Suicide and heat waves: the mental health effects related to climate change

thermometer and sunHigher temperatures increase suicide rates in the United States and Mexico”  was published in Nature Climate Change online on July 23, warning that up to 26,000 more people could die by suicide in the United States by 2050 if humans don’t reduce emissions of greenhouse gas pollution. The study has been widely reported and summarized: for example, in The Atlantic (July 23).  The authors used new statistical techniques, including analysis which correlates social media posts about depression with temperature conditions. Part of this social media analysis is based on the work of Patrick Baylis of the University of British Columbia, whose academic paper “Temperature and Temperament: Evidence from a Billion Tweets” was published by the Energy Institute at Haas, University of California at Berkeley, in November 2015.

A second article published in July 2018 is  “Associations between high ambient temperatures and heat waves with mental health outcomes: a systematic review”  appeared in the British journal  Public Health. It  reports on a literature review of 35 studies, and the authors conclude that: “High ambient temperatures have a range of mental health effects. The strongest evidence was found for increased suicide risk. Limited evidence was found for an increase in heat-related morbidity and mortality among people with known mental health problems. …. Mental health impacts should be incorporated into plans for the public health response to high temperatures, and as evidence evolves, psychological morbidity and mortality temperature thresholds should be incorporated into hot weather–warning systems.”

A 2014 article examined weekly suicide death totals and anomalies in Toronto between 1986–2009 and Jackson, Mississippi, from 1980–2006. The authors found that for both cities, warmer weeks had an increased likelihood of being associated with high-end suicide totals.  “Association of Weekly Suicide Rates with Temperature Anomalies in Two Different Climate Types” from the International Journal of Environmental Research and Public Health is here .

The  growing literature about the impacts of climate change on mental health has been summarized in an article in Forbes magazine, “Weather And The Warm Season Are Among Factors Associated With Suicide” (June 2018) and in the  April 2018 issue of  Corporate Knights magazine. The Corporate Knights article, “Deep Impact” is by Professor Helen Berry , the inaugural Professor of Climate Change and Mental Health at the University of Sydney, in Australia.   Although her brief overview emphasizes  mental health impacts of climate-change related disasters such as floods,  it also  provides links to recent articles linking mental health with chronic climate conditions such as heat waves and drought. Some examples of Professor Berry’s research: “The importance of humidity in the relationship between heat and population mental health: Evidence from Australia” in PLoS One (2016) ; “The Effect of Extreme Heat on Mental Health – Evidence from Australia”  from the International Journal of Epidemiology (restricted access) (2015); and “Morbidity and mortality during heatwaves in Metropolitan Adelaide”  in the Medical  Journal of Australia (2007).

Professor Berry and co-author   Dominic Peel  provoked public discussion in 2015 with an article in the British Journal of Psychiatry, “Worrying about climate change: is it responsible to promote public debate?

 

Recognition of the mental health impacts of flooding and wildfires in Canada – B.C. offers support

A June 2018 report from the Intact Centre for Climate Adaptation  at the University of Waterloo presents statistics about the rising financial costs of weather-related disasters in Canada, and  profiles the results of 100 door-to-door interviews with households in flooded communities around Burlington Ontario. After the Flood: The Impact of Climate on Mental Health and Lost Time From Work   found that members of households which had been flooded experienced significantly more worry and stress than non-flooded households, and the worry and stress persisted even up to 3 years after the event. After the Flood also reported that 56% of flooded households had at least one working member who took time off work, and that the average time lost was seven days per flooded household (10 times greater than the average absenteeism for non-flooded workers).

The report cites official documents concerning the growing financial costs of disasters for example, the 2016 report from Canada’s Office of the Parliamentary Budget Officer ,  Estimates of the Average Annual Cost for Disaster Financial Assistance Arrangements due to Weather Events and includes a bibliography of the growing  international public health literature concerning the health effects of weather disasters.

talk in tough times logoOther official recognition of the rising dangers of extreme weather events:  in May 2018, the Province of British Columbia, under the leadership of Judy Darcy, Minister of Mental Health and Addictions, announced mental health support services for those who might be impacted by re-living their experiences from the record-breaking 2017 wildfire season.   In partnership with the B.C. branch of the Canadian Mental Health Association, the program directs people to support services through a Facebook campaign called Talk in Tough Times, and a phone-based support program.

Federally, the  Minister of Infrastructure and Communities announced the Disaster Mitigation and Adaptation Fund in May 2018, a 10-year national program that will invest $2 billion in infrastructure projects such as diversion channels, wetland restorations, wildfire barriers and setback levees, to help communities better withstand natural hazards such as floods, wildfires, seismic events and droughts.

New research on climate change impacts on mental health

nature climate change special issue mental healthThe April Issue of Nature Climate Change focuses on the relationship between climate change and mental health. The introductory editorial  summarizes the three articles on the topic and makes the case that 1. Mental health issues are often neglected in the general research about the health impacts of climate change, and 2. more research is needed.  (Please note that all articles have restricted access and are available only for a fee. )  The first article in the issue, “Ecological grief as a mental health response to climate change-related loss” discusses the personal grief experienced by people as their natural world changes,  illustrated by the experiences of Indigenous people in  Northern Canada and the Australian wheatbelt.  The second article, “The case for systems thinking about climate change and mental health” examines the current state of research about climate change and mental health from a policy perspective, arguing for a more epidemiological research.  The third article, “Mental health risk and resilience among climate scientists” discusses whether climate scientists themselves face unique mental health risks because they are immersed in depressing information.  Dr. Susan Clayton, author of the third article, is also co-author of the influential 2014 report Beyond Storms & Droughts: The Psychological Impacts of Climate Change, published by the American Psychological Association and ecoAmerica.   In March 2017, the APA, ecoAmerica and Climate for Health  updated Beyond Storms & Droughts with   Mental Health and Our Changing Climate: Impacts, Implications, and Guidance .

 

Occupational health risks created by climate change: U.S. doctors get Guidelines, France releases expert report

tick_lyme_government of ontario

Warmer temperatures have brought the Black-legged tick  to Ontario, bringing an increase of Lyme’s Disease, especially for outdoor workers.

A  Guidance Document was released by the  American College of Occupational and Environmental Medicine in February 2018.  Responsibilities of the Occupational and Environmental Medicine Provider in the Treatment and Prevention of Climate Change-Related Health Problems  (also appearing  in the Journal of Occupational and Environmental Medicine ) is intended to set standards for physicians specializing in workplace health.  The Guidance Document  provides concise and very current information about  the direct physical impacts related to climate change (heat stress and ultraviolet exposure, air quality, and allergic sensitivities) as well as indirect impacts (disaster zone exposure, stress and mental health, and waterborne and vector-borne disease).  Most of this information is not new:  two previous major reports have covered the same ground: The Lancet Countdown Report for 2017,  (which links climate change and specific health conditions for the population at large, not just workers, and which included a report for Canada ), and the landmark U.S . Global Change Research Program report, The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment (2016)  .

What is important about this new Guidance Document?  It focuses on the workplace, and sets standards for the role of occupational health physicians which include a responsibility to protect workers.  For example:  “Provide guidance to the employers on how to protect working populations in the outdoors or in the field who are potentially exposed to the extreme temperatures…. Quickly identify employees with acute and chronic cardiovascular and respiratory illnesses within the organization who will be significantly affected by increasing temperature and worsening air quality, an increase in ozone, particulate matter, and high pollen count  ….Provide effective guidance to employers about seasonal activity and address the increasing risk of vector-borne disease among the working population…. Deliver support to the employees at risk for mental illness due to disasters, loss, and migration by providing more comprehensive programs through their employment….  The article concludes with: “ OEM providers are called to be on the forefront of emerging health issues pertaining to working populations including climate change. The competent OEM provider should address individual and organizational factors that impact the health and productivity of workers as well as create policies that ensure a healthy workforce.”

There is also a call to action in a new report from France’s Agency for Food, Environmental and Occupational Health & Safety.  The full expert analysis is available only in French ; an English abstract is here .  The report  predicts the occupational risks associated with climate change, from now till  2050, and identifies the main drivers of change: rising temperatures, changes in  the biological and chemical environment, and a change in the frequency and intensity of extreme events.  What’s new in this report?  It highlights the breadth of impact of climate change, stating that it will affect all occupational risks, except those associated with noise and artificial radiation.  The report also makes recommendations,  urging immediate workplace awareness campaigns and training about the health effects of climate change, with a preventive focus. From the English summary: “The Agency especially recommends encouraging all the parties concerned to immediately start integrating the climate change impacts that are already perceptible, or that can be anticipated, in their occupational risk assessment approaches, in order to deploy suitable preventive measures.”  The full report (in French only):  Évaluation des risques induits par le changement climatique sur la santé des travailleurs  (262 pages) is dated January 2018 but released in April. It was requested by France’s Directorate General for Health and the Directorate General for Labour, to support the country’s 2011 National Adaptation to Climate Change Action Plan (PNACC).

Climate change has consequences for mental health in the workplace

Mental Health and Our Changing Climate: Impacts, Implications, and Guidance  is a report released at the end of March by the American Psychological Association, Climate for Health, and ecoAmerica. The goal is to raise public awareness of the issue and to provide “climate communicators, planners, policymakers, public health professionals, and other leaders the tools and tips needed to respond to these impacts and bolster public engagement on climate solutions.”  Although it doesn’t directly address workplace issues, much of the discussion is relevant.  For example, the report catalogues the acute mental health impacts that result from the horror and disruption of natural disasters or extreme weather events such as Hurricane Katrina –  depression,  disrupted social relationships, domestic violence, and heightened intergroup aggression.  The report also highlights women as being at higher risk: “because, on average, women have fewer economic resources than men, women may also be more affected, in general, by the stress and trauma of natural disasters.” (p.39).

Extreme weather and disasters focus attention, but there are also chronic impacts resulting from longer- term climate changes – the key example given is a proven increase in violence and inter-personal aggression associated with higher temperatures.   Certain occupational groups are highlighted for their high risk to climate-related anxiety, including first responders to natural disasters, but also including health care-givers, and those directly employed in natural settings – conservation officers, park rangers.

The final section of the report deals with tips to build resilience at the individual and community level.  It urges that training be provided for first responders so that they can identify and deal with appropriate compassion for the victims of natural disasters.