Following the February 2011 earthquake in Christchurch, New Zealand (NZ), the authors participated in counselling local residents, and debriefing and supervising support teams. Indications were that risk for mental health disorders, including Post-Traumatic Stress Disorder (PTSD), may be elevated in residents, and that this risk may continue for some time. Patients may be de-prioritising their mental health issues when these become normalised throughout the city's population. The authors recommend that primary care patients are assessed using a brief, comprehensive tool (for example, the Case-finding and Help Assessment Tool) that targets many health and behavioural issues identified as increasing in the city following the earthquake. Anxiety and mood disorder symptoms may indicate assessment is appropriate to reduce harm arising from increased risk for PTSD. Concern also is raised for primary health care providers who may have experienced the trauma and additionally may be vicariously affected by patients' reported trauma.