What Mental Health Professionals Can Do About Climate Change

Robin Cooper, MD

This should not be our response

Despite the enormity and complexity of climate change impacts on mental health, there are things psychiatrists and mental health professionals can do. The public views physicians and health providers as trusted and credible leaders and can therefore be influential.

So what should our response be?

  • Start a discussion group/journal club at your institution, to loop more professionals into climate-aware practices. Request one of our senior members to join and assist, email info@climatepsychiatry.org.

  • Register as a climate-aware therapist

  • Give a talk at your institution, district branch meeting, etc. We can provide materials, mentorship, guidance, and even partnership with an accomplished speaker.

  • Do some writing for trade journals such as Psych News, Psych Times; peer-reviewed journals; mainstream media, etc.

  • Green your practice: free membership in My Green Doctor to CPA members.

  • Donate: as with so many groups, we have meager financial resources. Your contributions go a long way to helping us grow. Consider a regular monthly or quarterly donation.

There are things that we, as professionals, can do to maximize good health outcomes for our patients, families, and communities.

Health care providers, including psychiatrists, can have an impact at multiple levels, including in how they conduct individual patient management, help develop systems of care and advocate on behalf of public health policy.

Individual Patient Management

As physicians and providers, we are the first line in keeping our patients safe and healthy during the inevitable extreme weather events and the impacts of climate change. This is a focus on direct clinical care and derives from the doctor/caregiver-patient relationship model and principles of clinical practice.  

What we can do at the patient-care level:

  • Teaching patients and families about climate-related health risks and protective behaviors, especially regarding heat exposure and flood and storm protection in vulnerable areas  

  • Effectively managing psychiatric medications to reduce risk

  • Treating specific psychiatric syndromes associated with climate-related traumas

  • Teaching patients and families about individual resiliency behaviors, such as transformational resilience.

  • Consider psychotherapeutic techniques for patients who present with eco-anxiety

  • Utilize colleagues and peer consultation groups, especially to reflect on secondary trauma that therapists experience and countertransference

Prepare our Agencies and Practices

  • Plan for closer monitoring of vulnerable populations; Engage caregivers, case managers, visiting nurses, family members, etc

  • Help patients, families, and staff at residential institutes and day centers develop emergency plans including plans for respite shelters during extreme weather events

  • Identifying what your agency/practice needs regarding health record systems and information retrieval, and operating during emergency periods

  • Agency and practice leaders and administrators create a culture of attention to climate-related health interventions, providing regular staff training prior to periods of greatest vulnerability and identifying roles of staff members for safety plans.

Help Develop A Systems Of Care

This focus derives from a community mental health/public health model with attention to community and population health, safety and resiliency.  Components include prevention and community preparedness as well as community disaster response and recovery.  We can work to improve the readiness of community and mental health systems to respond effectively and quickly to emergencies requiring prior planning, coordination and capacity building.  

How we can help at the systemic level:

  • Building collaborative relationships between mental health and health agencies and community groups, including public health departments, schools, churches and synagogues, recreational centers, libraries, and homeless services.

  • Developing systems of responsiveness:  Who alerts vulnerable people/patients?  What plans are in place to direct vulnerable people/patients to areas of safety? 

  • Planning specifically for the homeless population

  • Supporting public health educators in developing and implementing community education strategies

  • Educating and coordinating with first responders (police, fire department, and local emergency departments)

  • Developing mental health disaster response plans and training: SAMHSA Behavioral Health Disaster Response training modules available.

    • Note: The scope of disaster preparedness and response may be beyond the skills of many practicing psychiatrists. All communities have Disaster Preparedness Plans usually within the Department of Public Health where useful sources of information and guidance may be found.

  • Training in Psychological First Aid

  • Providing consultation to community leaders on effective communication during acute disasters with emphasis on Psychological First Aid principles.

  • Training in media skills, so as to develop effective community communication

Advocate On Behalf of Public Health

This level of engagement derives from a public health prevention model with a focus on influencing pro-health policies thru engagement with social and political institutions.  

Since the impacts of climate change on mental health are substantially influenced by social factors, influencing outcomes requires engagement in public policies.  Physicians and psychiatrists have the expertise and credibility to inform the public and policymakers about the root causes of climate change, the impacts on health and mental health, and the pro-health and mental health benefits of policies that promote community resilience and public mental health. The public health model inherently recognizes that root causes are imbedded in broad socio-political and economic forces and that solutions are beyond the capacity of individuals requiring institutional and governmental programs. Influencing policy touches on creating and changing laws, establishing regulations and rules, and funding governmental and institutional activities.  None of this is done by individuals but requires collective engagement in advocacy organizations. The American Psychiatric Association represents these interests, as do many other effective groups.  

More Things We Can Do To Influence Public Awareness

  • Joining with colleagues: Climate Psychiatry Alliance and Climate and Mental Health Caucus of APA to influence professional organizations’ position and action

  • Testifying at public hearings on health and mental health impacts

Participating in lobbying activities of legislators, etc that professional organizations organize

Resources

Climate change and Extreme Heat; What You Can Do to Prepare, EPA & CDC, Oct. 2016

CDC Infographic for Public Education on Extreme Heat

SAMHSA guides for pre-disaster preparedness, on-the-ground assistance, post-disaster resources, and responses:

Excellent document from public health perspective from Climate Health Connect

Strategies for interventions with mental health and substance abuse patients with a focus on extreme heat

Extensive document with contributions from more than a hundred public health professionals and community health, equity, and environmental justice advocates outlining opportunities and recommendations for action