Mental Health Pathfinders: Confronting the Mental Health Impacts of Climate Change

In this episode of Mental Health Pathfinders, host Erin Connors speaks with Dr. Jacob Lee, chair of the APA’s Committee on Climate Change and Mental Health, about the growing intersection between environmental crises and mental well-being. They discuss the mental health impacts of climate-related disasters such as hurricanes, forced migration, and community displacement, as well as the toll on healthcare providers themselves. Dr. Lee shares the committee’s advocacy priorities, including the push for a diagnostic code for climate-related distress and support for the Community Mental Wellness and Resilience Act. He offers practical steps for psychiatrists to raise awareness, prepare for increased mental health demands, and engage with their communities, all while working toward more sustainable healthcare practices.

Episode Transcript

(00:09):
Thank you for joining us for this edition of Mental Health Pathfinders.
I'm your host, Erin Connors.
Climate change and mental health is the topic of today's podcast.
And I would like to welcome our guest, Dr.
Jacob Lee.
He is a child and adolescent psychiatrist based in Honolulu, Hawaii.
And he's also chair of the APA's Committee on Climate Change and Mental Health.

(00:29):
Dr.
Lee, thanks for being here today.
Thanks for having me, Erin It's great to be here.
You know, let's dive right in.
You know, I think when most people think about climate change, mental health may notalways be the first thing that comes to mind.
Why is it so important to bring mental health into this conversation?
Absolutely.
as we're seeing the number of these billion-dollar weather disasters rising year overyear, Americans around the country are experiencing natural disasters that are more

(00:55):
frequent and more severe.
If you look at one type of those disasters, say hurricanes, which are happening off-seasonor are happening with unusual power, if somebody sees gale-force winds physically harm
someone, it's really easy to understand that cause and effect.
But there's lots of ways that disasters can affect Americans in ways that just might notbe as obvious.
But I will say, increasingly people are noticing and are concerned about the mental healthimpacts.

(01:19):
In 2022, there was high quality polling performed by Morning Consult and the APA thatfound over half of Americans 18 to 45 already believe that climate change impacts their
mental health.
Yeah, and we did some updated polling numbers this year.
it's the same thing.
Over 55 % of adults say they believe climate change is impacting mental health.

(01:41):
And one thing I really found interesting about this poll this year is that there's cleargenerational and parental divides in these perceptions on climate change and mental
health.
The younger adults, as you mentioned, are obviously significantly more aware and impactedcompared to those 65 and older.
feel they understand the consequences of climate change and they feel personally affected.

(02:05):
Similar parents over non-parents are feeling it too.
What do you attribute this to?
Yeah, well, if you look at polling from across both the global north and the global south,we see widespread reporting that young people are more concerned about climate change.
And of course, there's a part that they simply have more exposure to these risks.
know, if the risk will be higher in 2030 and higher still in 2040, they're going to spendmore time and have more of their formative years during that time.

(02:32):
We also know that there's widespread consumption of
frightening, alarmist media.
Grist magazine called Climate Change, the social media story of the year, I believe thatwas 2019.
We know that these topics have been really on the mind and really the exposure to climaterelated disasters, either in person or over social media, we found to increase people's

(02:54):
level of stress and really the amount of young people that are exposed to some climaterelated disasters over social media.
It's almost 100%.
I mean, there's total
total widespread dissemination about this information.
It's a topic that's really on the minds of so many young people.
Yeah, it has to be because we're seeing it on TV right now with the situation in Texas,with the flooding.

(03:17):
What do you think are some of the most common or concerning mental health impacts you'veseen associated with climate related events?
Yeah, to maybe stick with hurricanes for a minute, because we're sort of in that season,we can look at like Hurricane Katrina.
So, you know, after Katrina, we saw many survivors develop serious mental illness.
So we saw rises in conditions like trauma related disorders, anxiety or depression.

(03:38):
And in the Katrina example, we saw suicidal ideation and suicidal planning more thandoubled.
And that's kind of a pattern we see across a variety of other disasters that are becomingmore frequent.
So.
In addition to those obvious physical injuries, many climate-related disasters are goingto cause forced migration, which the United Nations forecasts to be about 20 million plus
people every year related to climate disasters.

(03:59):
We also see disrupted family roles or families that are physically separated.
And unfortunately, this can even lead to a rise in things like domestic violence, whichyou might not immediately come to mind when you're thinking of these topics.
And just one other important thing I'd add, as mental health providers, as psychiatrists,we often think about the care of our patients, but
Taking a look at, say, the 2004 Florida hurricane season, we can really tell there's lotsof significant impact on the health workers themselves.

(04:26):
So like in the 2004 Florida hurricane season, we saw this horrible, unprecedented seasonwith four hurricanes and one tropical storm that cost like $5 billion in damage.
But the workers, the stay and local public health workers who were first responders there,after the disaster, they had
more post-traumatic stress disorder, more depression.
We're three times more likely to report cigarette and alcohol abuse.

(04:48):
So it's not just affecting our patients, it's also providing the, it's also affecting theproviders ourselves.
That makes a lot of sense and your committee is so important.
It's at the intersection of science, advocacy, and clinical care.
What kinds of projects or priorities are you currently focused on with this committee?
Yeah, there's a reason that the World Health Organization calls climate change thegreatest threat to health in the 21st century.

(05:12):
um Because of the scale of this climate crisis, which we sometimes call the polycrisis,efforts to protect our patients really require a multi-pronged approach, which is how the
committee has been working on this.
And there's certainly an advocacy element because of the power that the state or federalgovernment can bring to bear on solving these issues.
So the APA has, for instance, recently supported the Community Mental Wellness andResilience Act.

(05:36):
which we can talk about a little bit more, but works to build community level resiliencebefore and after natural disasters.
And as the government pulls back on funding for research, our committee has beenencouraging the APA's Council on Advocacy in Government Relations to support
sustainability and science research across federal, state, and grassroots levels.
The committee is also working to add a Z code to describe climate-related distress, andthat's part of our balancing act of trying to strike between...

(06:01):
not pathologizing rational climate distress, but with recognition that having a diagnosticcode is so important in our current system for people to get the services they need and
for physicians and public health workers to track the growing prevalence of these kind ofconditions.
Yeah, let's focus in on the clinical aspect of this too.
What can individual psychiatrists do to raise awareness about the connection betweenclimate change and mental health among their colleagues and actually within their

(06:28):
communities too?
Yeah, so first up, know, psychiatrists, mental health workers just ask themselves whatthey know about climate change and mental health.
And there's no need to reinvent the wheel here.
uh Many have lots to learn about this newer topic of research.
And I would point them towards uh the committee and other organizations have had multipletalks at every APA annual meeting the past several years to kind of increase that

(06:51):
education and
important APA webinars like Climate 101 or webinars with specific focuses like climaterefugees or indigenous peoples or psychological impacts.
So I'd recommend clinicians start there to make sure they have the appropriate knowledgebase to approach this topic with that background.
The psychiatrists are well positioned to share accurate climate-related messages, eithermessages from the APA or messages the APA has developed in partnership with groups like

(07:16):
the Climate Psychiatry Alliance or American Public Health Association.
easy to access resources, including the APA's Instagram page or other social media are aneasy starting point.
Those who feel that they've reached a higher level of expertise may wish to give grandrounds or informative talks at their facilities, may wish to testify before their state or

(07:36):
even federal government.
And just important to think that psychiatrists are really uniquely well positioned becausewe understand
both resilience factors and we understand how different groups might be disproportionatelyaffected by these rising and more frequent disasters.
So should this be part of a regular conversation with your patients?

(07:57):
Is this a question that psychiatrists should be asking?
Maybe all doctors should be asking their patients if they're feeling a little uneasy.
Yeah, I think it's really important that at baseline, we're providing the same kind ofservices we're providing to other patients.
We're understanding their story.
We're trying to understand traumatic events that they've experienced and help them withdeveloping healthy coping strategies and as necessary, we'll diagnose and treat any mental

(08:23):
illnesses because this is a frequent type of trauma that people are exposed to.
And because these are only becoming more and more prevalent in our communities,
it certainly should be a consideration in most psychiatric intakes.
And as we go forward, I think the importance of that conversation will only grow.
Yeah.
And from a systems perspective, how can the field of psychiatry prepare for and respond tothe increasing mental health demands brought on by climate-related stressors?

(08:51):
Absolutely.
Well, so again, to point back to the APA's recent support for the Community MentalWellness and Resilience Act, which just to mention it, would fund a CDC grant program to
try and build community level resilience for before and after natural disasters.
You know, this speaks to the fact that when there is a disaster, the needs in a communitycan raise very quickly, and that might overwhelm health systems as they already exist.

(09:13):
So that might point, uh I might point providers in that situation to tap into existingresources like
the government's ready.gov program or SAMHSA's disaster technical assistance center.
Those are kind of pre-built tools that providers can easily use uh to expand their reach,especially as these services become maybe overwhelmed and they follow up important

(09:34):
disasters.
And finally, what gives you hope as you look to the future of mental health and thechanging climate, and how can our listeners get involved or even stay engaged with this
issue?
Yeah, so I'll say uh the American Psychiatric Association has a caucus for interestedpsychiatrists and other mental health workers to follow, receive email updates and hear

(09:56):
the latest in this space.
In a culture where many feel atomized and lonely, everything that I've read shows thatcommunity holds the key.
We as patients and as communities can't face a challenge this large without a supportnetwork.
And because so many people already have a negativity bias, it's easy to feel like nobodyis out there working.
But as Mr.
Rogers says, look,
for the helpers, right?

(10:18):
There's many people in our communities that are cleaning, that are working towardssustainability and to tap into those networks can both be inspiring and help give us a
more accurate picture about how many people already care and are already working to makethe future a more sustainable and healthy place.
Is there anything else you'd like to add before we go?
Yeah, one of the big things that I think is important is that the practice of medicine isa polluting industry.

(10:41):
know, American health care produces 8 % of our country's greenhouse gases.
The practice of health care is directly harming people.
And as we look to reduce our own harms, we can look to successes other places likeEngland's National Health Service, the largest employer in Europe and the largest single
health, single payer health care system in the world.
They've been working to reduce their pollution and have been very successful while stilldelivering high quality care.

(11:04):
And in 2020, they announced their commitment to become the world's first net zero healthsystem.
I think that's a model that American health care and especially American psychiatry iswell positioned to follow.
And I think that gives psychiatry a real chance to be a leader in sustainable practice ofmedicine.
Absolutely.
This has been a fascinating discussion.
Dr.
Jacob Lee, thanks so much for joining us today.

(11:26):
And for our audience, you can always find Mental Health Pathfinders on your favoritepodcast platform.