An urgent call to mental health caregivers to help treat climate concerns

August 9, 2018

by H. Steven Moffic


Perhaps you noticed the special issue of the New York Times Sunday Magazine, which on Aug. 5 was devoted solely to the opportunity to address climate change in the 1980s. As I interpreted it, there ended up to be a political failure on the part of the United States to join a coalition to address the risks, and so we are left with an ever-growing climate change crisis.

So what does this history have to do with behavioral healthcare? As far as the magazine story goes, and as far as I know, those in our field were not involved in that endeavor in the 1980s. I personally became a climate change advocate about a dozen years ago, and there was barely any interest on the part of organized psychiatry and psychiatrists in general at that time. I started the loosely organized Psychiatrists for Environmental Action and Knowledge (PEAK).

Maybe we should have been more involved. Maybe we could have made a difference. After all, climate science supports that it is commonly accepted by now that human behavior and our embrace of fossil fuels is the new factor in this climate concern. Moreover, besides political priorities, it is psychological processes like denial, fear of change, and narcissism that are contributing to the stagnation. We are hard-wired to respond well to acute disasters, but not to slowly developing ones.

But now that we have so much more media coverage of the current weather instability and long-term climate risks, the mental health of the public, and even our patients, seems to be affected. In the United States, unprecedented fires in the West, floods in the East, and heat waves can be traumatic to one degree or another to those in their midst. New syndromes are being defined, including solastalgia, which refers to a loss of one’s desired environment, and climate anxiety, which represents undue existential fears.

All these psychological factors must mean that we have some responsibility to address climate change in our workplaces. Indeed, it an ethical priority. Psychiatrists, and I believe other mental health disciplines, have an ethical principle to address social issues which adversely affect public health and mental health. That means, among other things, contributing our knowledge and skills to advocate for reducing climate risks, including political involvement. That include educating the public. Hence, some of us psychiatrists have formed a new coalition, the Climate Psychiatry Alliance.

Perhaps we can even contribute to what would psychologically be the test terminology. Change can be either good or bad, so perhaps “climate instability” would better evoke concern. Similarly, warming, as in global warming, can be perceived as good or bad depending on location. “Global boiling” evokes more concern, as in the legendary frog experiment; toss a frog into slowly warming water and it will stay there until cooked to death, but throw one in a boiling pot and it will try to jump out.

We also need to stay on the alert for climate related anxiety, depression and trauma, either as overt or covert concerns in our patients. Those emotional reactions can either be appropriate or not to reality and will need to be addressed accordingly.

Our administrators and leaders need to model the relevance and concern for the well-being of our environment. Alternately, concern can be evoked from the bottom up by our clinicians. Regardless of how this wind blows, the climate is urgent for our involvement.