The Psychological Effects of Global Warming on the United States

8/10/2019 The Psychological Effects of Global Warming on the United States

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The Psychological Effectsof Global Warming on

the United States: And Why the U.S. Mental Health Care

System Is Not Adequately Prepared

National Forum and Research Report

FEBRUARY 2012

Kevin J. Coyle, JD and

Lise Van Susteren, MD,

National Wildlife Federation Climate Education Program

With Support from the Robert Wood Johnson Foundation

Copyright © 2011 National Wildlife Federation

©Perrush / Fotolia.com



PREFACE

Dear Friends and Colleagues,

Having the reality of the destructive forces presented by climate change fully register with people, so they will to act with the needed urgency, is indeed a challenge. And,

while the physical and environmental effects of global warming are studied anddescribed, what has rarely been addressed, and is as compelling a topic as any, are the psychological impacts.

This report aims both to fill in the gap in our awareness of the psychological impactsof climate change, and by exposing the emotional side of the issue, to find the place inour hearts that mobilizes us to fly into action, forewarned, determined, relentless. It alsois a call for professionals in the mental health fields to focus on this, the social justiceissue of all times, with their capacity to work through denial and apathy, to bring insightand commitment before it is too late.

The language of science is, admittedly, not a stirring call to action. Scientists are bynature cautious, and restrained. While this report does not aim to present the forumparticipants as flame throwers, for this work to accomplish a primary goal, the readerwill need to feel something in reading it. The language used here, and some of thequestions asked, may feel uncomfortably probing, as they pierce our armor. After all,most of us want to be patriotic, to be optimist about the future. But we need to fullyconfront certain realities.

If we continue the adolescent-like disregard for the dangers we are being warned of,driving green house gasses up with only casual concern, there will be consequences.As our world begins to unravel and our role is undeniable, all eyes will be on us.

Questions beg to be asked:

• What will the rest of the world think of us?

• Where will we be safe?

• How will we feel about ourselves?

The interplay between the climate realities we likely face and the potential psychological fallout from them was the subject of a conference convened in Washington D.C., inMarch 2009. A highly respected group of experts offered insights. Their thoughts,recommendations and supporting evidence are presented in this report.

We extend our heartfelt thanks to the RWJ Foundation and to our forum participants.We also note the sad death of forum participant and friend Dr. Jerilyn Ross. Sheadded her characteristic straight talk, practical knowledge, and bright intellect to thediscussion.

Sincerely,

Lise van Susteren, MD, Kevin J. Coyle, JDForensic Psychiatrist Vice President for Education



The Psychological Effects of Global Warming on the United States

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The Psychological Effects of

Global Warmingon the United States

Forum Participants: .................................................................................

Executive Summary: ............................................................................. i

Climate Change Lessons from the Dramatic Summer of 2011 ............ i

Summary of Findings ...........................................................................v

Solutions and Recommendations ........................................................ xi

Chapter One: Pyschological Effects ofGlobal Warming across the U.S. .....................................................1

Chapter Two: Most Americans Will Experience the Stressesof Climate Change as Incidents and Disasters ................................7

Chapter Three: Affect of Global Warming onVulnerable Populations .................................................................16

Chapter Four: Global Warming and the Stresses of War ...................20

Chapter Five: Nationwide Anxiety or Hope? ....................................26

Chapter Six: The High Cost of Ignoring Mental Health andClimate Change ............................................................................35

Conclusion: ........................................................................................38

Report Bibliography: .........................................................................39

Project Team: ......................................................................................41

TABLE OF

CONTENTS

World image ©-strizh-/Fotolia

Cover image ©Perrush - Shuttershock.com

Our thanks to the Robert Wood Johnson

Foundation for its support of this project.



National Forum and Background Report - 2011

N A T I O N A L W I L D L I F E F E D E R A T I O N

Forum Participants

Victor BalabanTravelers’ Health and Animal Importation

BranchDivision of Global Migration andQuarantine

Centers for Disease Control, Atlanta, GA

William BeckerExecutive Director, Presidential Climate

Action ProjectThe Wirth Chair in Environmental and

Community Development PolicySchool of Public AffairsUniversity of Colorado Denver, Boulder,

CO

Peter G. Bourne, MD, MAVisiting Scholar, Green-Templeton

College, OxfordVice Chancellor Emeritus of St. George’sUniversity, Grenada, West Indies

Chairman of the Board, MedicalEducation Cooperation with Cuba(MEDICC)

Wales, UK and Washington DC

James H. Bray, Ph.D.President, American Psychological

AssociationDepartment of Family and Community

MedicineBaylor College of Medicine, Houston TX

Gillian Caldwell, JD

Campaign Director, 1SkyTacoma Park, MD

Eric Chivian, MDFounder and Director, Center for Health

and the Global EnvironmentProfessor of PsychiatryHarvard Medical School Boston, MA

Lt. Gen. Daniel W. Christman (Ret.)Sr. Vice President for International AffairsUnited States Chamber of CommerceWashington DC

Robert W. Corell, PhDVice President for Programs

H.J. Heinz Center for Science, Economicsand the Environment

Washington DC.

Kevin J. Coyle, JDVice President for Education and TrainingNational Wildlife FederationReston VA

Spencer Eth, MDVice-Chairman and Medical Director,

Psychiatry and Behavioral HealthServicesSaint Vincent Catholic Medical CentersNew York, NY

Sherri Goodman, JDGeneral Counsel and Corporate Secretary,

Center for Naval AnalysesExecutive Director, Military Advisory

Board, “National Security and theThreat of Climate Change” projectAlexandria, VA

Jeffrey T. Kiehl, PhDSenior Scientist, Climate Change ResearchNational Center for Atmospheric

Research. Boulder, CO

Douglas LaBier, PhDFounder and DirectorCenter for Adult Development, N.W.,

Washington, DC

Andrew Light, PhDDirector, Center for Global EthicsGeorge Mason University, Fairfax, VASenior FellowCenter for American Progress

Washington, D.C. 20005

George Luber, PhDAssociate Director for Global Climate

ChangeNational Center for Environmental

HealthCenters for Disease Control and

Prevention, Atlanta, GA

Edward W. Maibach, PhDDirector, Center for Climate Change

CommunicationGeorge Mason University, Fairfax, VA

H. Steven Moffic, MDProfessor, Department of Psychiatry and

Behavioral MedicineMedical College of Wisconsin,

Wauwatosa, WI

Jerilyn Ross, M.A., L.I.C.S.W.President and CEO, Anxiety Disorders

Association of AmericaDirector, The Ross Center for Anxietyand Related Disorders, Inc.Washington, DC

Larry Schweiger,President and CEO

National Wildlife Federation, Reston, VA

Steven Shapiro, PhDClinical Supervisor and Counseling

Psychologist,Community Psychiatry ProgramBayview Medical Center, Johns Hopkins

University

Patrice L. Simms, JDSenior Project AttorneyNatural Resources Defense CouncilWashington, DC

Mike TidwellDirector

Chesapeake Climate Action NetworkTakoma Park, MD

Lise Van Susteren, MDForensic PsychiatristMember, Board of Directors, National

Wildlife Federation Washington, DC

Timothy WarmanVice President, Global Warming SolutionsNational Wildlife Federation,

Washington, DC.



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T

he extreme and sometimesviolent weather of thesummer of 2011 can offer

valuable insights intohow a warming climate will affectthe people in the United States andother parts of the world. The newsheadlines included: a worsening Texasdrought, record heat in the easternstates, a rise in heat-related deathsin many U.S. cities; violent floods inthe East and Midwest; an expandedrange and season for some of theworst tornados on record and more.

These same headlines included theseemingly unrelated famine andrefugee tragedy in Somalia, a rise

in mental health difficulties amongservice men and women returningfrom war, and anomalous weatherconditions and disease outbreaksin many parts of the world.

Climate scientists have begun toempirically link 2011’s extremeweather events and natural disasters toclimate change and report that theseare representative of what sciencepredicts the world will look like

Executive Summary

The Psychological Effects of

GLOBAL WARMING on the United States

CLIMATE CHANGE LESSONS FROM THE SEVERE

WEATHER OF SUMMER 2011

Global warming…

in the coming years…

will foster public trauma,depression, violence,

alienation, substance

abuse, suicide, psychotic

episodes, post-traumatic

stress disorders and

many other mental

health-related conditions.

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and Disasters to Advance Climate Change Adaptation. The report finds thatchanges in weather, due to climatewarming, will be felt everywherein the world. The physical and

economic destruction surely bogglesthe mind but what is not beingaddressed are the human psychological consequences of all this devastation.

To begin with, the incidences of mentaland social disorders will rise steeply.These will include depressive andanxiety disorders, post traumatic stressdisorders, substance abuse, suicides,and widespread outbreaks of violence.Children, the poor, the elderly, andthose with existing mental healthdisorders are especially vulnerable and

will be hardest hit. At roughly 150million people, these groups representabout one half of the American public.

The American mental healthcommunity, counselors, traumaspecialists and first responders arenot even close to being prepared tohandle scale and intensity of impactsthat will arise from the harsherconditions and disasters that globalwarming will unleash. It is not thatwe haven’t experienced natural

disasters before, but the scientificdata show that what lies ahead willbe bigger, more frequent, and moreextreme than we have ever known.

There are even broader implications,many of them beyond our shores. Asclimate related disasters and burdensspread across the world, the U.S.military will increasingly be calledupon to help keep order. Servicemembers will be faced with stressful,even horrifying conditions. Theywill see people - the young, the old,

the innocent – suffer terribly. Backhome their families will experiencethe ripple effects, suffering vicariouslyand experiencing their owndisruptions in finances, relationshipsand child-rearing. There will bethe disorders from the immediatetrauma, and in some cases chronic psychological disorders will follow.

with more warming. The physicaland economic harm caused by suchevents is evident but what will be thetoll on the public’s mental health?

To those who would deny, dismiss orjust fail to envision the psychologicalimpacts global warming, we urgeyou to take a deeper look. We maynot currently be thinking abouthow heavy the toll on our psychewill be, but, before long, we willknow only too well. A warmingclimate will cause many people, tensof millions, to hurt profoundly.

Global warming from increased greenhouse gases in our atmosphere is leadingto a spiral of worsening conditions that

will include extreme and sometimeviolent weather. What we are alreadyseeing is alarming indeed: in 2011alone we faced devastating droughts,raging wildfires, record breakingsnowstorms and rainfalls, stunningfloods in the East and Midwest, highertemperatures and more frequent 100degree days in more cities than we haveever known - with a commensuraterise in heat related deaths, an expandedrange and season for some of theworst tornadoes on record, and themost costly hurricane in our history.

In November of 2011, the U.N.sponsored Intergovernmental Panelon Climate Change confirmed thisin a report entitled: Special Report on

Managing the Risks of Extreme Events

The U.S. mental health

care system is only

minimally prepared to

address the effects of

global climate change-

related disastersand incidents.

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Another major problem for the militaryis a high rate of active service membersuicide. Even though the numbershave recently declined after reachinga high of nearly double the rate ofthe civilian population, the problempersists. While suicide is the result ofmany complex factors, the linkage toglobal warming with respect to militarypersonnel must be acknowledged.Burning fossil fuels for energy meansdepending on foreign areas where those

supplies are most abundant. To theU.S. military this can mean sendingyoung people into battle to protectour energy sources or to calm relatedunrest. Our service members willrecognize that their own lives and limbswere sacrificed even though alternaterenewable sources of energy couldbe more available. Our national needto put these young people in harm’sway would also decline if we weresimply more energy efficient. Howwill we answer these service members’

questions about why we didn’t workharder at fixing this problem?

Moreover, the United States isincreasingly disliked, worldwide, asa global warming villain. Thoughrepresenting less than 5 percent ofthe world’s population, the U.S. emitsabout 25 percent of the world’s greenhouse gasses. As the link betweenclimate disasters in other countries andthe production of green house gases in

the U.S. becomes clearer, Americanswill be blamed for inflicting harm onother countries. Critics may point toemissions from China (now surpassingthe U.S.) and India as reasons why theU.S. can “share the blame” but our percapita emissions are second to none.Alarmingly, our perceived indifferenceis already the subject of rallying criesagainst us. It is used by leaders ofterrorist groups, for example, as a toolto recruit new members. The President

of one African country hit hard bydrought linked to climate changeaddressed countries emitting highlevels of green house gases: “We havea message here to tell these countries,that you are causing aggression to us bycausing global warming.” The Presidentof Bolivia, faced with unprecedentedflooding from heavy rains, threatenedto sue the U.S. in international court.

The U.S. Department of Defensepredicts that events linked to climate

change, such as crop failures, watershortages, disease outbreaks, andmore will soon be the leading cause ofworld turmoil. Unstable states, facedwith these stressors, are at risk ofslipping into chaos, and failing. Thispaves the way for takeovers by groupshostile to the U.S. and is a growingreality widely feared by our military.

The forum was designedas an exploratory,

interdisciplinary

assessment of the

relationship between

global warming trends

in climate and how

those changes, or at

least their most acute

manifestations, will have

significant effects on the

state of American public

mental health and the

practice and provision

of mental services in

the United States.

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The economic costs of climate changewill be high by any measure. Butits specific effect on U.S. mentalhealth, societal well being andproductivity will increase current

U.S. expenditures on mental healthservices adding to our current $300billion annual burden. Incrediblythis probable cost is overlooked intoday’s national public health debateand environmental discussions. TheU.S. mental health care system is notprepared to address the full effectsof global watming-related disastersand incidents. A comprehensiveassessment of what will be requiredbegs to be undertaken. Training healthcare providers and first respondersto address the large-scale mental

distress arising from the emergenciesthat are coming is imperative. Timelyinterventions may keep some earlyinjuries from developing into costly,chronic, long-term conditions.

This report contains the proceedings,findings and recommendations of anational forum of experts in the fieldsof psychology, mental health, nationalsecurity, climate change science andpolicy. The forum was designed as anexploratory interdisciplinary assessment

of the effects that global warmingwill have on the state of Americanpublic mental health and the practiceand provision of mental services inthe United States. The forum, heldon March 19, 2009 in Washington,

D.C., was supported by the RobertWood Johnson Foundation. It soughtto add information and contextto an overlooked aspect of globalclimate change: the psychological and

public mental health implications.In addition to the professional insightsand advice of the forum participants,this report draws from a wide bodyof supplemental research to assess:

a) the most likely physical effectsof climate change in the U.S.,

b) the most likely psychologicaleffects resulting from directexperiences and also from theanticipation of future harm,

c) the subgroups of AmericanSociety most deeply affected,

d) the cost of doing nothingor doing very little,

e) the effect on the U.S. mentalhealth care system,

f) recommendations to researchers,policy leaders, publicagencies, health professionalsand first responders.

It is not a matter of

whether these problems

will occur, but rather

how frequently and

with what intensity.

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People may, indeed, suffer from anxietyabout climate change but not know it.They will have a vague unease aboutwhat is happening around them, thechanges they see in nature, the weatherevents and the fact that records arebeing broken month after month. Butthey won’t be sufficiently aware of thesource, and furthermore, we all conflateand layer one anxiety upon another.Not knowing exactly what bothers usis common. For this reason research,based on self-reporting, indicatingthat Americans do not worry about

climate change is unreliable and likelyunderestimates the actual numbers.

Major segments of U.S. societyare more psychologicallyvulnerable now:• Children: America’s 70 million

children will not only suffer longterm effects from climate changebut will also experience acutereactions to natural disasters andextreme weather events. Somechildren are already anxious aboutglobal warming and begin to obsess(understandably) about the future,unmoved by the small reassurancesadults may attempt to put forth.In the first known “climate changedelusion” a depressed 17 year oldboy was hospitalized for refusingto drink water out of fear itwould cause many more deathsin drought ridden Australia. Thedoctor who treated him has seen

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An estimated 200 millionAmericans will be exposedto serious psychologicaldistress from climate relatedevents and incidents:The severity of symptoms willvary, but in many instancethe distress will be great.

In the coming years, a majority ofAmericans will experience directadverse effects from the impacts ofglobal warming. Natural disasters

and extreme weather events willstrike many places that are denselypopulated: 50 percent of Americanslive in coastal regions exposed tostorms and sea level rise, 70 percent ofAmericans live in cities prone to heatwaves; major inland cities lie alongrivers that will swell to record heights,and the fastest growing part of thenation is the increasingly arid West.

Climate change will become atop-of-mind worry in the future:Some Americans already are or willsoon experience anxiety about globalwarming and its effects on us, ourloved ones, our ecosystems, and ourlifestyles. This anxiety will increase asreports of the gravity of our conditionbecome more clear and stark. Despitealarming evidence that environmentalconditions are worsening, a majority ofAmericans do not feel much consciousunease about global warming. Theyself-report not considering it “top ofmind” and most do not see that global

climate change has real implicationsfor their daily lives. They see theglobal warming problem as distantin both time and place. A lack ofknowledge about the basics of climatechange, the “point of no return”consequences of reaching atmospherictipping points, along with innatepsychological resistance are majorimpediments to fully grasping how direthe consequences can eventually be.

SUMMARY OF FINDINGS

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…anxieties could

increase with continuous

and frequent media

reports on the subject…


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• The elderly and the lowincome people: will also bedisproportionately affected, dueto more fragile overall healthand reduced mobility. Economic

limitations will affect many of the50 million elderly people in theU.S. and 35 million lower incomepeople with higher levels of climateand weather-related psychologicalstress. They are less able to payfor goods and services, such asair conditioning, that provideadditional protection from highertemperatures. The elderly oftenexperience severe psychologicaldistress during heats waves andlow income people likewise sufferanxiety from higher exposure to

the dangers of extreme weather.

• People with pre-existing mentalhealth conditions: The estimated 60million Americans who currentlysuffer from psychological disordersof varying degrees of severity willface additional challenges whenconfronted with the harsh realitiesof climate change. In additionto trying to contend with highertemperatures and more violent orextreme weather, they certainly willhave a harder time finding publiclyfunded mental health treatmentprograms as these budgets shrinkin favor of more basic emergencyresponse services and communityrepairs. As jurisdictions strugglefollowing natural disasters tomeet the bills to clean up, replant,feed or otherwise provide basicand emergency services, fundingfor the needy, the sick, and thevulnerable will inevitably becut. Funding for mental healthservices is among the “first to

go” in economic hard times.Indeed since 2008, two thirds ofU.S. states have cut funding, (ashigh as 47 percent in one state)though many of these servicesare deemed “critical.” (Medscape:Psychiatry and Mental Health)

Some 50 million elderly

people, and America’s

35 million low-income

people will suffer

a disproportionate

amount of physical and

psychological stress.

Comparision of 1992 to 2002Components of the Economic Burdenof Serious Mental Illness, Excluding

Incarceration, Homelessness,Co-morbid Conditions and Early

Mortality (in Billions)

Type of Cost 1992a 2002b

Health Care Expenitures $62.9 $100.1c

Loss of earnings $76.7d $193.2e

Disabilty beneftis(SSI and SSDI) $16.4d $24.3f

Total $156.0 $317.6a Normal 1992 dollars based on general Consumer Price

Index data; $1 in 1992=$128 in 2002 (www.bls.gov/cpi).b Normal 2002 dollarsc Source: Mark etal. (4).d Source: Rice et al. (7).e Source: Kessler et al. (6).f Author’s calculations based on data from the Soical SecurityAdministration (www.ssa.gov/policy/docs/stat-comps).

0 50 100 150 200 250 300 350

FY 2002

FY 1992

Total

Disabilty

Beneftis

(SSI and SSDI)

Loss of

Earnings

Health Care

Expenitures

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other children suffering fromclimate related anxiety disorders.A body of research showinghow distressed Russian and U.S.children were by the threat ofnuclear bombs during the coldwar era underscores the potentialfor global climate change to havethe same destructive impact.




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• Members of the Military andtheir families: One of the mostdramatic manifestations of theimpact of global climate changeon the mental health of Americans

could originate from beyond itsborders. The U.S. Military hasconcluded that global climatechange will have destabilizingeffects on economically, politicallyand environmentally fragilenations, putting them at risk ofcollapse and opening them up toconflict and war. Many of thesecrisis zones will draw in Americanfighting forces. Some of thesefailed states may become seedbedsof terrorism; putting Americansin danger on our own soil. U.S.

military interventions in failingnations will have many seriouspsychological effects as evidencedby experiences with the wars inAfghanistan and Iraq. Commonmanifestations include anxietiesand fears associated with enteringor being in combat, post traumaticstress disorders, emotionalreactions to injuries, suicide,painful separations from family,and the economic and emotionalhardships back home that often

accompany having a spouse orparent in the active military.

First responders will

need further education

and training on handling

psychological symptoms

of those they are helping.

The mental health care system ofthe U.S. is not prepared to handlethe wide-spread psychologicalstresses of climate change:While the U.S. mental health care

professions are coming to recognizeand address the larger scale perilsassociated with climate change, nocomprehensive strategies are in placeto cope with the full psychologicaland public mental health implications.Given the foreseeable magnitude ofthe impacts and the rate at which theworld is changing, a campaign focusedon what this segment of the U.S. mentalhealth service community can do tohelp is certainly needed. Examples ofneeds include how to address large

populations (sometimes millions) whohave witnessed or been displaced byviolent weather, are suffering throughheat waves or drought and otherconditions that create the need forlarge scale emergency mental healthinterventions in affected locations.

There is also low firstresponder preparedness:Due to the number of emergencysituations in which global climate

change and mental health issueswill be connected, first responderswill need additional education andtraining to handle the immediatepsychological trauma and symptomsof climate disaster victims. Suchtraining will support rescue operations,triage decisions, application ofmedications, patient safety and more.

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Priority for guidelines,

models, training and other

support should be given to

mental health professionals

Some climate change-related conditions and their

psychological effects meritspecific preparation:• Summer heat waves: the physical

distress arising from prolongedheat waves is well known.What is not widely known isthe psychological distress that iscaused by higher temperatures,and, in particular, the relationshipbetween rising temperatureand aggression. Research fromIowa State shows that, as thetemperature rises, so does the

incidence of violence. (DeLisi 2010)• Coastal and river flooding: the

direct adverse effects of floodingare obvious, but these weather andclimate related events are especiallylikely to lead to psychic injuryfrom the stress of displacement,loss of possessions (including pets),and uncertainty about interim andfuture housing and employment.

• High impact and more intensestorms: the far-reachingconsequences of destructiveweather saw its prototype inHurricane Katrina. The Hurricanescattered residents of New Orleansall across the U.S. It shattered aculture, broke up families, spikedoutbursts of outrage and blameat a government that was slow torespond, and lead to a jump inviolence in at least one city thattook them in (Houston). Six yearslater New Orleans has yet to fullyrecover, and many of the victims

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have experienced post-incidentstress and post-traumatic stressdisorders (PTSD). Their shakenconfidence in institutions andgovernment is less quantifiable butalso potentially damaging especiallyas a cumulative effect over time.

• Severe drought and reduced snowpack: the unrelenting day by daydespair of watching and waitingfor water that doesn’t come willhave a singularly damaging impacton the psyche of the people whohave depended on Mother Nature’srainfall for their livelihood.Already underway is a 21st centurydust bowl in Australia that hasspawned a growing populationof desperate migrants. Texas hasrecently experienced a drought(with accompanying wildfires)the likes of which has not beenseen in more than 50 years.

• Increased large-scale wildfires:raging wildfires are incrediblydangerous and have a particularlysavage effect on our psyches bydevastating landscapes, wiping

out homes and possessions,incinerating wildlife and cloggingthe air with pollutants that sickenpeople locally and can travelhundreds of miles to sickenpeople at a distance. Persistentpsychological stress is common,with anxiety reactions recurringfrom unavoidable re-exposureto the odors, smoke and ash.

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There is no organized disciplinefor the study of the psychological

aspects of global warming:While considerable research andprofessional literature report onpsychological reactions to naturaldisasters, no overarching disciplineor field of study connects humanpsychology to the many faces ofglobal warming. A long term anddisciplined approach to studyingthese problems within public healthagencies, the academic and clinicalcommunity is needed to adequatelyassess and address the full meaningof global warming on the mentalhealth of the American public.

• New disease threats: highertemperatures favor the formationof ozone which triggers asthmaattacks. Anyone who has asthmaand parents of children with

asthma are familiar with the fearsthis illness engenders. People diefrom untreated asthma. Manyother fears linked to diseaseare harder to “nail down.” Asmalaria and dengue fever andother infectious diseases marchnorthward due to warmertemperatures, inchoate fears ofthreat and vulnerability drift intopeople’s consciousness. This willbe compounded by a growingnumber of sensational mediareports tied to disease outbreaks

and public health warnings.

When natural disasters areno longer truly natural:Research shows that when a disasteris viewed as avoidable, as is the casewith the harm caused by man-madecarbon emissions, people find it harderto accept, become resigned to, and moveon. The anger and outrage at callous,willful ignorance toward public welfarewill make for incendiary, difficult toget over conditions. With increasingmedia coverage educating people aboutthe causes of climate change and theensuing extreme weather events andother disasters, we can expect morepowerful and troubling responsesto human-caused climate disastersthan when disasters were previouslyexperienced as natural or “acts of God”.

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© a t t e

m

/ S h u t t e r s t o c k . c o m

Persistent psychological

stress is common,

with anxiety reactions

recurring from

unavoidablere-exposure to the

odors, smoke and ash.

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The mental health communitycould be more effective atcommunicating the threatof climate change and theurgent need to take action:Although the field of psychology hasdeveloped policy positions in climatechange, it has remained relativelysilent on the depth and scale of thethreat. Americans must have thethreat register, in order to find theimpetus and sustained interest inadopting solutions and supportingofficials and policies that recognizewhat we stand to lose. This willrequire more education, persuasivemessages, and consistent reinforcementfrom people and organizations with

a reputation for trustworthiness andobjectivity. The magnitude of thetask is daunting, but deploying thecollective influence of members ofthe mental health community, whohave both an understanding of scienceand a commitment to helping peoplebreak through their resistance anddenial, would be a major help.

There will be huge nationalprice tag for ignoring themental health implicationsof climate change:The mental health care expenses of

large scale events such as HurricaneKatrina in 2005, or Hurricane Irenein 2011, point dramatically to how thecurrent estimated average annual U.S.mental health care and lost productivityThe current estimated average annuallevel of more than $300 billion toprovide mental health services andto accommodate the indirect costssuch as lost work time in the UnitedStates will increase significantlyas a direct result of the physical,economic, social and psychological

effects of global warming and relatedincidents in the coming decades.

This will require more

education, persuasive

messages, and consistent

reinforcement from

people and organizations

with a reputation

for trustworthiness

and objectivity.

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SOLUTIONS AND RECOMMENDATIONS:

Mental health practitioners,first responders and primarycare professionals should havecomprehensive plans andguidelines for climate change:The psychology and mental healthfields have many well-developedtools and approaches to help respondto disasters and to take care ofpatients faced with emergencies. Butthese need to be honed and better

placed in anticipation of meeting thedemands of escalating large-scalecrises. Increased and better targetedemergency management and disasterresponse training on the psychologicalreactions of victims to violent weatherand other disasters is needed.

Priority should be givento training mental healthprofessionals who serve themost vulnerable populations:

Examples include: school counselors,pediatric health care professionals,healthcare specialists serving the aged,public clinic staff, and specialists servingpatients susceptible to stress reactions.

Improve the assessment,diagnosis, and treatment ofpeople suffering from climaterelated mental health problems:We need a new discipline of study andpractice that will help practitioners andpublic health officials prepare for theforeseeable and unavoidable mentalhealth effects of global warming. Thiswill require research, professionaldevelopment, operating centers of

excellence in practice and best methods,and guidelines for interventions andtreatment for those psychologicallyinjured or in torment. This body ofknowledge should also be incorporatedinto existing academic disciplines:environmental studies, law, business,other social sciences and medicine.

A rigorous estimate should bemade of the cost of addressingthe psychological effects of

climate change vs. the costsof ignoring the problem:The size and scope of the problem ofclimate change disasters will causemental distress requiring care ona massive scale. The existing $300billion direct and indirect annual pricetag will increase as the frequency ofdisasters mounts, but the greatestpublic costs could come from ignoringthe effects. Timely interventionscould reduce the number of disorders

…anxieties could

increase with continuous

and frequent media

reports on the subject…

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that become chronic. An assessmentshould be made of what the mentalhealth consequences of globalclimate change will mean to the U.Seconomy in the short and long term.

Governments should developand deploy mental healthincident response teams:This would be similar to currentpractices used by public health agenciesfor disease outbreaks but would bedesigned for trained mental healthprofessionals. These teams wouldarrive at the time of a climate orweather related incident to advise localclinics, mental health providers andfirst responders on what psychologicalresponses to expect and how to addressthem. They would also coach them onhow to deal with their own emotions.

Helpful models for positiveindividual and communityaction should be developed:Health professions have had successchanging behaviors in campaigns tostop smoking, use seat belts, and getvaccinated. The “health belief model”and its many refinements used by health

institutions could be effective tools tofight global warming. A campaign toshow how coal is not only driving upCO2 but sickening and killing peoplefrom cardiovascular disease, lungailments, cancer and more, could be atest case. People feel better when theytake steps to improve their lifestyle andhelp their communities. Lowering ahome’s carbon footprint, saving energyand working on collective efforts tolower green house gas emissions are all

Professionals in the

American mental health

community can help

shape the best language

and tone to help us

understand, prepare for,

and face the challengesof climate change.

examples of behaviors that engenderoptimism. There are psychologicalbarriers to taking action and hiddenimpediments and fears that stand inthe way of these efforts. The field can

help leaders to learn how to get themout of the way or break them downinto components that can be corrected.

Steps to Changing your OutlookUnderstanding the issue

Identifing five steps you can do in your ownhome or work place to reduce impact.

Surround yourself with good people

Share with others your concerns

Learn how to deal with stress from outsideinfluences

Get help when you need it.

©Pew Research Center

Psychological implicationsof global warming shouldbe factored into publicpolicy development:No public policy framework currentlyexists that would assess and addressthe capacity of U.S. public healthdepartments, first responders andpractitioners to handle disastersand other manifestations of globalwarming that will require largescale mental heath care responses.

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policy statements such as that publishedby the American PsychologicalAssociation, the relative silence of the

mental health care community on thesubject of climate change is a subliminalsuggestion that danger does notabound. Given the truth of the threat,this could be a deadly misconception.

The American mental healthcommunity should havean ethical call to action:This would include publishing andupholding a strong ethics positionon climate change. Mental health

practitioners are trained, indeedare ethically bound, to respond toemergencies. They are also requiredto report to authorities if they havereason to believe, for example, that achild is being abused. The requirementis a legal one, but it is also a moralone. We must ask, knowing full wellwhat the science is telling us, if thecall for climate change action is anyless compelling than stopping childabuse or protecting the sick. In thefinal analysis inflicting the burdenof climate change on the vulnerableis an immoral act that puts futuregenerations in mortal danger.

The following report and forumproceedings provide the backgroundand rationale for these findingsand recommendations.

Ramping up and

sustaining pressure

on public officials

is imperative

The American mental healthcommunity should help teachthe public and leaders abouthow global warming will affectus and what we can do:Professionals in the American mentalhealth community can help shapethe best language and tone to helpus understand, prepare for, and facethe challenges of climate change.Furthermore, with all the direconsequences being discussed, thepopulace risks becoming discouragedand avoidant, and even paralyzed.Psychologically minded messages canhelp counter this. America’s leadersshould be trained to use the mostpersuasive educational tools to influence

people to change and to sustain theirchanges. The underpinnings of denialand inaction should be commonknowledge and openly addressed.Being versed on how to craft messagesthat resonate and stick with peopleshould be a fundamental part of anyscience communication training.Mental health professionals are in anideal position to show that collective,altruistic action is an antidote to feelingsof powerlessness and other painfulemotions. Also in the province of

professionals is the courage to tackletaboo issues, such as how and whatwe eat, as well as our mode of travel.These are uncomfortable questions thatwe need to find a better way to ask.

The American mental healthcommunity needs to become astrong public voice for protectingthe public from climate change.Ramping up and sustaining pressureon public officials is imperative. The

American mental health community,with its combination of clout andexpertise, could help confront publicpolicy leaders with the full implicationsof inadequate action on climate change.As experts in breaking down denial,and dedicated to bringing reality andrational thinking into decision makingto help people get off destructive paths,mental health professionals should bein the vanguard of the fight againstglobal warming. With the exception of

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CHAPTER ONE:

Psychological Effects of

Global Warmingacross the U.S.

The March 2009 forumthat contributed to thedevelopment of this reportbegan with an overview of

the physical impacts of climate changeon the U.S. and North America. InApril 2007, the IntergovernmentalPanel on Climate Change (IPCC)released its’ much anticipated reporton how global warming will likelyaffect the world. It was the clearestand most detailed assessment ever ofhow both the global environment andhuman health are likely to be affectedby global warming. It spelled out the

minimum degree of warmingwe are likely to see by the endof the century regardless ofour future success in abatinggreenhouse gas emissions. TheIPCC group of 2,000 scientistsand experts received the 2007Nobel Peace Prize for theirwork in revealing the depth and

extent of the global warmingthreat to policy makers and thepublic worldwide. Their reportalso provided a closer look atthe anticipated effects of climatechange on North America.

Our Last ChanceIn offering welcoming remarksto the forum participants,National Wildlife Federation

President and CEO, Larry Schweiger,emphasized the importance of reachingout to professionals in many disciplines,warning them about the threats fromglobal warming and involving themin the solution. Without awarenessand vigilance, he remarked, its effectscan “sneak up on us like a thief in thenight.” The more light we shed onthe climate problem, the more likelywe will have an effective nationalconversation to address the threat,and the more likely the public willbe healthy, prosperous and safe inthe future.” Schweiger discussed

© n a s a . g o v

The IPCC group of 2,000

scientists and experts

received the 2007 Nobel

Peace Prize for theirwork in revealing the

depth and extent of the

global warming threat

to policy makers and

the public worldwide.





the findings of his book, (publishedin September of 2009) Last Chance:

Preserving Life on Earth, where hewrote that “all life is threatened byglobal warming. Humans are partof that web and will experience

the threat in many ways that maybe difficult to imagine in light ofthe relatively stable environmentalconditions humanity has experienceduntil now.” (Schweiger, 2009)

A Dissolving “StabilityAssumption”Forum participant and scientist Dr.Robert Corell offered a revealingperspective on understanding the futurephysical effects of global warming. Hesaid that “as a society, we would dowell to appreciate the relative climatestability we have had since the last iceage.” He said that during this 10,000year period, all of human civilization,as we know it, evolved by relyingon relative climatic “calm.” Havingpredictable temperature, precipitationand seasonal variations over longperiods assured the climatic stabilitythat was needed for the invention andinitiation of organized farming, fishingand livestock husbandry, the growth ofsettlements, trade and other organized

activities needed to form largercommunities, cultures and city states.Modern society, he said, “has come todepend on a comforting sense of thepermanence in our natural world.”

The United States is no exception.Our entire region is highly dependenton climate predictability for economicgrowth and development. We arerich in natural resources and have

an economy that was originallybuilt on an abundance of good soil,water, forests, livestock, and fish.Climate science shows that globalwarming will profoundly alter theseresources and could leave incalculablehuman turmoil in its wake.

To support the forum discussion,Dr. Corell presented a summaryof the IPCC (2007) predictionsfor North America:

• Warming in western mountains

is projected to cause decreasedsnow-pack, more winterflooding, and reduced summerflows, exacerbating alreadydifficult and sometimes divisivecompetition for water resources.

• Pests, diseases and wild resare projected to increasinglydamage the health of forests.The fire seasons will belonger and more intense, withmany more acres burned.

• Moderate climate change in theearly decades of the 21st centuryis projected to increase aggregateyields of rain-fed agriculture by5-20 percent, but this will varygreatly from region to region.

• Major challenges are projected forcrops that are near the warmerend of their suitable range and forcrops that require abundant water.

• Cities that currently experiencehot weather are expected toface additional challenges as the

number, intensity and durationof heat waves increase. Thenumber of deaths and illnesseswill rise, especially among thevery young, the old, and theotherwise vulnerable. Coastalcommunities will be stressed bysea level rise and more intensecoastal storms. (Wheaton, 2007)

We are witnessing anunraveling of climate

stability and therefore

human stability and are

seeing physical changes

that are unprecedented

in all of history.

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Dr. Corell warned that: “We arewitnessing an unraveling of climatestability and therefore human stabilityand are seeing physical changes thatare unprecedented in all of history.We are going to a place wherewe humans, and all we connect

with, have never been before.”Educator and environmentalist BillMcKibben describes this phenomenonprovocatively as the “end of nature.”He says that: “our comforting senseof the permanence of our naturalworld, our confidence that it willchange gradually and imperceptibly,if at all, is now the result of a subtlywarped perspective. Climatic changesthat can affect us can happen in our

lifetime. By the end of nature I do notmean the end of the world. The rainwill still fall and the sun will shine,though differently from before. WhenI say ‘nature,’ I mean a certain set ofhuman ideas about the world andour place in it.” (McKibben, 2006)

Dr. Corell used several examples toillustrate that the already stunningpredictions of the 2007 IPCCreport may actually underestimate actual climate change impacts:

• The IPCC estimate of one to twofeet of sea level rise by the year2100, for example, may actuallybe closer to six feet. Estimatesof the extent of ice melt in

The current policy and

legislative proposals

being discussed by

public policy leaders do

not reduce greenhouse

gas emissions enough

to restore balance

to our world and

avoid long termenvironmental damage.

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Greenland have been understatedand may be too low. The summerflow rate from the massive icesheets there is now three timesthe flow rate of the Nile River

having tripled in recent years.• Previous data showed that the

north polar sea ice was at risk of atotal summer melt by mid century.New data show that this couldhappen in a dozen years or less.That would be 30 years earlierthan the original prediction. Windsblowing across polar ice cap arechilled by it and, as they continuetheir long path southward, theybring cool temperatures to warmerareas. The melting of the north

polar ice cap will have the effectof turning off a large part of theplanet’s natural air conditioner.

Melting polar ice exemplifies a majorconcern for climatologists: thatof climate change tipping points.According to NASA, about 90 percentof the sun’s rays are reflected backinto outer space when they hit thebright ice of the polar cap. By contrast,when the sun’s rays hit darker openocean water, as much as 90 percentof the sun’s heat energy is absorbed.

The polar ice cap serves as a massiveplanetary cooling system by reflectingheat away from the planet. The datathat polar ice is melting faster thanever could mean a rapid shift from acooling system to a warming system.

The arctic region holds other climaterelated perils. Millions of tons of carbonfrom plants that died millions of yearsago have been trapped in the frozentundra of the north. Cold temperatures

over thousands of years have keptthe gases from these ancient depositsfrozen and trapped underground.Temperatures are rising quickly inthis part of the world, however, andthat is causing the tundra to melt. Asglobal warming advances, the rateof warming near the poles is fasterthan areas closer to the equator. Thisreleases carbon in the form of methane.Methane is a greenhouse gas that is 10times more potent in its atmosphericheating potential than carbon dioxide.

Dr. Corell also warned that highertemperatures could very likely unleashsome new disease pandemics. Hepointed to how species, plants andeven disease vectors are movingnorth into areas previously too coldto support them. We have seenrecent North American examplesof this with West Nile virus anddengue fever carried by insects.

We can also expect some new physicalgeography in North America. Wecan no longer assume that our coastswill remain where they are today, andwe can no longer expect that it will besafe for people to live along them. InFlorida, Dr. Corell indicated that athree-foot rise in sea level would flood

Summary Rural Impact• Prolonged drought is a serious stressor

for rural communities, involving financialhardship, practical uncertainty, and anxietyabout future prospects.

• Drought can affect all members – adults and

children – of farming families.• The stressful effects of drought extend to

farm and nonfarm related businesses inrural communities and may increase socialisolation.

• Chronic stress and uncertainty combinedwith relative isolation increase the riskof developing a mental disorder such asdepression or anxiety.

• People are unlikely to present directly withcomplaints of depression or anxiety, but mayappear with symptoms relating to physicalcomplaints, injury, sleeping problems,or problems relating to ‘self medication’with alcohol. They may also present withconcerns about family members.

• Rural agency workers can be a good sourceof information about current issues andstressors in the farming community. Theyoften receive a high degree of trust fromfarmers and their families. Collaborationwith rural agency workers can decrease

http://www.racgp.org.au/ afp/200712/200712Sartore.pdf (reference)

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and/or endanger as much as 20 percentof the State. With so many peopleliving directly along the coast, an evengreater percentage of the populationwould be affected. Though slightly

higher elevations may not be vulnerableto permanent flooding from sea levelrise, these same areas may experienceincreased intermittent flooding becauseof higher sea levels that extend thewater’s reach during a storm surgesuch as is common with a hurricane.With these new flooding events, morepeople will die or they will be injured,as was evident from Hurricane Irenein 2011 and over the long run, a wayof life could be permanently destroyedfor people in coastline regions. Theclean-up costs will be major, revenues

from tourism and local industry willbe reduced or even lost entirely, andecosystems such as major coastal marshsystems will increasingly be destroyed.

The National Oceanic and AtmosphericAdministration (NOAA) reports thatabout 50 percent of Americans (over150 million people) live in coastalcounties (Tibbetts, 2002). Many majorcities lie along the coasts and a sizablepercentage of these people live in flood-prone areas. The Federal Emergency

Management Agency (FEMA) estimatesthat 10 million homes lie in floodprone areas along coasts and in inlandriverine flood plains (FEMA, 2003).

To help make the connection betweenthe physical and psychological, Dr.Corell spoke of the “difficulty weoften have predicting the future inthe behavioral world will, for the

first time in modern history, have acloser parallel in the physical world.”He emphasizes that ”the currentpolicy and legislative proposals beingdiscussed by public policy leaders donot reduce greenhouse gas emissionsenough to restore balance to our worldand avoid long term environmentaldamage.” Given the speed withwhich the world is changing andthe potential for catastrophic climatechange, he emphasized the urgencywith which Congress and individual

states should act to adopt policies torein in greenhouse gas emissions.

Given the speed with

which the world is

changing and the

potential for catastrophic

climate change, he

emphasized the urgency

with which Congress and

individual states should

act to adopt policiesto rein in greenhouse

gas emissions.

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A Problem “FlowingSouthward”Dr. Corell concluded his remarksby relating a personal story aboutthe indigenous people of Ilulissat,Greenland. It is a village of 3,000inhabitants near the Arctic Circle.While on a research expedition there,he noticed that the increased meltingof polar ice in the summer months hadcaused profound changes in the hunting

habits of the people in the village.“Basically,” he said, “a father can nolonger teach a son to hunt. That is thetraditional role played by a man as a

as global warming

spreads and takes hold,

what is happening up

north will eventually

flow southward

provider to his family.” This has forcedyoung men to abandon their familialvillage to seek livelihoods in cities.This new urban lifestyle is foreign andalienating to them. Many experience

enormous difficulty adjusting to theurban environment. They feel outof place, and end up returning home.They have few plans for the future.Others are too discouraged to musterthe initiative to leave the village insearch of better circumstances. On avisit there in March 2007, Dr. Corelland his team noticed that the localcemetery contained an unusually highnumber of graves belonging to youngmen. They learned that in one yearalone, 2007, 17 boys committed suicide.This is a stunning suicide rate for such

a small community. It is many timesthe norm. With their “men folk” gone,the young women have become singlemothers. Even though these devastatinglosses and damage to the structure ofthe society are seemingly unique tothis place and its culture, Dr. Corellsays that, “as global warming spreadsand takes hold, what is happening upnorth will eventually flow southward.”

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CHAPTER TWO:

Most Americans WillExperience the Stresses ofClimate Change as SpecificWeather Incidents or Disasters

scale strip mining to the landscapechanging impacts of global warming,diminish the mental health of thepeople who live there. (Albrecht, 2005)

Common PsychologicalReactions to Climate-RelatedIncidentsIn the aftermath of events linked toglobal warming, many of the affectedpeople will experience fears, feelings ofguilt, anger, and despair. How people

“carry on” will be determined by theirbackground, current mental state,personality, life experiences and otherfactors. The nature of the climate-related event they experienced will,itself, carry some weight in determiningtheir psychological reaction. Thedegree of the sense of powerlessness,the sheer force of the incident, the

The Acute Manifestations ofClimate Change in AmericaThough many Americans willexperience the effects of climate changequite directly, they may not make animmediate connection. Instead, theywill have distress and anxieties fromsuch occurrences as “nature turningbizarre” and will not likely perceivethe real culprit: climate change due toincreased greenhouse gas emissions.When they do link them, those

connections will be striking andpotentially psychologically painful.

When the Centre for Rural and RemoteMental Health at the University ofNewcastle in Australia conductedinterviews in drought-affectedcommunities in New South Walesin 2005, some of the intervieweesseemed to suffer from a psychologicalcondition that has come to be describedas “solastalgia.“ Researchers describeda “palpable sense of dislocation and

loss that people feel when they perceivechanges to their local environmentas harmful.” Glenn Albrecht, anenvironmental philosopher at theUniversity of Newcastle’s School ofEnvironmental and Life Sciencesin 2003, named the condition afterobserving communities damaged bylarge-scale coal mining. Albrechtbelieves that shifts in the health ofan ecosystem, as evidenced by thedesolate wastelands created by large-

Weather Phobias 2011 Phobia Fear of...

lilapsophobia tornadoes or hurricanesbrontophobia lightning and thunder

antlophobia floods

chionophobia snow

ombrophobia rain

ancraophobia wind

heliophobia sun

thermophobia heat

cryophobia cold

homichlophobia fog

nephophobia clouds

pagophobia ice or frost

cymophobia waves

“Solastalgia“...

researchers described

a “palpable senseof dislocation and

loss that people feel

when they perceive

changes to their local

environment as harmful.”

C o u r t e s y : p h o b i a l i s t . c o m





event’s suddenness, degree of damage,loss of life and injury and the extentto which people personalize theseincidents will determine the depthand extent of the psychopathology thatresults. Mental health experts expectan increase in depressive, anxietyand aggressive disorders generally.

The degree to which the event hitshome on a personal level will also makea difference. For example, the lossof a bird greatly appreciated in one’s“neck of the woods” (e.g., Baltimoreoriole) will be experienced differentlyfor those who simply enjoy the sight

of birds. A coral reef bleached orcovered in sediment could make theperson who simply hears about it sad,while the scientist who has studiedthat particular reef most of hisor hercareer or the fisherman who relies onit for livelihood would be devastated.The more personally involvedone is, the more psychologicallydestructive the event will become.For some it could mean loss oflivelihood, property, and even life.

Along the CoastsMore than 150 million Americans livein coastal counties and the FederalEmergency Management Agencyestimates there are millions of U.S.homes situated in highly flood proneareas along coasts. In Florida, forexample, where 35 percent of thestate is classified as wetlands, andmost people live along the coasts.A high percentage of residents liveat risk from storms and flooding.

The degree to which the

event hits home on a

personal level will also

make a difference.

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© N O A A . c o m

2000—$ 2.4

1997—$4.8

1983—$6.3

2005—$17.1 2008—$7.02001—$5.61985—$2.92005—$133.82008—$5.01985—$2.5

1983—$4.21985—$2.31983—$4.21985—$2.3

2006—$1.02010—$1.5

2004—$7.7

1993—$1.4

1994—$4.2

2010—$2.31980—$55.4

1986—$2.4

1998—$9.5

1989—$15.3

1996—$6.61999—$7.4

2003—$5.6

2007—$2.01993—$7.9

1998—$1.31999—$1.2

1999—$1.62001—$2.22002—$1.92003—$3.82006—$1.1&$1.52008—$1.02009—$1.0&$1.1

2009—$1.4

2002—$2.32006—$1.0

1991—$2.3

1992—$2.

1998—$1.8

2004—$9.9

2004—$16.52005—$17.11992—$40.0

1995—$2.9(U.S. Virgin Island)

1998—$7.4

1988—$71.22002—$11.42005—$1.12007—$5.0

1998—$1.9

1996—$4.0

2008—$1.2

1982-83—$2.31990—$1.61994—$1.41998—$1.3

1993—$30.22008—$15.0

1989—$1.72006—$6.2

1996—$1.3

1995—$4.1

1991—$3.9

Hurricane

LEGEND

Tropical Storm

Flood

Severe Weather

Blizzard

Fires

Nor’ easter

Ice StormHeat Wave /DroughtFreeze

1990—$5.51998—$3.22007—$1.4

1993—$1.42003—$2.82008 / $2.02009 / $1.0

2010—$2.01999—$2.02003—$1.82006—$1.02008—$1.12008—$2.4

2010—$3.0

1995-96—$6.82000—$4.82008—$2.02009—$5.0

2002—$2.32006—$1.0

1992—$2.7

1994—$1.42007—$1.0

1982-83—$2.31996-97—$3.9

Billion Dollar Weather Disasters 1980-2010

• Dollar amounts shown are approximatedamages/costs in $billions.

• Location shown is the general area for theregional event. Several hurricanes mademultiple landfalls.

• Additional information for these events isavailable at NCDC www.ncdc.noaa.gov/ol/ reports/billionz.html

• The U.S. has sustained 99 weather relateddisasters over the last 30 years withoverall damages/costs exceeding $1.0billion for each event. Total costs for the99 events exceed $725 billion using a GNPinflation index.

1995—$4.12004—$15.42005—$2.11994—$1.4

1998—$1.32007—$1.52009—$1.2




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In the HeartlandEven though summers may begenerally drier due to climate change,climatologists estimate that winterrains will be more intense and createmore flood conditions throughout theMidwest. Moreover, farming and foodproduction, so key to this region, willbe subject to many more uncertainties.

In the WestThe arid and semi-arid parts ofthe American West are likely to

become drier. Predicted droughtsand catastrophic wildfires alsothreaten to create emergencyconditions in many western andsouthwestern states. (Wheaton, 2007)

Psychological Responses toViolent Weather GenerallyExtreme weather events can lead toimmediate psychological problemsrelating to loss, economic disruption

and physical displacement. Fear, grief,depression, anxiety, problems sleeping,eating disorders and self medicationwith alcohol and drugs are commonresponses. Symptoms may subsidewhen safety and security have beenreestablished, but sometimes they donot. Post traumatic stress disorder isfrequently seen in populations exposedto violent disasters, particularlyof course, those that recur. Thepsychological toll is cumulative.

Hurricane Katrina is illustrative.

Affected communities showed highrates of depression, domestic violenceand significantly higher rates of suicideand suicide attempts (14.7 and 78.6times above the area’s baseline rate,respectively). This population alsoshowed high rates of post-traumaticstress disorder. These mental healthinjuries were a consequence not only ofexposure to the event itself, but also tothe subsequent general displacement,uncertain housing and employment,insufficient access to support services,

and the belief that those in authoritywho could have done something, didnot do enough or adequately prepare.

Responses can be direct or indirect.A study following North Carolina’sHurricane Floyd concluded, forexample, that children are more likelyto be abused by family membersfollowing disasters. This is undoubtedlyone among the many potentialmanifestations of the breakdown of thefamily that disasters can precipitate.People with severe pre-existing mentalillnesses are especially vulnerableto the challenges of handling andresponding to a disaster. Additionally,the urgent care that this segment ofthe population needs is already hardto come by (Keenan et. al., 2004).

Research shows that some people areconstantly in fear of the possibilityof extreme weather events. Dr. JohnWestefeld, a University of Iowa

Hurricane Katrina is

illustrative. Affected

communities showed

high rates of depression,

domestic violence and

significantly higher rates of

suicide and suicide attempts

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professor of psychology who lives where

tornados and tornado warnings arecommon, sees cases of fear of severeweather that are so extreme it couldbe considered a phobia. He studied 81individuals who had expressed seriousworries about extreme weather toassess their reactions to thunderstormsand tornadoes and found that even aweather forecast a week in advancecould leave some participants “prisonersin their own homes.” (Westefeld, 1996)

In order to relate better to disastervictims, the American Academy of

Experts in Traumatic Stress describesthe need for first responders andhealth care providers to understandtheir own internal responses todisasters and emergencies in stages:

• Stage of anticipation comes right after we are notifiedof the incident. Anticipatory stressdeals with the unknown. We haveno idea of what we are facingand no idea of what to expect.The media plays an important

part in this stage and can oftenterrify our psyche into believingwe are incompetent because theincident is “too overwhelming”.

• Stage of Reality Shock develops when we arrive at thesite. Often we are overwhelmedby the task at hand. This stagebrings anxiety, a sense of shock, afeeling that we cannot do enoughto help. Also, this stage can leadto the need to work feverishly.

• Stage of DeSpeRation/

Stage of acute ReactionS develops after the job is completed.It is normal to push physical andpsychological stress out of the wayuntil the job is done. Feelings ofdepression, anguish, remorse andsadness can result. Talking aboutthe incident becomes difficult, andwe become introspective. We mayfeel guilty because we did not doenough. We become vulnerable,and our world as we knew it hascollapsed. These post-traumaticstress reactions are normalresponses to abnormal events.

It is also this stage that can leadto affect disintegration: chronicillness emerges, psychotic episodesdevelop, loss of trust shattersmeaningful attachments, chronicguilt and self-blame becomesintrusive. What can emerge isPosttraumatic Stress Disorder(PTSD). The degree of stressexperienced is proportionalto these five factors:

1. The amount of empathyone possesses,

2. Past traumatic eventsone has experienced,

3. Unresolved traumaticconflicts one may harbor,

4. The amount of exposureto family, children’s orfriends’ trauma,

He studied 81 individuals

who had expressed serious

worries about extreme

weather to assess their

reactions to thunderstorms

and tornadoes and found

that even a weatherforecast a week in

advance could leave some

participants “prisoners

in their own homes.”

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5. The degree of maladaptiveresponses one uses asa survival strategy.

• Stage of Reconciliation/ Stage of acute

poSttRaumatic StReSS iswhen we live through and learnfrom our stress. In this stage wecan grow from the traumaticevent and incorporate it intoour psyche, or we can developacute stress symptoms. Distressduring the days that followthe incident resemble those ofPTSD; however, it is difficultto differentiate between normalresponses to an abnormal incidentand responses that develop into

PTSD” (Neudeck-Dicken, 2000).The global impact of climate changeassures that the psychological damagesfrom disasters cited above will likelybe seen on a massive scale. Dr. DavidSatcher, former U.S. Surgeon Generaland member of the Commissionon Social Determinants of Health,and Drs. Sharon Friel and RuthBell, members of the CommissionSecretariat, wrote, in the Journal ofthe American Medical Association,that 39 percent of Hurricane Katrina

evacuees experienced moderatesymptoms of post-traumatic stressdisorder and 24 percent experiencedsevere symptoms. Studies indicatethat similar long-term conditionsshould be expected among survivors ofHurricane Rita (Satcher et al., 2007).

Hurricane Katrina showed that climatechange and extreme weather eventswill displace significant numbers ofpeople living in already vulnerablecommunities. Two hundred thousandpeople ended up leaving the Gulf coast

after Katrina. The U.S. GeologicalSurvey and other governmentalorganizations predict that sea levelrise and more intense storms willaffect as many as a billion peopleworldwide in the coming century.

Post-traumatic stress disorder (PTSD)is an intense physical and emotionalresponse to thoughts and reminders ofa particular event. Forum participant,Dr. Spencer Eth, discussed the

symptoms of PTSD and noted thatthe disorder was added to the mentalhealth lexicon in the 1980s even thoughthe phenomenon has been around formillennia. PTSD occurs when people

exposed to a life threatening occurrencecannot stop reliving the experience.The memory of the event is a constantsource of psychic “re-injury.” Themore powerless an individual feels atthe time of the event, the more likelyhe or she is to suffer from PTSD.Early treatment is more likely to beeffective than treatment initiated lateron. Despite appropriate and well-timed interventions, PTSD can becomea chronic and debilitating disease.Symptoms can last months and evenyears after the precipitating event.

The symptoms fall into threebroad types: re-living, avoidanceand increased arousal.

• Re-living: flashbacks,nightmares, and extremeemotional and physical reactionsto reminders of the event. Feelingsof guilt, fear verging on panic,and emotional numbing arecommon reactions. Uncontrollableshaking, racing heart, debilitatingheadaches and more arecommon physical reactions.

• avoiDance: conscious orunconscious avoidance ofactivities, places, thoughts, orfeelings evoking the trauma,detachment from customarybehaviors and events andestrangement from others.

• incReaSeD aRouSal: heightened watchfulness,increased startle reflex, irritability,explosive anger, difficulties

sleeping and concentrating.Other symptoms linked with PTSDinclude: panic attacks, depression,suicidal thoughts, substance abuse,and emotional paralysis impeding theperformance of activities of daily life.

39 percent of HurricaneKatrina evacuees

experienced moderate

symptoms of post-traumatic

stress disorder and 24

percent experienced

severe symptoms.

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Agencies that were

responsible for providing

psychological support and

treatment were unprepared

and overwhelmed by the

magnitude of the sudden

need for services.

Human Caused vs. NaturalDisastersReport co-author and forum organizerDr. Lise Van Susteren remarked tothe forum participants that “peoplesuffer more from disasters thatare ‘man made’ than they do fromnatural disasters. The pain caused by

intentional or avoidable acts is muchharder to get over than those causedby events perceived as accidental oruncontrollable.” Most natural disastershave an identifiable low point, afterwhich “the worst is over” and therecovery process can begin. In contrast,a human-caused disaster elicits asense of outrage that encumbers thegrieving process, making recovery moredifficult. Global Warming, though anapparent manifestation of nature, istriggered by the actions of humans. The

knowledge and pain of having “done itto ourselves” will be especially deep andhard to accept for many disaster victims.

Dr. Van Susteren then re-introducedDr. Eth who was present duringand in the aftermath of the attackon the World Trade Center.

Lessons From America’sSearing MomentDr. Eth, of St. Vincent’s Hospitalin Lower Manhattan, reviewedthe mental health lessons from theSeptember 11, 2001 attack on theWorld Trade Center in New York.He describes the attack as a searing

or “flashbulb” moment, forever fixedin the observing public’s mind.

“St. Vincent’s is the closest hospital inlower Manhattan to ground zero.” Ethsaid. “The relative number of peoplekilled (versus injured) in this attackwas proportionately very high. Onhearing that the towers had been struck,the Hospital immediately mobilized,and within the first two hours, a fewhundred patients arrived. But they weretreated mostly for minor injuries. Not

a single surgery was performed and,contrary to expectations, everyone at St.Vincent’s noted that, after the first twohours, the ambulances stopped coming”.

Later that day the traumatized beganto arrive and soon they literallysurrounded the Hospital, causing theemergency rooms to overflow. Theirneeds were emotional rather thanphysical. Some of them were lookingfor loved ones. Some were undone by

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Ecosystems are already

showing negative impacts

under current levels of

climate change … which

is modest compared to

future projected changes….

In addition to warming

temperatures, more frequent

extreme weather events and

changing patterns of rainfall

and drought can be expected

to have significant impacts

on biodiversity. Secretariat

of the Convention onBiological Diversity

(2010), Global Biodiversity

Outlook 3, May, 2010

terrible events they had seen. Manyhad been in the zone of danger andwere reacting. St. Vincent’s neededto borrow extra treatment space fromthe nearby New School to handle thelarge numbers. Seven thousand peopledisplayed acute emotional reactionsin that initial time period. Agenciesthat were responsible for providing

psychological support and treatmentwere unprepared and overwhelmedby the magnitude of the sudden needfor services. Dr. Eth noted “Evenin a highly sophisticated city suchas New York, it took weeks and,for some interventions, even months to assemble and mobilize the rightpsychological treatment resources.”

Not surprisingly the closer people wereto the site of the disaster the more likelythey were to suffer acute symptoms.

But the suffering was not limited tothose in close physical proximity, manypeople felt close to it emotionally, andsuffered the psychological falloutaccordingly. Additionally, althoughthe 9-11 attack occurred in lowerManhattan, the people who were killedor injured lived throughout the metroarea. Whether from the pain of theirloss or suffering or the trauma of theincident generally, finding the peoplemost in need of help and treating themwas difficult. They were spread outover a large geographic area. Dr. Ethalso described the “toxic” effect of thecontinuous graphic coverage of theattack, explaining that this made theexperience worse for those directlyaffected as well as for those whowere witnessing it from a distance.

Though the initial reactions of fearand anxiety were normal, Eth saidthat many who were unable to workthrough their feelings would goon to develop PTSD. For a health

care system called upon to addresswhat will be a growing number oflarge-scale disasters, this has seriousimplications. Dr Eth concluded hiscomments by emphasizing that the

9-11 first-responders were themselvesdeeply affected by what they hadexperienced, and did not alwaysfully consider their own emotionalstruggles with the horror and panicthey experienced. He pointed outthe potential to overlook more subtletraumatizing effects, such as in childrenattending a school that faces the site.

Heat Waves andMental HealthMany Americans may not recall orhave paid attention to the reality thatsome 70,000 people died during theheat wave in Europe in 2003. This wasthe largest heat-related death toll onrecord. During an average summer inthe U.S., 400 people will die from heatrelated causes (Ho, 2004). During therecord breaking heat of the summerof 2010, that number was even higher,particularly in the normally coolerEast and Midwest where people wereless acclimated to hot temperatures.

The IPCC, in its 2007 report, predictedthat average temperatures in the U.S.will increase 4 to 5 degrees Fahrenheitwithin the next century. We are alreadya degree or two hotter than in the lastcentury. Importantly, this increase intemperatures will occur even if we wereable to get immediate control of globalgreenhouse gas emissions. While one tofive degrees Fahrenheit may not seemto be a huge change from where we aretoday, in many areas of the nation itwill bring a significant increase in the

number of days above 90 to 100 degrees.Areas that are generally cooler today(Chicago is an example) will be hithardest since they are not currentlybraced to fight the heat the waytraditionally warmer locations are.When Chicago had an extraordinaryheat wave in the 1990s, 700 people,mostly residing in places withoutair conditioning, died. Many of theChicago-area people who were most

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S A G W i e s b a d e n P u b l i c A f f a i r s )

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Climate change is already

having an impact on

biodiversity, and is projectedto become a progressively

more significant threat in

the coming decades. Loss

of Arctic sea ice threatens

biodiversity across an entire

biome and beyond. The

related pressure of ocean

acidification, resulting

from higher concentrations

of carbon dioxide in

the atmosphere, is also

already being observed.

affected were the elderly or poor. Theydid not have the money or sufficientopportunity to find cooler, life savingenvironments. For many peoplearound the world, air conditioning

is a luxury they cannot begin to orimagine affording. In “The LongHot Summer”, his article on the 2003European heat wave, Norman Ho wote:“heat waves are a horrific phenomenon,killing thousands around the worldannually, more than any othermeteorological catastrophe.” (Ho, 2004)

U.S. public health services consistentlyreport that hot summer temperaturesand prolonged heat waves haveunhealthy effects on people’s mentalstatus. A link has been shown

between heat and different types ofhuman behavior, especially aggression,with an increase in the number ofmurders, assaults, and domesticviolence incidents when the weatheris hot (Rotton & Cohn, 2004; Cohn &Rotton, 2005; Anderson, 1987). Studiedsince the early 1970s, the connectionbetween temperature and aggressionwas initially disputed. Now it is nolonger a question of if , but rather aquestion of how strong the link is.

Other studies report a connectionbetween higher temperature andsuicide. (Deisenhammer et al, 2003).This association appears to be strongerfor violent suicides than for non-violentsuicides (e.g., Maes et al, 1994).

People who have pre-existing mentaldisorders are especially vulnerableto the effects of heat waves. Duringthese hotter periods, they appearto get sicker than expected, showgreater dangerousness towards othersand require more frequent use of

restraints (Severity of PsychiatricIllness (SPI) Scale for Dangerousnessand Bulbena, et al., 2006).

Economic Disruption andMental DistressMany sectors of the U.S. economy areparticularly vulnerable to a changingclimate. American agriculture, theseafood and forest products industriesor tourism-related enterprises such asrecreational beaches and ski resorts areexamples. Some of the effects on theseindustries are being felt now and somewill emerge more as the years pass.The BP oil spill in the Gulf of Mexicoin 2010 is, by analogy, instructive.Though a man-made disaster, the oilspill demonstrated how certain types oflarge scale events can upset the balance

of nature in key natural resourceareas and cause the loss of jobs, thedisplacement of people and economicdisruption costing billions of dollars.

For an illustration of how globalwarming is likely to affect identifiedregions of the U.S., we can draw uponthe impacts of the multi year droughtthat has been plaguing Australia (Fritzeet al, 2008). The report states: “Theinteraction of climate related economicimpacts and mental health is already

being felt in drought affected ruralAustralia. Reduced income security dueto ongoing drought has contributed toa number of social impacts includingstress, social isolation, strains onrelationships, and evidence of increasedrates of suicides. Farm families areemploying a number of economiccoping strategies, such as seekingwork outside the agricultural sectorand reducing household expenditures.However, without adequate support,

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these strategies, in themselves, mayhave mental health impacts. Reducingparticipation in ‘optional’ activitiessuch as social events can contribute toisolation, while increased workloads

and separation of families to accessemployment opportunities createsadditional emotional stress. Inadequateservice and policy responses to supportcommunities economically affected byclimate change and necessary economicrestructuring are likely to increase thenegative impacts on well-being at bothan individual and community level.”

Feelings about the Loss ofNature and Species:The United Nations EnvironmentProgram (UNEP) and organizationssuch as the World Wildlife Fundhave looked at how global warmingcould affect the survival of globalspecies and estimate that as many asone third could go extinct. It wouldinclude millions of plant and animalspecies. The loss of this diversity andthe disappearance of species forever is amatter of concern to many Americans.

global warming could

affect the survival of global

species and estimate

that as many as one

third could go extinct.

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CHAPTER THREE:

Affect of Global Warming onVulnerable Populations

The American PsychologicalAssociation points out in itsclimate-related emergencyresponse guidelines that

“there is greater understandingthat the effects of climate changewill be disproportionately felt byalready vulnerable communities,including people with low incomes

and communities directly dependenton their local environment forsurvival.” Other segments ofAmerican society will experiencedisproportionate adverse effects as well.

People with Pre-existingMental Health NeedsResearch consistently shows that peoplewho have pre-existing mental healthproblems (from 5 percent to 15 percentof the population) are more dramaticallyaffected by traumatic weather events.An uptick in the incidence of psychosis,suicides, and other mental disordersis common during such times.

Brief reactive psychoses are oftenseen in the face of natural disasters.(See, for example, WebMed’sSchizophrenia Guide for a review

of the subject.) (http://www.webmd.com/schizophrenia/guide/mental-health-brief-psychotic-disorder)

Low-income PeopleAccording to the U.S. Census Bureau,about 12 percent of U.S. residents (36million people) live below the povertyline. This segment of the populationhas less capacity to adapt to the trials

Research consistently

shows that people

who have pre-existing

mental health problems

(from 5 to 15 percent of

the population) are more

dramatically affected by

traumatic weather events.

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that climate change presents: theyare less able to get out of the way ofnatural disasters and are more exposedto harmful environmental conditionssuch as heat waves and poor air

quality. Many poor people in the U.Sare employed in climate-dependentsectors, such as agriculture, or theylive in crowded, hot urban areas orflood zones or other hazardous areas.

Again, Hurricane Katrina surelydemonstrated how the natural hazardof an intense coastal storm, for example,can have a disproportionate effect onpoor people who are unable to evacuatein an emergency. At the time, morewell off people wondered why otherresidents did not leave when they

were told to evacuate. Society seemsto fail to grasp the degree to whichsuch people are vulnerable and canbe quickly “cornered” by a disasterthat puts them in harm’s way. Foryears experts had warned that the“big one” could drown New Orleansunless the levees were upgraded.

The ElderlyNearly 50 million Americans areover 60 years of age. As people getolder, their capacity to withstandenvironmental pressures declines.

Higher rates of untreated depressionand physical ailments contribute totheir overall vulnerability, adding tothe challenge of responding to climatechange. As noted above, the majorityof the 70,000 deaths that occurred asa result of the European heat waveof 2003 were among the elderly.(Robine et al, 2008) In the U.S. it isno different: a disproportionately highnumber of fatalities from urban heatwaves occurs among the elderly.

ChildrenThere are 70 million children in theUnited States. They will certainly beaffected when the consequences oftoday’s energy choices come “home

to roost” in their lifetimes. Theexperience in drought-hammeredAustralia provides a glimpse ofthis: In a 2007 survey of Australianchildren, researchers Tucci, Mitchelland Goddard found that “a quarterare so troubled about the state of theworld that they honestly believe itwill come to an end before they getolder” (Tucci, et al. 2007). Childrenare also more emotionally vulnerableto increased family violence,natural disasters and other dramaticmanifestations of climate change.

Some of the stresses can be quite acute.Rising air pollution is an example. Awarming planet will present humanswith significant challenges to theirrespiratory systems. These will bestressful to all of us. But childrenwill be particularly affected (Shea,2007). There are few traumas as greatas a child having a life threateningrespiratory attack. The child andeveryone in the vicinity are profoundlyaffected. Children are especially

vulnerable to both short-term illnessand long-term damage to their lungsfrom air pollution. They breathe ata faster rate than adults, and somespend more time outdoors engaging invigorous physical activity. Additionally,the developing lungs of childrenare more sensitive to irritation. Airpollution (such as ozone and particulatematter) causing respiratory illnesses andasthma are already an enormous burden

Asthma among pre-school

children is already at

epidemic levels, having

more than twice the growth

rate (75 percent) of the

overall U.S. population.

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For some professionals

global warming amountsto a daily confrontation

with a deadly and

devastating existential

threat. The emotional toll

can be overwhelming.

to our health care system and resultin many more emergency room visits,hospitalizations, absences from schooland work for parents. Air pollutantscan cause a life-long reduction in lungfunction. Children who are active inoutdoor sports in communities withchronic high levels of ozone are atincreased risk of developing asthma.

Shea and others at the AmericanAcademy of Pediatrics have compiled

research that shows a relationshipbetween global warming, hotterweather and children’s health. Thestudies show an increase in a numberof respiratory illnesses, including

asthma. Higher temperatures favorthe formation of ozone, the majorcomponent of smog. Ozone is toxic tolungs and bronchial tubes. Exposurecan cause inflammation, infection

and decreased lung development.According to warnings issued byHarvard researchers and the AmericanPublic Health Association (APHA),millions of poor and minority childrenin America’s cities will suffer evenhigher rates of asthma and otherrespiratory illnesses as discussedabove. Asthma among pre-schoolchildren is already at epidemic levels,having more than twice the growthrate (75 percent) of the overall U.S.population. And, the Centers for

Disease Control, reports that nearlyone in five of all pediatric emergencyroom visits is asthma-related. Thisis an increase of approximately 45percent in the past decade. While thesenumbers are not wholly attributableto climate change, some are.

The 1970 Clean Air Act (CAA)developed six criteria to define airpollutants (CAPs). Amendmentsto the CAA in 1990 identified 188hazardous air pollutants and set

standards to protect human healthand the environment. With warmingtemperatures, many of these pollutantsincrease, resulting in an increasedincidence of allergy and asthma.

Carbon dioxide wasrecently determined tobe a pollutant under theClean Air Act. Thisdesignation will help thegovernment to monitorand control CO2 pollutionlevels that contribute torespiratory illnesses.

Smoke from wildfiresis also likely to increasein the face of globalwarming. Highertemperatures, increasedevaporation and newweather patterns arecausing larger regions ofdrought, drying out forestsand greatly raising the riskof fire. Smoke typically

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contains a mix of respiratory irritantsincluding: carbon monoxide, carbondioxide, nitrous oxide, particulatematter, and volatile organic compounds.Epidemiologic studies, many of which

have been conducted in Australia wherethere have been major drought-relatedfires, have shown short-term increasesin hospitalizations for cardiac andrespiratory illnesses resulting from acuteexposure to wildfire smoke, particularlyin the elderly (Johnston et al. 2007).

Anyone who has asthma knows whatit is like to gasp for air. Anyone whohas seen a person fighting for airknows how terrifying this can be.And that doesn’t count the worry inbetween. It is difficult to conceive

of a more elementary battle to fightas a parent than for our children tobreath air that will not harm them.

The “Working Wounded”For some professionals global warmingamounts to a daily confrontation witha deadly and devastating existentialthreat. The emotional toll can beoverwhelming. Forum participantGillian Caldwell, former head of anational campaign to fight global

warming as the Executive Director of 1Sky, has been consistently exposed to theoften alarming climate-related findingsthat surface regularly. She is amongmany of the scientists and professionalsin the environmental and technicalfields who are in actual anguish aboutthe future. She says: “As I startedto immerse myself in the science andearly impacts of global warming, Ibecame increasingly distraught. ButI soldier on, hoping against hope thatI will be so busy in an ambitious new

campaign and so relieved to be tryingto do something about it that I will notbe able to feel the angst or despair.”

Caldwell hopes that an enlightenedpublic and political mobilizing willresult in policies that lower theplanet’s global warming risks, but sheis also deeply distressed at the starkvision of the harm that will come tothe planet and to people if we fail toact in time. Caldwell knows things

most people do not about the risks,and reflects on the possibility of aglobal Katrina remarking that sealevel rise of a meter would displacemore than a 100 million people.

Mike Tidwell, Director of theChesapeake Climate Action Network,shares her fears. “As a byproduct oftheir professional work strugglingwith worries about global warming,many government officials, academics,public interest advocates and scientistsare frustrated and burned out.”

Biologist Camille Parmesan of theUniversity of Texas at Austin hassaid: “I don’t know of a single scientistthat’s not having an emotional reaction

to what is being lost. Some of thesepeople have been studying a particularreef or a particular bird or a particularmammal for 40 to 50 years. And tostart seeing it die off is a very hardthing.” Referring to an ocean reef shehas studied since 2002: “It’s gotten tobe so depressing that I’m not sure I’mgoing to go back to this particular siteagain, because I just know I’m goingto see more and more of it dead, andbleached, and covered with brownalgae.” For the majority of the publicthe unspooling tragedy taking placein our oceans is out of sight and out ofmind, but not for Camille and peoplelike her who are studying and tryingto address the climate problem.

For the majority of thepublic the unspooling

tragedy taking place in our

oceans is out of sight and

out of mind, but not for

scientists who are studying

and trying to address

the climate problem.

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CHAPTER FOUR

Global Warming and theStresses of War

The link between globalwarming and futuremilitary conflicts may not

be immediately apparent,but it is now a major factor in thepolicies and strategies of the U.S.military’s Joint Chiefs. At our forum,Dr. Lise Van Susteren introduced thesobering subject of the relationshipof global climate change to war andnational security, quoting the findingsof the Military Advisory Board thatclimate change is a bigger threat tonational security than terrorism initself. The Military Advisory Boardreport recognizes “that unabated

climate change could bring an increasedfrequency of extreme storms, moredrought and flooding, rising sealevels, and the rapid spread of disease.These projected effects are more thanenvironmental challenges, the military

sees them as security risks brought onby “massive human evacuations andmigrations, increased border tensions,

greater demands for rescue andevacuation efforts, and conflicts overessential resources, including food andwater.” Many of these conflicts couldlead to direct U.S. military involvement.

Forum participant William Beckeradded that military leaders believethe U.S. military must do its partto help the nation shift away fromfossil fuels but national security isnot solely the responsibility of ourmilitary. Civilians must do their

part in this time of need. “Pursuingand promoting wise energy choicesshould be the primary goal of theauthentic American patriot,” he said.

Climate Change LiteracyWill Mean Not Fighting the“Last War”Lt. General Dan Christman (Ret.),Vice-President for International Affairsfor the U.S. Chamber of Commerce,spoke to the forum participants aboutsteps the military has already taken

to address Global Warming. Hereminded the group that the militarycontinually strives to operate on up-to-date assumptions and not engagedin “fighting the last war.” Severalexamples showed what a challengethis has been in the face of changingtechnologies and world ideologiesand conditions. He sees addressingglobal warming as a critical meansand opportunity to avoid fightingthe “last war.” By this he means

As the U.S. military looks

ahead to the likely causes

of war in the next 30

years... global warming

is front and center.

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acknowledging how global warminghas risen to the top of conflict causesin recent years and suitable responsesto these climate-driven conflicts willnot be found in past experience.

“As the U.S. military looks ahead tothe likely causes of war in the next30 years,” Christman noted, “globalwarming is front and center.” In theview of the Army and other branchesof the armed forces, climate changewill be the number one underlyingreason that the U.S. goes to war.Scarce resources exacerbated by globalwarming will be the major reason thatconflicts arise in the world. “Fragilestates will become failed states”according to Christman. Both the Iraq

and Afghanistan wars are examples ofstates that, destabilized, have becomeseedbeds of terrorism. From now onwe will need to keep an eye out forthose places becoming destabilized byclimate change. The devastating 2011drought in Somalia is a recent example.

“Since 2006, the leaders of today’s armyhave been working to incorporate adeep understanding of the importanceof climate change into its proactiveand defensive strategies.” Christman

said. He specifically pointed out howservice-wide doctrinal manuals haveredefined stability operations to takeclimate change into consideration.When it comes to global warming, therisks are immense and disasters suchas Hurricane Katrina are modest incomparison to what could lie aheadfor many nations. The destabilizingeffect these disasters would have onnations is indisputable. The U.S.military, Christman warns, “mustlearn how to prepare for and respondto the human suffering that will

be on a scale not seen before.”

Christman presented evidence ofthe military’s concern about globalclimate change, beginning with thenew Unified Command Plan thatcovers how the military is organizedgeographically. Recognizing howglobal warming will be the drivingforce behind the destabilization ofnations, the U.S. military has realignedits strategic regions to coincide with

those of the State Department. Becausepreventive measures and economic andenvironmental factors will be criticalto avoid conflict, the U.S. militaryrecognized that a military responsealone will not achieve lasting security.

Army manuals 3-27 and 3-07 addressmilitary operations around thissubject. They include guidance onhow to insure that young officersunderstand global climate changethrough the lens of stability, and

follow guidance on the propertraining, equipping and planningof military operations and services.(Department of the Army, 2008)

To Illustrate, Army Manual 3-07states: “Peace becomes sustainablewhen the sources of conflict havebeen reduced to such an extent thatthey can be largely managed bydeveloping host-nation institutions.This facilitates the subsequent reductionof external actors to levels that fosterthe development effort with minimal

outside presence.” The main threatsto world security and U.S. security willcome from countries that are fragileand become destabilized. The instabilityleaves a country open to takeoverby external, even criminal forces.

The doctrinal manual usesthe following definitions:

The U.S. military, Christman

warns, “must learn

how to prepare for and

respond to the human

suffering that will be on a

scale not seen before.

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A fragile state is a nation that suffersfrom institutional weaknesses seriousenough to threaten the stability of thecentral government. These weaknessesarise from several root causes, including

ineffective governance, criminalizationof the state, economic failure, externalaggression, and internal strife due todisenfranchisement of large sections ofthe population. Fragile states frequentlyfail to achieve any momentum towarddevelopment. They can generatetremendous human suffering, createregional security challenges, andcollapse into wide, ungoverned areasthat can become safe havens forterrorists and criminal organizations.

A crisis state is a nation in which

the central government does notexert effective control over its ownterritory. It is unable or unwillingto provide security and essentialservices for significant portions of thepopulation. In crisis states, the centralgovernment may be weak, nonexistent,or simply unable or unwilling toprovide security or basic services. Thisincludes states that are failing or havefailed altogether and where violentconflict is a reality or a great risk.

States on the brink of economicand political collapse can becomedestabilized by a number of climate-related factors including: cropfailures, water shortages, diseaseoutbreaks, natural disasters, andlong term droughts. Many of theseconditions will be caused by or

made worse by global warming.One example of the destabilizing forceof climate change is the diminishingsnow pack in the Himalayas. Eachspring warmer temperatures partiallymelt the ice and snow on the “rooftop of the world.” Scientists arefinding increasing water flow tohundreds of rivers that supply onebillion people downstream in theshort run causing flood damage andmisery but this ice mass is expected toshrink dramatically by the end of the

century and cause water shortages.

Forum participant Sherri Goodman,JD, is a former Deputy Under Secretaryof Defense for Environmental Security.Because it underlies many of the majornational security issues we face today,Goodman emphasizes that globalwarming is a “threat multiplier.” Shequotes retired head of the SenateArmed Forces Committee, SenatorJohn Warner, who stated that after hismany years in working with military

strategy, he considers climate changeas important in today’s security andintelligence environment as nuclearweapons were during the ColdWar. During a time when Policyleaders often become paralyzed by theslightest gap in scientific information,Goodman praised our military leaderswho did not “wait” for 100 percentcertainty to decide that the UnifiedCommand Plan realignments shouldbe made. Goodman notes the new

The most profound danger to

world peace in the coming

years will stem not from

the irrational acts of states

or individuals but from

the legitimate demands of

the world’s dispossessed.

Of these poor and

disenfranchised, the majority

live a marginal existence in

equatorial climates. Globalwarming, not of their making

but originating with the

wealthy few, will affect their

fragile ecologies most. Their

situation will be desperate

and manifestly unjust.”

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official “big four” determining USstrategy: proliferation, terror, energy,and now, global climate change.

In fitting emphasis to Goodman’spoint, in January of 2010, the CentralIntelligence Agency establisheda new CIA Center for ClimateChange and National Security tolook at how droughts, rising seas,mass migrations, and competitionfor resources will affect the nation’smilitary and economic priorities.

In December 2001, even in theimmediate aftermath of the WorldTrade Center and Pentagon disasters,100 Nobel Laureates declared ina public statement: “The most

profound danger to world peacein the coming years will stem notfrom the irrational acts of states orindividuals but from the legitimatedemands of the world’s dispossessed.Of these poor and disenfranchised, themajority live a marginal existence inequatorial climates. Global warming,not of their making but originatingwith the wealthy few, will affecttheir fragile ecologies most. Theirsituation will be desperate andmanifestly unjust.” (Science, 2001)

Goodman cited the NationalIntelligence Assessment on ClimateChange and the report of NationalIntelligence Council under AdmiralDennis Blair as additional examples ofhow the impacts of climate change havebeen incorporated into military strategy,planning and operations. In testimonybefore the US Senate in 2009, AdmiralBlair warned of the need to addressthe dangers posed by energy issuesand global warming. Other examplesof the military’s concern can be found

in the National Defense Strategy andthe Quadrennial Defense Review.

Forum participant Peter Bournestressed the significance of the U.S.military’s verification of the threatof global warming. While someAmericans might perceive the idea offighting global warming as reflectinga political agenda, a “lefty” one atthat, the alignment of the Joint Chiefsand the military in their assessment

of the dangers presented by climatechange and their efforts to preparefor the consequences should dispelthis notion with force. Their workshould be understood for what it is:

a practical response to the reality andscience of global climate change.

The U.S. Mental Health Tollof War and ConflictThe psychological toll from war andconflicts is profoundly heavy. Forumparticipant Dan Christman statedthat “the U.S. military knows thatboth acute and chronic psychologicalstress has hurt soldiers and familiesdeeply.” As climate change ravages theplanet, destabilizing fragile nations andcausing chaotic conditions elsewhere,more battles and more strife will beunleashed. The U.S. needs betterpreventative measures and more fundsfor treatment of military personnel.Addressing sound policies to reverseglobal warming and to reducegreenhouse gas emissions would get

According to the Army,

roughly 20 out of

100,000 soldiers have

killed themselves.

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at the underlying problem. Absentrecognition of climate realities, expertswonder if the U.S. military will beable to continue to function with anall volunteer army if more frequent,

climate-driven, conflicts were to occur.Wars have profound psychologicaleffects on service members, their familesand friends. At a congressional hearingby the House Committee on Oversightand Government Reform (May 2007),it was concluded that: “hundreds ofthousands of military personnel willlikely need mental health screeningand/or treatment. Experts report thata sizable percentage of the 1.5 millionsoldiers that have been deployed to Iraqor Afghanistan either have returned or

will return from battle suffering frommental health difficulties. U.S. Armysurveys from 2004 indicate that 20percent of returning soldiers sufferedfrom clinical anxiety, depression, orpost-traumatic stress disorder. Morerecent assessments have found that halfof National Guard troops returningfrom battle report mental healthconcerns. The problems are madeworse because of a shortage of troops;an increasing number of soldiersare serving second and even third

deployments in Iraq and Afghanistan,and deployment times are increasingto as long as fifteen months.” DanChristman told forum participants thatthe U.S. Army is working to increasethe overall size of the recruiting pool

Health professionals whohave worked with war

veterans know that war

produces mental health

injuries as debilitating

as wounds from bullets

or explosions.

so there are more ground troops andtherefore fewer and shorter terms ofcombat duty to try to relieve the stresson military personnel and their families.

At the May 2007 oversight hearing itwas likewise reported that the numberof combat deployments: “dramaticallyincreases the risk that soldiers will comehome with mental health problems.”One of the witnesses at the hearing, Dr.John Fairbank, testified that “multipletours and extended tours increasethe probability of developing adversepsychological reactions.” The HouseVeterans’ Health Care OversightCommittee heard the testimony ofone soldier, Army Specialist ThomasSmith, who was diagnosed with

PTSD but was ordered to returnto Iraq. Independent experts haveidentified numerous problems withtreatment of mental health conditionsby the Department of Defense andthe Veterans Administration, withthe Department of Defense MentalHealth Task Force concluding that “themilitary system does not have enoughresources or fully trained people tofulfill its broad mission of supportingpsychological health in peacetime andfulfill the greater requirements during

times of conflict.” Army SpecialistsMichael Bloodworth and ThomasSmith described another key barrierto adequate psychological care forailing soldiers: the stigma admittingthe need for mental health supportprevents many soldiers from seekinghelp. (House of Representatives, 2007)

Suicide Rates: MoreDangerous to OurselvesThen the Enemy

A 2010 report by the Army on HealthPromotion, Risk Reduction, and SuicidePrevention found that suicide ratesamong active duty soldiers were attheir highest rate since records beganto be kept in 1980. While the civilianrate remained relatively stable between2001 and 2007, both the Army andMarine Corps rates have increasedsteadily. The report’s presenter, U.S.Army General Peter Chiarelli, saidhe “believed, but could not prove ©

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Army Suicides Rise As Wars ContinueBoth the number and rate of U.S. Army soldiers committing suicide have risen steadily over the lastfive years, despite attempts at prevention.

Levin A. Combat just one cause of Army suicide. Psychiatr News. 2009 SMAR 44(5)4. Accesed 06Mar2009

Source: U.S. Army

statistically, that the overall Armysuicide rate had been driven up by the21 percent of suicides committed bysoldiers with multiple deployments.”

The report also said that if the Army

included accidental deaths, which itsaid are often the result of high-riskbehavior involving drinking anddrugs, “fewer young men and womendie in combat than die by their ownactions.” It concluded: “We are oftenmore dangerous to ourselves thanthe enemy.” According to the Army,roughly 20 out of 100,000 soldiers havekilled themselves (U.S. Army, 2010).

The suicide rate among Americans as awhole is about 8.9 per 100,000, but thelevel among veterans has been at least18.7. That gure rose to a minimumof 22.9 per 100,000 among veteransaged 20 to 24, almost 2.5 times thenonveteran average for people of thesame age. The psychological sufferingamong returning soldiers not only hurtsthem, their families, and communities,but it drives up the scramble foralready scarce health care dollars.

Dr. Thomas Insel, Director of theNational Institute of Mental Health,described the “ripple effect of mental

illnesses on family members,” notingthat “this is not simply a problemfor the Veterans Administration orthe Department of Defense. Theburden of illness will spill over fromthe public sector to mental healthcare in the civilian sector.” (U.S.House of Representatives, 2007)

Health professionals who haveworked with war veterans knowthat war produces mental healthinjuries as debilitating as woundsfrom bullets or explosions. Troopswith mental health problems fromwars often feel traumatized in waysthey themselves cannot fully express.

National Guard members’ familiesexperience the same stressors as activeduty families before, during, and afterdeployment, although they do nothave anywhere near the same level ofsupport. Many Guard members andtheir families report being shunned bythe active duty mental health system.

Army National Guard Specialist and

Iraq War veteran Brandon Jones saidthat when he and his wife soughtpost-deployment counseling, they were“made to feel we were taking up aresource meant for active duty soldiersfrom the base.” In addition to regularservice members, a large percentageof military personnel come from theNational Guard. These familiestypically experience a significantdrop in household income whentheir loved ones are deployed. Thisfinancial pressure is an added stressor.

0

30

60

90

120

150

Nonactive DutyActive Duty

200820072006200520042003

N U M B E R

O F S U I C I D E S

YEAR

79

16 15

29 33

61

43

67

87

102

115

128

© n a t i o n a l g u a r d . m i l





CHAPTER FIVE:

Nationwide Anxiety or Hope?

In the introduction to this report,

the authors said they initiatedthe inquiry into the psychologicalaspects of global climate change by

wondering if, in the face of increasingmedia coverage and public awareness,Americans would become generallymore anxious about it and what effectthat would have on the provisionof mental health care in the U.S.

Forum participant Dr. Jerilyn Ross,then head of the Anxiety DisordersAssociation of America, asked thegroup for their views on “how manypeople in the public are thinking muchabout global warming and how top-of-mind is the climate change threat tomost people”? Dr. Ross’s organizationstudies, treats and educates peopleabout anxiety and related disorders.At the time of the forum she said thatconcerns about global warming are notbeing reported (2009) although thatdoes not mean that individuals are not“getting the message” on some level.

Roughly 40 million Americans suffer

from anxiety disorders. They cost ourhealth care system about $42 billionper year in direct expenses and lostproductivity. According to findingspublished in the May, 2008 AmericanJournal of Psychiatry, serious mentalillnesses, which afflict about 6 percentof American adults, cost our society$193.2 billion in lost earnings per year.Dr. Thomas Inse, Director of theNational Institute of Mental Health,in 2008 stated that the national burden

of mental health care and problems

in America is in excess of $317 billionper year. That averages to about $1,000per person per year (Insel, 2008).

Dr. Ross also stated that, in herexperience, global warming is not atop issue of concern for most people.Research bears this out. Though peoplemay be aware that global warming ishappening, they do not see its violentand disastrous implications and saythey feel it will not affect them much.

Seriously Concernedbut not ScaredRoss pointed out that fear can motivatepeople to take action against globalwarming, but that too much fear can beparalyzing. Striking the right balancewith messages about the dangersof climate changes requires skillfulbalance. Our levels of sensitivity varyso what alarms and energizes someto take action may shut others down.Apathy arising from too many reportsabout consequences and too little

emphasis on solutions breeds a feelingof powerlessness. This can cause peopleto distance themselves from the subject.

Forum participant Dr. EdwardMaibach confirms this in his research.“People are aware,” he says, “but theyare largely indifferent.” His team’s2009 public survey found that while 17percent of people in the U.S. expresssome worry about global warming butmost people do not. When asked, “how

Apathy arising fromtoo many reports about

consequences and too

little emphasis on solutions

breeds a feeling of

powerlessness. This can

cause people to distance

themselves from the subject.




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much they thought global warmingwould hurt them personally,” just 10percent thought that it would. Hisresearch also shows that more peoplesee global warming as having adverse

effects on plants and non-human speciesbut that “even if something bad ishappening to the environment, it willnot necessarily happen to people.” Inhis words, people see this “as aboutpenguins and polar bears and notabout them or their loved ones.” Thisreinforces the commonly held notionthat humans somehow stand outsidethe biosphere looking in rather thandepending on it for their very existence.

Maibach’s and his colleagues’ researchalso shows this is not so much about

active denial of the problem. Thesurveys find fewer “denialists” aroundtoday than in previous years. (The termdenialist refers to people who activelydisbelieve the existence of globalwarming or that it is human-caused.)But, these days, Maibach believes thatpeople are just not connecting to theissue. Fully 80 percent of Americanssay that global warming will affectthem either “a little, or not at all.” Just5 percent, or one-in-20, feel that theywill be affected by global warming

“very often.” (Leiserowitz, 2009)

A small percentage of Americansdefinitely worries about the largerthreat of global warming and thecontinuing news that the earth isoverheating, oceans are threatened,prolonged droughts are predictedand people will be driven fromtheir homes in search of refuge.

Global Warming’s Cold WarParallels

Forum panelist Dr. Eric Chivian drewcomparisons between the threat ofglobal climate change and the threatof global nuclear war. In the 1980’s heco-founded International Physiciansfor the Prevention of Nuclear War.It received the Nobel Peace Prize in1985 for making the threat of a nuclearholocaust more understandable andvivid to the public. He says this wasaccomplished “by helping peoplegrasp what a nuclear war would really

be like and by translating technicallanguage and abstractions into realterms so people could develop a visionof what “nuclear winter” would mean.

Dr. Chivian stated that the destructivepotential of global warming is, inmany ways, “greater than what wefaced with nuclear war.” Public healthexperts must focus on this reality andrespond to it. But it is more difficultto draw their attention to a threat thatis harder to see and comparativelyslower-moving. Global warming,says Chivian, does “not yet have aHiroshima or Nagasaki to serve as amodel.” Unlike nuclear war, however,where individuals have no influenceover what happens, people can takeaction individually and collectively tostop or reduce the carbon emissionsthat are causing global warming.

Most Americans aged 50 or olderremember the palpable threat ofnuclear war. That is especially truefor those who remember the 1950sand 1960s when it appeared imminent.Children then were shown films ofnuclear explosions and their effects.Drills were held in school to practiceputting their heads down and undertheir desks during mock air raids.Homes had their own bomb sheltersand food and medical supplies were

Dr. Chivian stated that the

destructive potential of

global warming is, in many

ways, “greater than what we

faced with nuclear war.”

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n M e d o m M a d s e n / S h u t t e r s t o c k . c o m





stored in public buildings. Dr. Chivianand others studied children in theUnited States and the former SovietUnion and found that nearly onehalf of children thought that nuclear

war would directly affect their livesand reacted with despair and loss ofmotivation. Many believed the worldwould soon end. (Chivian et al., 1985)

Communication:Dreams and NightmaresDiscussing the question about the bestway to “awaken” people, to the threat ofglobal warming, the forum participantsreviewed public education strategiesthat focus on dangers as opposed tothose that emphasize solutions.

Forum participant Andrew Lightadvocated for communicating positiveoutcomes or what he described as an“I have a dream” framework versus “Ihave a nightmare.” He referred to a2005 examination of the disadvantagesof using fear-based approaches ina paper provocatively titled, “TheDeath of Environmentalism” by TedNordhaus and Michael Shellenberger.The paper recommends presenting apositive vision of the future rather than

attempting to motivate the public totake environmental action motivatedby fear(Shellenberger, 2005). The fear-oriented approach emerges from thebelief that warnings about pending

catastrophes would shock people intotaking action. This approach worksfor some people but not others.

The mental health professions havemuch to contribute to this discussion.Forum participant Victor Balabanfrom the Centers for Disease Controlunderscored the role of research inidentifying the factors most effectivein persuading people to take action.Research could show what kindof public education would be mosteffective at persuading people to changeto behaviors that lower their carbonfootprint. The national campaignsto stop smoking and to use seat beltsare two examples of efforts thattook advantage of the psychology of

messaging to accomplish their goals.

Maibach noted other public educationcampaigns that have been successful:HIV prevention, teen drug use, controlof high blood pressure, sun safety,birth control, immunizations, infantsurvival (SIDS, ORT) and others. But,Maibach also said that most publiceducation programs are only mildlysuccessful. The work of Dr. JohnKrosnick, of Stanford University, hasoffered a framework that might help.

Dr. Krosnick says a publichealth campaign must be,

• Real: scientically supportedand actually happening

a new green economy

would provide opportunities

for struggling Americans

workers and some

stalled or outmoded

enterprises dependent

on older industries and

burning fossil fuels.

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• Caused by humans

• Bad for people

• Solvable: it can be xed or theconsequences mitigated

Maibach recommended focusing onthe “solvable” part of the messagewhich shifts the image from a bleakfuture to that of a better life.

While not a “feel good” message,showing how global warming makespeople sick dispels the notion that itwill be felt “later” and somewhereelse. Also, portraying climatechange victims, in their own voices,sharpens public capacity to identifywith them. Social psychologistsknow that this identification added

with a single, compelling voice, ismore deeply moving than a stackof statistics. Climate fighters havenot taken full advantage of thishuman communications reality.

Coal provides abundant energy andhas a reputation for being inexpensive.But few analysts fully consider thehealth care and environmental costs ofextracting and burning it for power.The late Dr. Paul Epstein and associatesat Harvard Medical School’s Center for

Health and the Global Environmentshow that once the extrinsic costs ofcoal are included, estimates of the actualcost of coal should be doubled or evenmore likely tripled. When the true costof coal is presented, it’s easy to see thatcoal is anything but cheap. Showingwhat alternative forms of energy cando for us, particularly in terms of jobs,in addition to preserving or restoringthe vitality of the environment, andprotecting our health, are messagesthat subscribe to Dr. Krosnick’swork and could help shape thinkinginto lasting behavior change.

Psychology of a Vision of aPositive FutureForum participant Dr. Douglas LaBierindicated that the psychological healthcommunity could help to define

a promising and healthy future.Patrice Simms added that people mayembrace something conceptually butstop short of changing because of fearof change itself. Forum participantDr. Steven Moffic described thisas relating to the “anxiety of loss.”William Becker felt that a focus onthe “new energy economy” mightresonate with the public as a messageof hope especially during toughfinancial times. “Green jobs and agreen economy would be a usefulway to frame the issue.” Kevin Coyleof the National Wildlife Federationand report co-author discussed howa new green economy would provideopportunities for struggling Americansworkers and some stalled or outmodedenterprises dependent on olderindustries and burning fossil fuels.

Timothy Warman, also of theNational Wildlife Federation,suggested that the mental healthcommunity could help explain howa physical healing model could be

used to promote healing the planet.

one potential challenge

is that the psychology ofhappiness, with its focus on

self, can be highly motivating

to individuals but it is often

at odds with a broader

support of the common good,

such as making the world

better for our children.

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The Motivation in Making ABetter World for the KidsAndrew Light said public educationcampaigns should look at the largebody of research that reviews how

motivating it is for people to be calledupon to protect children. A numberof public interest causes have exploredthe types of personal concerns that willmotivate people to act to address globalclimate change in their personal lives.Light pointed out that many peoplewill not take steps to make things betterfor themselves personally but they willbecome highly motivated and active ifthey feel they are making better worldfor their children and are meeting theirobligations to future generations.

Light described this as a “moralmotivator” that may have particulareffectiveness in addressing globalwarming. He believes that “ourchildren’s long-term mental healthwill suffer” if they are exposed topoor climate conditions, catastrophicweather events, and such and that theywill likely look at their parents andgrandparents and ask “why was morenot done to leave a safer and healthierplanet for them to live in”? Lightreminded the group that a “plea for the

kids” could be an important pathwayinto significant societal change.

Serving One’s Self Interest:Positive PsychologyResearch about changing people’sbehaviors shows that many peoplemust feel a benefit to themselves

personally in order to change. Askingpeople to sacrifice for the sake of theplanet may be motivating for somebut it will not work for everyone. Dr.James Bray remarked that trying toget people to diet was an example of apractice that people felt mostly involvedsacrifice, even when they understoodit was good for them overall.

An example of how the mental healthdisciplines can support public educationwas offered by Steven Moffic whosaw the opportunity to draw from the

basic area of study of personal “positivepsychology” which is a part of theoverall modern field of the psychologyof happiness. The message here is that“going green is good for your mentalhealth and for you.” Ed Maibach saidthis is an example of where the researchwould support that idea because 25percent of American adults feel stronglythat their lifestyle would improve bygoing green, and that by a two to onemajority they feel that making greenchanges in their lifestyle will allow

them to live a higher quality of life.

Dr. Moffic pointed out that onepotential challenge is that thepsychology of happiness, with itsfocus on self, can be highly motivatingto individuals but it is often atodds with a broader support of thecommon good, such as making theworld better for our children. Waysto combine these dual goals maybe found. (Seligman et al., 2005)

Americans are walking

away from the public square

because leaders no longerreflect the reality of the

average people’s daily lives

in their words and actions.

FREQUENCY OF VARIOUS GREEN BEHAVIORS“How often do you do each of the following in your daily life?”

Summary of those saying “Always” or “Often”

Base: All adults

2009 2010Total % Total %

Keep unneeded lights off or turn lights off when leaving a room 83 81

Recycle 68 68

Reuse things that I have instead of throwing them awayor buying new items 65 63

Make an effort to use less water 60 57

Unplug electrical appliances when I am not using them 40 39Purchase locally grown produce 39 33

Buy food in bulk 33 32

Purchase locally manufactured products 26 23

Purchase used items rather than new 25 24

Purchase all-natural products 18 16

Purchase organic products 17 15

Compost food and organic waste 17 15

Carpool or take public transportation 16 16

Walk or ride a bike instead of driving or using public transportation 15 15

Note: percentages may not add to 100% due to rounding.

Source: Harris Interactive




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Clarity on the Real Barriersto Behavior ChangeEd Maibach reminded the forumparticipants to “listen to the research.”Those designing public educationprograms that prompt change needto be experts on what thw researchshows are real barriers to taking action.The work of Doug McKenzie-Mohrstresses this. Mohr advocates for“community-based social marketingapproaches” that specifically focuson understanding and reducing thebarriers to desirable behavior. Whiledifferent avenues may theoretically

lead to a desired public benefit, such asreducing a personal carbon footprint,or changing a safety or dietary habit,the path may be fraught with hiddenbarriers. (McKenzie-Mohr, 2002)

One example of subtle barriersis in public education campaignsrecommending the installation ofprogrammable thermostats. Underlyingthese simple and economicallyadvantageous activities are a number

of hidden barriers. These include:fears of using technology (consider

the number or programmable videoplayers in America that have neverbeen programmed), or the fear ofchoosing the wrong apparatus, orthe fear of finding an installer whowill have a fair and reasonable price.People also worry about havingpeople they don’t know come intotheir homes. As a way to overcomethese barriers in Austin Texas, wherea large percentage of homes haveprogrammable thermostats, the utilitycompany there installs them for free.

The discipline of psychology can beused to uncover what the barriersare to reducing our carbon footprintand adopting a green lifestyle.Large and small ticket items shouldbe assessed. Many, according toMcKenzie-Mohr, are specific to theaction being recommended. Hiddensurprises abound and reflect thefull complexity of people’s minds,beliefs, emotions and lifestyles.

The discipline of psychology

can be used to uncover what

the barriers are to reducing

our carbon footprint and

adopting a green lifestyle.

ENVIRONMENTAL ACTIVITIES IN LAST YEAR“Which of the following environmental activities, if any, have you done within the past year?”

Base: All adults

2009 2010Total % Total %

Energy-Efficient Lighting/Appliances (NET) 69 66

Replaced regular light bulbs with more energy-efficient lighting (e.g., CFLs, LEDs) 63 61

Purchased energy-efficient (e.g., Energy Star) appliances 36 30

Paperless Statements/Online Bill Pay (NET) 53 54

Started paying bills online for my personal financial accounts 46 44

Switched to paperless statements for my personal financial accounts 40 41

Donated or recycled a computer, cell phone or other electronic device or its parts 41 32

Switched from bottled water to filtered tap water 29 23

Low-Flow Showerhead/Toilet (NET) 25 20

Installed a low-flow showerhead 17 13

Installed a low-flow toilet 16 13

Patronized/Avoided a Business (NET) 15 15

Patronized a business because of their environmental activities 11 10

Avoided patronizing a business because of their environmental activities(or lack thereof) 9 10

Made home improvements that enabled me to take advantage of a “green”government tax credit (e.g., installed dual-pane windows, solar panels, insulation) 14 13

Hybrid/Fuel-Efficient Car (NET) 13 8

Purchased a more fuel-efficient car that is not a hybrid 11 7

Purchased a hybrid car 2 1

None 13 16

Note: percentages may not add to 100% due to rounding, the acceptance of multiple responses, and theexclusion of “other.”Source: Harris Interactive





Psychology of EmpoweredCivic ActionPsychology can help us understandwhat ignites an environmentalconsciousness and steers it into action.What motivates individuals to maketheir personal life style contributeto what is good for them, futuregenerations, and the planet. Thevarious disciplines can shed light onwhat makes people feel “empowered,”moving them to address public issues,take action at the community leveland advocate for policy reform.

That Americans can “stand up andbe heard” is a broadly held value

in the U.S. But, how often do weactually practice this? What are thebarriers to speaking out on issuesof community concern that couldbe addressed with support fromthe psychological disciplines?

We need people to learn about andsupport positive steps at home andin their communities in order tolower carbon footprints. But researchindicates that people born in the

1930s through the 1940swere the last generationto be truly engaged incivic participation. Sincethen there has beenan overall decline.

In its 2006 report calledBroken Engagement,the National Conferenceon Citizenship used 40different indicators of civicinvolvement to measure how

That Americans can “stand

up and be heard” is a

broadly held value in the

U.S. But, how often do we

actually practice this?

Americans are engaging in communityand civic affairs, including politics.The report included “indicators ofcommunity participation (such asbelonging to groups and attending

meetings); trust of other peopleand major institutions (such as thegovernment and the press); volunteeringand charitable contributions; votingand other political activities; politicalexpression (for instance, makingspeeches and contacting the media);and following and understandingthe news and public affairs.”

These indicators were woven into aCivic Health Index by the Conference.It showed that “Americans’participation had dropped substantially

from the 1970s into the 1990s, andthen recovered somewhat in the 2000s.Overall, there were alarming trends,[of decline] but also a few signs ofhope, particularly in the voting andvolunteering patterns of young people.”

In the book, Civic Responsibility andHigher Education, Thomas Erlich andco-authors Anne Colby, et al, discussthe decline of Civic Engagement inAmerica. They refer to “a growingsense that Americans are not responsible

for or accountable to each other; adecline in civility, mutual respect, andtolerance; and the preeminence of self-interest and individual preference overconcern for the common good. Goals ofpersonal advancement and gratificationdominate our culture, frequently atthe expense of broader social, moral,or spiritual meaning. Though thisemphasis on individual success hassome social benefits, it can also entailhigh social costs by promoting a worldview in which there is no basis forenduring commitment beyond the self.”

In his book, Hope Unraveled, RichardHarwood stated that: “Americans arewalking away from the public squarebecause leaders no longer reflect thereality of the average people’s dailylives in their words and actions. Thisis a retreat that transcends race, class,gender, socioeconomic status, andeven political party. People are angrywith the conduct of their leaders at


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the national and even local level,but feel powerless to do anythingabout it.” (Harwood, 2005.)

Attitudinal Profile: The SixAmericas of Global WarmingIn his team’s work, the “Six Americasof Global Warming,” Ed Maibachshows how social research can tailorpublic education to the characteristics ofspecific groups to motivate them to takeaction. Consideration of motivationaldifferences enhances the effectiveness ofpublic education campaigns. Effectivemessages consider where people “are.”Some have little or no awareness ofthe threat that global climate changepresents, while others are alarmed andwant to know what to do. Audienceresearch in Maibach’s work corroborateswhat the civic engagement researchshows: citizens have almost no trust incommunity leaders and governmentagencies. (Leiserowitz et al, 2009)

Maibach spelled out some of thecharacteristics of the “Six Americas.”

The Alarmed (18 percent) arefully convinced of the reality andseriousness of climate change and are

already taking individual, consumer,and political action to address it.

The Concerned (33 percent) –the largest of the six Americas– are also convinced that globalwarming is happening and aserious problem, but have not yetengaged the issue personally.

Three other Americas – the Cautious(19 percent), the Disengaged (12percent) and the Doubtful (11percent) – represent different stages of

understanding and acceptance of theproblem, and none are actively involved.

The final America – the Dismissive(7 percent) – are very sure it is nothappening and are actively involvedas opponents of a national effort toreduce greenhouse gas emissions.

Maibach also pointed out that 22percent were in the “concerned”category in 2007 but that this categoryincreased to 33 percent by 2009; which

suggests that Americans understandthere is a problem but do not yetknow specifics or what to do

The study also finds that relatively fewAmericans (7 percent) were negativelyengaged, a group denying the threatof climate change and taking steps toprevent public action on the issue.

When looking at trends in civicengagement from a motivational andpsychological stance, research showsthat relatively few people feel that

taking actions on their own will makemuch of a difference in addressingglobal climate change. But whenthe research drills down further andasks how people would feel if theyknew that most people in the U.S.were taking steps to address energyusage and global warming 40 percentwill say they believe their personalactions will matter. And, fully 60percent feel their personal actionswould matter if they knew mostpeople worldwide were taking steps.

75 percent of Americans feel thatmore good than bad will occur ifwe work together on this issue.About a third feel it would makea large positive difference whileanother third feel it would makea medium positive difference.

Most assumptions on the subject ofmotivating behavior change are thatpeople will respond to education andin many circumstances that is, indeed,

22 percent were in the

“concerned” category in2007 but that this category

increased to 33 percent by

2009; which suggests that

Americans understand there

is a problem but do not yet

know specifics or what to do

Dismissive

7%

Doubtful

11%

Disengaged

12%

Cautious

19%

Concerned

33%

Alarmed

18%

Highest Belief in Global Warming

Most Concerned

Most Motivated

Lowest Belief in Global Warming

Least Concerned

Least Motivated

Proportion of the U.S. Adult Population in the Six AmericasProportion represented by area

Source: center for American progress





that often happens. But, there is also a“backwards” approach that has beenevident in some behavior-change effortssuch as stop-smoking campaigns. Inthose instances the development and

passage of new policies, such as smokingbans in public buildings, instigate thebehavior change. Ideally behaviorchange come from positive motivationsbut several of the forum participantsalso noted that even if the public resistsa legislated response to a behavioralproblem, once it is passed, they willoften see its benefits and embrace it.

Individual and CommunityEmpowermentForum participant Steven Shapiro ofJohns Hopkins University’s CommunityPsychiatry Program pointed out thatmany people affected by climate changeare reluctant to stand up and protest inpublic forums. This is especially true ofresidents of lower income communitieswho feel their protests don’t packsufficient “punch” to be worth theeffort. Of course the areas they live inare often the most environmentallyunhealthy and this makes their situationparticularly bad. Helping residentsovercome barriers to effective civic

engagement is a compelling opportunityfor the mental health community.

Shapiro stressed the need to stoke thepublic fervor to protest the disregard forpollutants that damage the environmentand make people sick. Many agenciesand businesses choose to locate pollutingfacilities in lower-income areasbecause they know they will (usually)encounter less opposition. Shapiroworks in impoverished neighborhoodsin Baltimore with people who are

frequently hurt by government andbusiness policies. These populationsneed to be empowered to defendthemselves in the short term rather thanwaiting for larger societal-scale reforms.

Maibach agreed and mentioned thatthe segment identified in his researchas the most “alarmed” about globalwarming, are not nearly as civicallyengaged as the ‘dismissives’, who,though just a third their numbers, are

more vocal and active in public settings- such as town meetings. He saysthe ‘dismissives’ are “very political”:involved with elections, governmentaldecision making, communicating

with the media and more.

The Head of the GlobalWarming SerpentCoal plants are often described asthe “head” of the carbon dioxide orgreenhouse gas emitting “serpent.”They produce electricity by burninghuge amounts of coal and are amajor factor, worldwide, in planetarywarming. Patrice Simms of the NaturalResources Defense Council saysstopping the building and operationof coal-fired power plants in theUnited States is a key to reducingour nationwide carbon emissionsand to lowering toxic pollution.With more than 100 coal plants stillin the planning stage for the U.S.,he stated that much civic activismis needed to fight their being builtand insread to find alternatives.

Shapiro observed that the people wholive in communities with less financialand political clout need professionals

and the mental health care communityto help them voice their outrage.Psychologists for Social Responsibility, agroup he helped organized, has set thisas a goal. Academic research is surelyneeded but waiting for the outcomecan mean harmful delays. Many ofthese issues need to be addressed now.

Seeing a parallel with communityengagement, Dr. LaBier says thatAmerican business culture could beimproved by enlightened workersmobilized to demand a healthierenvironment. Huge opportunitiesexist for U.S. business to presentenvironmentally sound productsthat will steer the consumer tomake ethical purchases.

Many agencies and

business choose to

locate polluting facilitiesin low income areas

because they will usually

encounter less opposition

© l u i g i n i f o s i ’ / S h u t t e r s t o c k . c o m




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CHAPTER SIX:

The High Cost of IgnoringMental Health and ClimateChange

The U.S. Department

of Health and HumanServices (HHS) reportsthat roughly one in four

Americans has a diagnosable mentaldisorder. Six percent suffer fromschizophrenia, bipolar disorder, or someother serious mental illness. The costto the American economy is estimatedat $317 billion per year. According tothe American Psychiatric Association(APA), in a one-year period, about 50million Americans are diagnosed witha mental disorder serious enough tointerfere with their daily functioning.This represents close to 20 percent ofthe population. Nearly one-fourthof elderly people suffer some form ofmental illness and about 20 percent ofthe complaints for which Americansseek medical care are related to anxietydisorders such as: panic attacks,

phobias, or obsessive-compulsive

disorder. A. Langlieb et al. indicatethat 29 percent of Americans will beaffected by an anxiety disorder at sometime in their lives (Langlieb, 2005).

Not all of the costs are direct. TheAmerican Journal of Psychiatryestimates that mental illness results inlost earnings of $193.2 billion per year.

Depression has become one of America’smost costly illnesses. Untreated, it isas costly to the US economy as heartdisease or AIDS and ranks among

the top three workplace problemsfor employee assistance professionals,after only family crisis and stress. TheWorld Health Organization reportsthat one in every 20 Americans will bedepressed in a given year and that bythe year 2020, depression will becomethe second leading cause of disability.

Anxiety and depressive disorderscan be as debilitating as any majorchronic illness” (Langlieb, 2005). Itwas estimated that in 2000, the UnitedStates spent $83.1 billion for costsassociated with depression and $63.1billion in 1998 for costs associatedwith anxiety disorders. According toLanglieb’s review, “such costs includenot only direct health care costs, but also“indirect” costs stemming from suicide,increased medical morbidity, reducedadherence to outpatient treatmentleading to relapse and hospitalization,lost wages caused by missed work, anddecreased workplace productivity.”

Not all of the costs

are direct. The American

Journal of Psychiatry

estimates that mental illness

results in lost earnings of

$193.2 billion per year.

© E r n e s t R . P r i m / S h u t t e r s t o c k . c o m





The Mental Health Cost ofGlobal Climate ChangeIt is beyond the scope of this forumand report to estimate exactly howmuch the effects of climate change in

the United States will add to currentmental health care costs. But as naturaldisasters, heat waves, dislocations, jobshifts and other climate-related changesincrease in frequency and becomemore obviously caused by globalwarming, it is reasonable to assumethat the costs will increase dramtically.

• More people in the United Stateswill be exposed to natural disasterssuch as hurricanes, flooding,wind storms, large-scale wildfires,and more. Incidents such as

these produce very serious andvery persistent mental healthconditions, including briefreactive psychoses and PTSD.

• Droughts: More people in theUnited States will experiencelonger term and more intensedrought which can causeagricultural failures, job loss, andmunicipal water shortages whichin turn can cause a series of stressesand mental health problems.

• Dislocation: will increase throughincreased incidents of coastalflooding, water supply failures insome areas, and sea level rise.

On the positive side, focusing on solvingthe global warming problem in wayslarge and small may itself be a healthyway to lower anxiety over its effects.

Global Warming’s HiddenOpportunity CostsA cost to mental health that is notincluded in most assessments of thetroubles that lie ahead is cited byDr. Eric Chivian. Eric and his teamstudy the capacity of nature to providemedicines that would cure or treat

some of the world’s most intractable,costly, and widespread diseases. Manyof these potential treatments have beenidentified in species that are at riskof extinction. Some, like the gastricbrooding frog that likely held the key tocuring gastric ulcers, are already extinct.With their work on at risk species,scientists see themselves as in a raceagainst time. Repeating often reportedwarnings, Dr. Chivian reminded thegroup that we are, today, in the clutches

Mental health professionals

will need a new focus

and new energy to

help those who will be

hurt most grievously

by global warming.

© n o l a . c o m

Components of the Economic Burdenof Serious Mental Illness, Excluding

Incarceration, Homelessness,Co-morbid Conditions and Early

Mortality (in Billions)

Type of Cost 1992a 2002b

Health Care Expenitures $62.9 $100.1c

Loss of earnings $76.7d $193.2e

Disabilty beneftis(SSI and SSDI) $16.4d $24.3f

Total $156.0 $317.6

a Normal 1992 dollars based on general Consumer PriceIndex data; $1 in 1992=$128 in 2002 (www.bls.gov/cpi).

b Normal 2002 dollarsc Source: Mark etal. (4).d Source: Rice et al. (7).e Source: Kessler et al. (6).f Author’s calculations based on data from the Soical SecurityAdministration (www.ssa.gov/policy/docs/stat-comps).

0 50 100 150 200 250 300 350

FY 2002

FY 1992

Total

Disabilty

Beneftis

(SSI and SSDI)

Loss of

Earnings

Health CareExpenitures




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of a planetary wide mass extinction.In earth’s 4 to 5 billion year past, it isonly the 6th mass extinction our earthhas seen. The last one occurred 65million years ago. Although habitat loss

and pollution are factors, it is globalwarming that will deliver the deadliestblow to species. It will wipe themout at the rate of 1 every 20 minutes.Compare this to a much slower rate inthe past. Over the past millions of years,scientists find, through fossil records,an extinction rate of 1 species every 5years. Biologist E. O. Wilson, in 2002,estimated that, should current rates ofhuman destruction of the biospherecontinue, one-half of all species of lifeon earth will be extinct in 100 years.Eminent biodiversity specialists all over

the world have implored governmentsto establish a political frameworkto save the species of the planet.

Of a magnitude that elicits near panicin experts, the reality is that mostpeople do not even know that theworld is experiencing a mass die-off of species. Nor do they realizethat the interplay of species is thenurturing force that sustains ourecosystems. Even less known is therole some of these at risk species could

have on biomedical research. Theresults of this research could cureor treat diseases, lower health carecosts, and reduce human suffering.

While not at risk, the Pacific Yew treeprovides an example of a substancefound in nature, in this case comingfrom the tree bark, that has servedas the basis for the development ofpowerful anticancer drugs that treatbreast, lung and ovarian cancers. Dr.Chivian cited a number of speciesthat may hold the biological keys

to treating a variety of diseases butare at risk of extinction. Some ofthese “at risk” species and what theymight provide: dog sharks producesubstances that can block the growthof cancerous tumors; the Africanclawed frog produces a substance thatkills bacteria in ways that could helpresearchers develop a powerful newline of antibiotics for which there is noknown bacterial resistance. Amphibians

have the capacity to regenerate lostlimbs and other body parts. Humanshave this capacity too but it lies hiddensomewhere in our DNA. It awaits thediscovery of the key that will unlock it.

Brown bears become hugely overweightbefore “retiring” for their winterhibernation, and while they presentthe same insulin levels as their obesehuman counterparts, in contrast theynever become ill with type II diabetes.Polar bears remain immobile formonths during hibernation and thoughmassive amounts of calcium are lostfrom their bones during this time - aswith humans who are immobilized -something causes the bones to re-calcify.

Imagine treatments that could control

cancer, diabetes, osteoporosis, deadlyinfections and possibly restore lostlimbs. Research on cone snails, theirhabitat in coral reefs threatenedby die offs all around the world, isalready providing opportunities totreat intractable pain with substances1,000 times more powerful thanmorphine, without causing toleranceproblems. These biological potentialsoften disappear when animals are incaptivity. So, while efforts to preservespecies through captive breeding is

admirable, it is far from an answer evenin the extremely unlikely event that itcould be secured on as widespread abasis as would be needed to accomplishthe research. Other fascinating butnot yet clinically useful data abound,and researchers are in a race againsttime to capture the data before theyare lost forever. Dr. Chivian identifies,for example, the gastric broodingfrog - which developed offspring inits stomach and held valuable clues tothe treatment of gastric ulcers - butis now extinct. The psychologicalcosts of losing opportunities to easesuffering, as well as grappling withthe feeling of profound failure asstewards of the environment, is ofcourse, incalculable. (Chivian, 2008)

Dr. Chivian cited a number

of species that may hold the

biological keys to treatinga variety of diseases but

are at risk of extinction.

© M i l a n K r y l / S h u t t e r s t o c k . c o m





Conclusion

The threat of global climatechange to the psychologicalwellbeing of Americanshas yet to become a priority

concern of the U.S. mental healthcommunity, but it surely will becomeone as the damages from climatechange mount in its many compellingand disastrous forms. Mental healthproviders and their professionalassociations are making note of theproblem and responding with newguidelines and policies, but more isneeded. The looming disaster thatis global warming begs for greaterpublic and professional attention. The

sheer scale of mental health impactsfrom violent weather, crop failures,water shortages and more will putpressure on the nation’s mentalhealth care systems as never before.

The economic costs of ignoring the realimpact that climate-related disasterswill have on our national psyche andthe American spirit are potentiallyimmense. The human sufferingassociated with these disasters will

be widespread and run very deep.The national security implicationsare likewise as yet inconceivable.

American mental health care needs tobe ready for the coming climate-relatedpressures it must address. It can beginwith improved training and preparationand can add its credible and importantvoice to stopping the problem at issource by supporting the lowering ofgreenhouse gas emissions. The healthcommunity stepped up on the threat ofnuclear war some 30 years ago and ithad a huge effect on making the worldsafer from physical and mental harm.

Our hope is that this message willhelp address the global warmingproblem while professionals preparefor the unavoidable mental healthproblems we will undoubtedly see.Mental health professionals willneed a new focus and new energyto help those who will be hurt mostgrievously by global warming.

Mental health professionals

will need a new focus and

new energy to help those who

will be hurt most grievously

by global warming.

© D a v i d M a c e / F E M A . g o v





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PROJECT TEAM

LISE VAN SUSTEREN, MD is a forensic psychiatrist in private practicein Washington, DC. In 2006 she sought the Democratic nomination to the U.S.Senate in Maryland. Van Susteren received her medical degree in 1982 fromthe University of Paris and interned at the Hospital St. Anne and the AmericanHospital in Paris, and at Hospital Tokoin in Lome, Togo. She was a resident inpsychiatry at St. Elizabeth’s Hospital in Washington, D.C. She was board certified ingeneral psychiatry in 1989 and in forensic psychiatry in 1999. She worked as a staffpsychiatrist at the Alexandria Mental Health Center in Alexandria, Virginia and atthe Springfield Mental Health Center in Springfield, Virginia. She also worked as aconsultant to the Central Intelligence Agency, conducting psychological assessmentsof world leaders. Van Susteren is a frequent commentator on television and radio.She serves on the Board of Directors of the Climate Project and is member of the

Board of Directors of the National Wildlife Federation and the Chesapeake ClimateAction Network. In September 2006, Van Susteren was chosen as one of the first50 persons to be trained by Former Vice President Al Gore’s Climate Project togive her version of his global warming slide show, An Inconvenient Truth.

KEVIN J. COYLE, JD is Vice President for Education and Training at theNational Wildlife Federation (NWF) where he oversees its citizen science andeducation programs. In 2006, he adapted Al Gore’s book and film, An InconvenientTruth, into a training course curriculum that has been used by the Climate Projectto prepare nearly 2,000 advocates to make educational presentations to civic andbusiness leaders in the U.S. and abroad. Prior to NWF, Coyle was Presidentof the National Environmental Education Foundation. His 2005 monograph,

“Environmental Literacy in America,” is a comprehensive review of the state ofenvironmental knowledge and learning. Prior to that, Coyle was President ofAmerican Rivers, the nation’s principal river conservation organization. He wasalso a founding board member and a Vice President of River Network and co-founder and President of the American Land Resource Association. He servedfor ten years with the U.S. Department of the Interior managing the Wildand Scenic Rivers planning Program and Land and Water Conservation FundGrants for the Northeast Region and if former Chair of the Natural ResourceCouncil of America. He has a Juris Doctor from Temple University and aBA in sociology and social work from LaSalle University in Philadelphia.

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Documents

The Psychological Effects of Global Warming on the United States