.
A Climate Council report into the mental health burden of disasters across Australia showed adequate insurance coverage was central to recovery.
In a national telephone poll of more than 2000 people, 80 per cent reported experiencing some form of disaster since 2019.
One in five respondents said they did not have insurance and among those who did, 64 per cent said their premiums rose in the last two years.
A small percentage reported cancelling their insurance because of the cost, while others had reduced their coverage. About one in 20 said insurance companies would not cover them and a similar number had claims rejected.
"The clean-up and the emotional toll is huge," one flood-affected Brisbane resident told the researchers.
"Especially the months after - chasing up insurance claims, dealing with insurance companies constantly, coordinating trades to repair the house, stock-taking losses. It's enormously draining and takes a toll on your mental health."
Climate Council research director Simon Bradshaw, the report's lead author, said recovery could be profoundly disrupted by red tape.
"There's a very long tail for these disasters and we really need to be listening to what communities need to recover and rebuild," Dr Bradshaw said.
Initial data from the poll released last month showed half its respondents who lived through a disaster reported an adverse effect on their mental health, while one in five reported a "major or moderate impact".
Ms Buckland said watching children process trauma was particularly difficult, as some relived the events or regressed.
"Parents are noticing that children are really unattached to toys," she said.
"They've gotten new toys and they'll play with them and set them aside and the (parents) ask, 'Why don't you want to play with that anymore?'
"They say, 'I'm going to lose it, it will be gone'."
The report made several recommendations including prioritising the lowering of emissions, greater investment in resilient infrastructure, improved mental health services and increased affordability and uptake of insurance.
"People have seen their lives turned upside-down," Dr Bradshaw said.
"They know that due to past inaction we have to prepare for a lot more."
