Mental Health Climate Change Training Module 625 Robert Street North PO Box 64975 St. Paul, MN 55164-0975 Minnesota Climate and Health Program Minnesota

Mental HealthClimate Change Training Module

625 Robert Street NorthPO Box 64975

St. Paul, MN 55164-0975

Minnesota Climate and Health ProgramMinnesota Department of Health

Environmental Impacts Analysis UnitJuly 2013

Mental Health, Climate Change and Public Health

MDH developed this presentation based on scientific research published in peer-reviewed journals. References for information can be found in the relevant slides and/or at the end of the presentation.

Notice

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• Climate Change in Minnesota– Temperature– Dew Point– Precipitation

• Climate Change Awareness• Mental Health Impacts of Climate Change– Place– Disasters and Mental Health– Loss– Violence

• Vulnerable Populations• Psychological Barriers to Climate Action• Role of Public Health

Outline

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• Weather — conditions of the atmosphere over a short period of time

• Climate — conditions of the atmosphere over long periods of time (30 year standard averaging period)

Definitions

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• Mental health – a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to contribute to his or her community

Definitions

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Outline

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There have been three recent significant observed climate trends in Minnesota:

The average temperature is increasing

The average number of days with a high dew point may be increasing

The character of precipitation is changing

Observed Climate Changes

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Outline

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Temperature Changes in Minnesota

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• Winter temperatures have been rising about twice as fast as annual average temperatures

• Minimum or overnight low

temperatures have been rising faster than maximum or daytime high temperatures

Significant observations in warming pattern:

Temperature Changes in Minnesota

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Outline

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• Dew point – a measure of water vapor in the air

• A high dew point makes it more difficult for sweat to evaporate off the skin, which is one of the main mechanisms the body uses to cool itself

• The number of days with high dew point temperatures (≥ 70°F) may be increasing in Minnesota

Dew Point Changes

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Dew Point Changes

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Outline

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Changes in Precipitation

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Precipitation in Minnesota is changing:

•More localized, heavy precipitation events

•Potential to cause both increased flooding and drought

Changes in Precipitation

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Outline

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Understanding climate change is difficult•Hazards are experienced differently based on geographic location, population, and season•Effects of climate are unknown and uncertain•Cannot be identified by personal experience alone

We have to rely on scientific models and expert judgment, often through the lens of mass media

Climate Change Awareness

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• Emotional reactions to the awareness of climate change include:– Fear– Sadness– Depression– Anxiety– Helpless and hopeless– Anger


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Outline

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• Psychological effects of climate change are likely to be gradual and cumulative

• The connection to climate change may not always be clear to those affected

• Manifests as two types of stress– Discrete– Continuous

Mental Health Impacts of Climate Change

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Outline

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• Places are “nested collections of human experience, locations with which people and communities have particular affective relationships.”

• Ties to a place are a part of identity– Familiarity– attachment

• Climate is fundamental to an individual’s understanding of place

Place

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• Attachment to place is so strong that it can be a primary driver of inaction

• The loss of a connection to place and sense of belonging in that place undermines mental health

• Solastalgia: palpable sense of dislocation and loss that felt when changes to a local environment are perceived as harmful

• Place is a key determinant of exposure to the impacts of climate change

• Climate change may alter look and feel of the defining attributes a place

Place

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Outline

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• Individual vulnerabilities:– Proximity to the disaster– Low socioeconomic status– Low social connectedness– Existing mental illness

• Community vulnerabilities:– Outdated emergency plans– Shortage of mental health

resources at time of event– Repeated exposure to

disaster or crisis

Disasters and Mental Health

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• Poor mental health outcomes are not only attributable to exposure to the event – Displacement– Unstable or unknown

housing circumstances– Lack of access to

support services– Loss, particularly of

employment, possessions


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• Specific post-disaster mental health outcomes may include:– Confusion– Depression– Anxiety– Grief– Post-traumatic stress disorder

• Case Study: Hurricane Katrina– Many victims have experienced stress disorders– Very high rates of suicide attempts (78.6 times higher than baseline

rate) – High rates of suicide completion (14.7 times higher than baseline

rate)– High rates of depression – Domestic violence/child abuse


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• Risk of living in ‘disaster-prone’ areas– Cumulative mental

health impacts are associated with the repeated exposure to natural disaster

– Ongoing uncertainty, anxiety, dread can cause a build up of stress before disaster occurs


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• Displacement can lead to grief, anxiety, loss

• Fractured social networks and community connection

• Impact on receiving communities – Real or perceived lack of

resources such as support services, housing, jobs, and natural resources

– Perceived competition for resources can contribute to discrimination


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Outline

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• Climate change can contribute to several sources of loss:– Loss of bio-diversity– Loss of habitat– Extinction of species – Crop failure – Water shortage– Drought – Loss of livelihood– Forced migration/displacement and

the loss of place – Loss of property, pets, possessions

Loss

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• Loss can impact our sense of self and disrupt our sense of place

• A series of losses is particularly devastating– Distinct bereavement for each loss– Impacts slow to dissipate without support

Loss

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Outline

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• As temperature rises, so does the incidence of violence – Increase in murders, assaults,

violent suicide, and domestic violence when the weather is hot

– Predicted: 24,000 assaults or murders in the US per year for every 2° F increase in average temperature

• Stress of experiencing natural disaster can lead to violence

Climate Change and Violence

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Mental health conditions significantly more common amongst those exposed to violence:•Anxiety•Depression•Post-traumatic stress disorder •Aggression and violent behavior•Increased risk of suicide

Mental Health Impact of Violence

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Outline

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• Vulnerable communities are already beginning to experience disruptions to the social, economic, and environmental determinants of mental health – Disaster-prone areas– Economically dependent

on environment

Vulnerable Populations

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• Individuals who are at increased risk of mental health impacts of climate change include:– Persons with pre-existing mental illness– Persons on low incomes and/or unemployed– Persons who experience disaster– Victims of violence

Vulnerable Populations

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• Financial hardships related to climate change– Reduced income or

employment in climate sensitive industries

– Increased costs of essential goods and services• Disruption to food

systems• Decrease or loss of clean

water supply• Higher insurance rates

Vulnerable Populations: Financial Hardship

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• Children may understand and experience the threat of climate change very different than their parents or grandparents

• Children so troubled by the state of the world that they honestly believe it will come to an end before they get older – The psychological impact on

children has been compared to the impact on children worried about nuclear arms during the Cold War Era

• Children are more emotionally vulnerable to increased family violence and the occurrence of natural disasters

Vulnerable Populations: Children

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Outline

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• Ignorance• Uncertainty• Denial• Place Attachment• Perceived Behavioral

Control

Psychological Barriers to Climate Action

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• Social Comparison, Norms, Conformity, and Perceived Equity

• Conflicting Goals and Aspirations

• Belief in Solutions Outside of Human Control

Psychological Barriers to Climate Action

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Outline

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• Mental/Behavioral Health Annex to All-Hazards Plan

• Reduce the number of people with traumatic stress reactions by rapidly restoring key psychosocial domains – Safety and security– reuniting families – systems of justice – foundations for returning to work – institutions that provide meaning

The Role of Public Health

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• Local public health departments are not expected to provide a full range of mental and behavioral health

• Identify and partner with the mental health resources available in your community before a disaster affects your community


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• Well-meaning attempts to create urgency about climate change can lead to denial, paralysis, apathy

• Focus on place– understand and communicate the local exposures of climate change and the response


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• Promote the benefits of climate action: – Positive coping

mechanism– Personal meaning

and satisfaction– Sense of control or

contribution– Climate action has

physical health benefits as well


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Society’s Grand Challenges: Global Climate ChangeAmerican Psychological Associationhttp://www.apa.org/science/resources/grand-challenges.aspx “Human behavior is recognized as a main contributor to today’s climate crisis, and yet, it is one of the least understood components of this complex problem. Learn how psychologists are studying ways to address global climate change.”

Ambit Network at the University of Minnesota is a leader in helping communities use research-based prevention and intervention techniques to increase children’s ability to deal with trauma. http://www.cehd.umn.edu/fsos/projects/ambit/default.asp

“A Public Health Approach to Prevention of Behavioral Health Conditions”A Presentation from the Substance Abuse and Mental Health Services Administration (SAMHSA)http://store.samhsa.gov/product/A-Public-Health-Approach-to-Prevention-of-Behavioral-Health-Conditions/SMA12-PHYDE051512This presentation discusses the public health model to prevent substance abuse and mental health disorders. Additionally, it reviews some of the challenges in preventing behavioral health problems and potential solutions, with an emphasis on early intervention.

General Resources for Public Health

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Behavioral Health and Emergency PreparednessMinnesota Department of Health, Office of Emergency Preparednesshttp://www.health.state.mn.us/oep/responsesystems/behavioral.htmlThis website provides expanded information on Psychological First Aid, continuity of operations, resources for responders, disaster planning, and suicide prevention.

Disaster Behavior Health Information Series SAMHSAA collection of resources, presentations, and toolkits pertinent to disaster behavioral health. Resources target specific populations or relate to specific types of disaster. http://www.samhsa.gov/dtac/dbhis/

Psychological First Aid Mobile AppNational Child Traumatic Stress Networkhttp://www.nctsnet.org/content/pfa-mobile PFA Mobile™ lets responders review PFA guidelines and assess their readiness to deliver PFA in the field. The app provides additional support for successful interactions with different survival groups.

Disaster Behavioral Health Resources for Public Health

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• Minnesota’s climate is changing– Increases in temperature– Increases in high dew point temperatures– Changing character of precipitation

• Climate change can have harmful impacts to our mental health– Continuous stress due to a changing environment– Discrete stress from exposure to natural disasters and other emergencies

• Certain populations are at greater risk of mental illness due to climate change, especially individuals who: – live in disaster-prone areas– survive a disaster– are economically dependent on a stable climate– have pre-existing mental illness– are children

• Public health awareness, planning, and training as well as effective climate communication can reduce the mental health impacts of climate change.

Summary

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This work was supported by cooperative agreement 5UE1EH000738 from the Centers for Disease Control and Prevention (CDC).

Special thanks to the following people for their contributions to the creation of this training module:

Nancy CarlsonMinnesota Department of Health Office of Emergency PreparednessSusan Littrell, LiCSW, LADCHennepin County Community Outreach for Psychiatric Emergencies (COPE)Ken Winters, Ph.D. University of Minnesota Department of Psychiatry Chris Bray, Ph.D., LPAmbit NetworkMary Jo VerschayMinnesota Department of Human Services

Acknowledgements

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JULY 29, 2013

Contact Minnesota Climate and Health Program:

651-201-4898

651-201-5759 TTY

[email protected]

http://www.health.state.mn.us/divs/climatechange/index.html

Questions?

Thank You

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Benson E. Society’s Grand Challenges: Global Climate Change. American Psychological Association, Washington, DC. Available online at: http://www.apa.org/science/resources/grand-challenges.aspx

Berry HL, Kelly BJ, Hanigan IC, Coates JH, McMichael AJ, Welsh JA, Kjellstrom T. 2008. Garnaut climate change review: rural mental health impacts of climate change. National Centre for Epidemiology and Population Health, ANU College of Medicine and Health Sciences.

Coyle KJ, Van Susteren L. 2012. The Psychological Effects of Global Warming on the United State: And Why the U.S. Mental Health System is Not Adequately Prepared. National Wildlife Federation.

Doherty TJ, Clayton S. 2011. The psychological impacts of global climate change. American Psychologist, Vol. 6:4, page 265.

Ebi KL, Balbus J, Kinney PL, Lipp E, Mills D, O’Neill MS, and Wilson M. 2008. Effects of global change on human health. In: Analyses of the Effects of Global Change on Human Health and Welfare and Human Systems [Gamble JL (ed.), Ebi KL, Sussman FG, and Wilbanks TJ (authors)]. Synthesisand Assessment Product 4.6. U.S. Environmental Protection Agency, Washington, DC, pp. 39-87.

Ebi KL, Semenza JC. 2008. Community-based adaptation to the health impacts of climate change. American Journal of Preventative Medicine, 2008; 35 (5): 501.

Fritze J, Blashki GA, Burke S, Wiseman J. 2008. Hope, despair and transformation: Climate change and the promotion of mental health and wellbeing. International Journal of Mental Health Systems, 2: 13.

Frumkin et. al, 2008. Framing Public Health Matters, Climate Change: the Public Health Response, Howard Frumkin, MD, DRPH, Jeremy Hess, MD, MPH, George Luber, PhD, Josephine Malilay, PhD, MPH, and Michael McGeehin, PhD, MSPH, American Journal of Public Health, March 2008, Vol. 98, No. 3, pp 435-445.

Harvey JH. 2001. The Psychology of Loss as a Lens to a Positive Psychology. American Behavioral Scientist, January 2001, 44: 838.

Hess JJ, Malilay JN, Parkinson AJ. 2008. Climate change: the importance of place. American Journal of Preventative Medicine 35:5, p. 468.

Interagency Working Group on Climate Change and Health. 2010. A Human Health Perspective on Climate Change: A Report Outlining the Research Needs on the Human Health Effects of Climate Change. Published by Environmental Health Perspectives and the National Institute of Environmental Health Sciences.

Keim ME. 2008. Building human resilience: the role of public health preparedness and response as adaptation to climate change. American Journal of Preventative Medicine 35:5, p. 508.

References

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Midwestern Regional Climate Center. 2010. Climate Change & Variability in the Midwest. Temperature and Precipitation Trends 1895 – 2010. Available online: http://mcc.sws.uiuc.edu/climate_midwest/mwclimatechange.htmNational Aeronautics and Space Administration (NASA). 2005. What’s the Difference Between Weather and Climate?

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References

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Mental Health Climate Change Training Module 625 Robert Street North PO Box 64975 St. Paul, MN 55164-0975 Minnesota Climate and Health Program Minnesota