Mental Health, Climate Change and Public Health

1. Mental Health, Climate Change and Public Health Minnesota Climate and Health Program Minnesota Department of Health Environmental Impacts Analysis Unit July 2013

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

3. Outline • Climate Change in Minnesota • Temperature • Dew Point • Precipitation • Climate Change Awareness • Mental Health Impacts of Climate Change • Place • Disasters and Mental Health • Loss • Violence • Vulnerable Populations • Psychological Barriers to Climate Action • Role of Public Health

4. Definitions • Weather — conditions of the atmosphere over a short period of time • Climate — conditions of the atmosphere over long periods of time (30 year standard averaging period)

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

6. Outline • Climate Change in Minnesota • Temperature • Dew Point • Precipitation • Climate Change Awareness • Mental Health Impacts of Climate Change • Place • Disasters and Mental Health • Loss • Violence • Vulnerable Populations • Psychological Barriers to Climate Action • Role of Public Health

7. Observed Climate Changes There have been three recent significant observed climate trends in Minnesota: • The average temperature is increasing • The average number of days with a high dew point may be increasing • The character of precipitation is changing

8. Outline • Climate Change in Minnesota • Temperature • Dew Point • Precipitation • Climate Change Awareness • Mental Health Impacts of Climate Change • Place • Disasters and Mental Health • Loss • Violence • Vulnerable Populations • Psychological Barriers to Climate Action • Role of Public Health

9. Temperature Changes in Minnesota

10. Temperature Changes in Minnesota Significant observations in warming pattern: • Winter temperatures have been rising about twice as fast as annual average temperatures • Minimum or overnight low temperatures have been rising faster than maximum or daytime high temperatures

11. Outline • Climate Change in Minnesota • Temperature • Dew Point • Precipitation • Climate Change Awareness • Mental Health Impacts of Climate Change • Place • Disasters and Mental Health • Loss • Violence • Vulnerable Populations • Psychological Barriers to Climate Action • Role of Public Health

12. Dew Point Changes • Dew point – a measure of water vapor in the air • A high dew point makes it more difficult for sweat to evaporate off the skin, which is one of the main mechanisms the body uses to cool itself • The number of days with high dew point temperatures (≥ 70°F) may be increasing in Minnesota

13. Dew Point Changes

14. Outline • Climate Change in Minnesota • Temperature • Dew Point • Precipitation • Climate Change Awareness • Mental Health Impacts of Climate Change • Place • Disasters and Mental Health • Loss • Violence • Vulnerable Populations • Psychological Barriers to Climate Action • Role of Public Health

15. Changes in Precipitation

16. Changes in Precipitation Precipitation in Minnesota is changing: • More localized, heavy precipitation events • Potential to cause both increased flooding and drought

17. Outline • Climate Change in Minnesota • Temperature • Dew Point • Precipitation • Climate Change Awareness • Mental Health Impacts of Climate Change • Place • Disasters and Mental Health • Loss • Violence • Vulnerable Populations • Psychological Barriers to Climate Action • Role of Public Health

18. Climate Change Awareness Understanding climate change is difficult • Hazards are experienced differently based on geographic location, population, and season • Effects of climate are unknown and uncertain • Cannot be identified by personal experience alone We have to rely on scientific models and expert judgment, often through the lens of mass media

19. Climate Change Awareness

20. Climate Change Awareness • Emotional reactions to the awareness of climate change include: • Fear • Sadness • Depression • Anxiety • Helpless and hopeless • Anger

21. Outline • Climate Change in Minnesota • Temperature • Dew Point • Precipitation • Climate Change Awareness • Mental Health Impacts of Climate Change • Place • Disasters and Mental Health • Loss • Violence • Vulnerable Populations • Psychological Barriers to Climate Action • Role of Public Health

22. Mental Health Impacts of Climate Change • Psychological effects of climate change are likely to be gradual and cumulative • The connection to climate change may not always be clear to those affected • Manifests as two types of stress • Discrete • Continuous

23. Outline • Climate Change in Minnesota • Temperature • Dew Point • Precipitation • Climate Change Awareness • Mental Health Impacts of Climate Change • Place • Disasters and Mental Health • Loss • Violence • Vulnerable Populations • Psychological Barriers to Climate Action • Role of Public Health

24. Place • Places are “nested collections of human experience, locations with which people and communities have particular affective relationships.” • Ties to a place are a part of identity • Familiarity • attachment • Climate is fundamental to an individual’s understanding of place

25. Place • Place is a key determinant of exposure to the impacts of climate change • Climate change may alter look and feel of the defining attributes a place • Solastalgia: palpable sense of dislocation and loss that felt when changes to a local environment are perceived as harmful • The loss of a connection to place and sense of belonging in that place undermines mental health • Attachment to place is so strong that it can be a primary driver of inaction

26. Outline • Climate Change in Minnesota • Temperature • Dew Point • Precipitation • Climate Change Awareness • Mental Health Impacts of Climate Change • Place • Disasters and Mental Health • Loss • Violence • Vulnerable Populations • Psychological Barriers to Climate Action • Role of Public Health

27. Disasters and Mental Health • Individual vulnerabilities: • Proximity to the disaster • Low socioeconomic status • Low social connectedness • Existing mental illness • Community vulnerabilities: • Outdated emergency plans • Shortage of mental health resources at time of event • Repeated exposure to disaster or crisis

28. Disasters and Mental Health • Poor mental health outcomes are not only attributable to exposure to the event • Displacement • Unstable or unknown housing circumstances • Lack of access to support services • Loss, particularly of employment, possessions

29. Disasters and Mental Health • Specific post-disaster mental health outcomes may include: • Confusion • Depression • Anxiety • Grief • Post-traumatic stress disorder • Case Study: Hurricane Katrina • Many victims have experienced stress disorders • Very high rates of suicide attempts (78.6 times higher than baseline rate) • High rates of suicide completion (14.7 times higher than baseline rate) • High rates of depression • Domestic violence/child abuse

30. Disasters and Mental Health • Risk of living in ‘disaster-prone’ areas • Cumulative mental health impacts are associated with the repeated exposure to natural disaster • Ongoing uncertainty, anxiety, dread can cause a build up of stress before disaster occurs

31. Disasters and Mental Health • Displacement can lead to grief, anxiety, loss • Fractured social networks and community connection • Impact on receiving communities • Real or perceived lack of resources such as support services, housing, jobs, and natural resources • Perceived competition for resources can contribute to discrimination

32. Outline • Climate Change in Minnesota • Temperature • Dew Point • Precipitation • Climate Change Awareness • Mental Health Impacts of Climate Change • Place • Disasters and Mental Health • Loss • Violence • Vulnerable Populations • Psychological Barriers to Climate Action • Role of Public Health

33. Loss • Climate change can contribute to several sources of loss: • Loss of bio-diversity • Loss of habitat • Extinction of species • Crop failure • Water shortage • Drought • Loss of livelihood • Forced migration/displacement and the loss of place • Loss of property, pets, possessions

34. Loss • Loss can impact our sense of self and disrupt our sense of place • A series of losses is particularly devastating • Distinct bereavement for each loss • Impacts slow to dissipate without support

35. Outline • Climate Change in Minnesota • Temperature • Dew Point • Precipitation • Climate Change Awareness • Mental Health Impacts of Climate Change • Place • Disasters and Mental Health • Loss • Violence • Vulnerable Populations • Psychological Barriers to Climate Action • Role of Public Health

36. Climate Change and Violence • As temperature rises, so does the incidence of violence • Increase in murders, assaults, violent suicide, and domestic violence when the weather is hot • Predicted: 24,000 assaults or murders in the US per year for every 2° F increase in average temperature • Stress of experiencing natural disaster can lead to violence

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

38. Outline • Climate Change in Minnesota • Temperature • Dew Point • Precipitation • Climate Change Awareness • Mental Health Impacts of Climate Change • Place • Disasters and Mental Health • Loss • Violence • Vulnerable Populations • Psychological Barriers to Climate Action • Role of Public Health

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

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

41. Vulnerable Populations: Financial Hardship • Financial hardships related to climate change • Reduced income or employment in climate sensitive industries • Increased costs of essential goods and services • Disruption to food systems • Decrease or loss of clean water supply • Higher insurance rates

42. Vulnerable Populations: Children • Children may understand and experience the threat of climate change very different than their parents or grandparents • Children so troubled by the state of the world that they honestly believe it will come to an end before they get older • The psychological impact on children has been compared to the impact on children worried about nuclear arms during the Cold War Era • Children are more emotionally vulnerable to increased family violence and the occurrence of natural disasters

43. Outline • Climate Change in Minnesota • Temperature • Dew Point • Precipitation • Climate Change Awareness • Mental Health Impacts of Climate Change • Place • Disasters and Mental Health • Loss • Violence • Vulnerable Populations • Psychological Barriers to Climate Action • Role of Public Health

44. Psychological Barriers to Climate Action • Ignorance • Uncertainty • Denial • Place Attachment • Perceived Behavioral Control

45. Psychological Barriers to Climate Action • Social Comparison, Norms, Conformity, and Perceived Equity • Conflicting Goals and Aspirations • Belief in Solutions Outside of Human Control

46. Outline • Climate Change in Minnesota • Temperature • Dew Point • Precipitation • Climate Change Awareness • Mental Health Impacts of Climate Change • Place • Disasters and Mental Health • Loss • Violence • Vulnerable Populations • Psychological Barriers to Climate Action • Role of Public Health

47. The Role of Public Health • Mental/Behavioral Health Annex to All-Hazards Plan • Reduce the number of people with traumatic stress reactions by rapidly restoring key psychosocial domains • Safety and security • reuniting families • systems of justice • foundations for returning to work • institutions that provide meaning

48. The Role of Public Health

49. The Role of Public Health • Local public health departments are not expected to provide a full range of mental and behavioral health • Identify and partner with the mental health resources available in your community before a disaster affects your community

50. The Role of Public Health • Well-meaning attempts to create urgency about climate change can lead to denial, paralysis, apathy • Focus on place– understand and communicate the local exposures of climate change and the response