Overview presentation for Community Mental Health Team Leaders

Prepared by NS&CC MHDA 2011

(Acknowledgement: slides from a disaster response presentation by Professor Beverly Raphael were adapted in this overview)

A public health issue

State Emergency Service brochure, South Australia

Hot weather is dangerous

High temperatures are a threat to health, especially in summer and extreme heatwave conditions.

Heat can affect consumers on psychotropic medications – anticholinergic drugs impair sweating – neuroleptic drugs impair thermoregulation.

Early recognition of heat stroke and prompt treatment reduces mortality

Summer “Heat” Social Behaviours

Increased alcohol and drugs use – ‘water first’ preferable

Heat and violent behaviours

Motor vehicle accidents

Vulnerable youth – risk behaviours

Drownings

Heat-related stress – “tipping point”

“She’ll be right mate” attitudes

Signs and Symptoms of heat-related illnessSigns and symptoms of heat exhaustion

– thirst, paleness and sweating– weakness and discomfort – rapid shallow breathing– muscle cramps– nausea and vomiting– dizziness or fainting– rapid heart rate

Prevention strategies– cool, non-alcoholic drinks– resting out of the heat– cool shower, bath or sponge bath– wearing lightweight clothing

– watch for inappropriate clothing in hot weather

Signs and Symptoms of heat-related illness

Signs and symptoms of heat stroke (medical emergency)– core body temperature > 40.5°C– confusion or disorientation– Red, hot, dry skin (no sweating)– rapid pulse– severe headache & dizziness & nausea– possible loss of consciousness– shallow, rapid breathing

Management– Encourage rapid cooling & Ambulance

NSW

Risks for mental health consumers in extreme heat

Particular risk for those maintained on antipsychotic medications:– Recurrent heat-related health problems associated with

antipsychotic treatment– set point of temperature regulation centre could be elevated by

antidopaminergic effects of anti-psychotics e.g. phenothiazines and thioxanthenes

– Neuroleptics may impair hypothalamic thermal regulatory pathways

Meta-analysis of risk from extreme heat:– increased risk with pre-existing psychiatric illness – Mortality: death rate tripled particularly if isolated, housebound

(Bouchama et al Arch in Med 2007)

Suggested Mental Health Service Strategies Identify vulnerable consumers Encourage consumers to write self-care strategies in a wellness

plan e.g. Use of fans, air conditioning, fluids, showers for prevention and treatment of heatstroke

Work to implement the care plan to budget and purchase appropriate curtains and fans etc prior to summer. Check consumers have keys for locking windows to be able to open for a cool breeze.

Contact charity organisations re curtains and fans if financial constraints for consumer

Check clients have a plan for power failures (high grid load in summer)– E.g. for essential medical equipment such as CPAP.

Consider partnership with NGO’s to provide support during summer

NS & CC MHDA resources Guideline: Hot weather preparation and actions for mental

health Consumers [a guideline for staff to assist consumers during hot weather and heat wave conditions 2011]

Brochure

Promotion materials– Poster – caps – drink bottles– fridge magnets

guidelineInterimHot weather preparation and actions for Mental Health consumers

Document Number

Publication Date July 2011

Intranet location/s

Summary Assisting consumers to better monitor and manage body temperature during summer and heat waves.

Author Department NSLHD & CCLHD MHDA

Contact (Details) Liz Newton MHDA GSU, GroupWise

Endorsed By Andrea Taylor, NSLHD & CCLHD MHDA Executive Sponsor

Sector/Service All services (community& inpatient) within NSLHD & CCLHD MHDA

Audience All Staff of NSLHD & CCLHD MHDA

Date Created July 2011

Review date July 2014

Previous Reference No. n/a

Related Policy/s

Key Words Heatwave, summer, Consumers, medications

Status active

Attachments Heat Wave Brochure and Flyer

Health promotion items

Capsprinted on the front with ‘HEATWAVE keep cool’

Fridge magnets with clipto attach brochure to fridge

Simple fridge magnets

Logo was selected in a transparent style, as it cost $70 set up fee per colour – cheaper to use the colour of the product to colour the centre of the sun than pay to have it coloured.Hats were chosen in light colours that would be more dirt resistant than white or natural.

Rationales of some decisions