Good afternoon, my name is Jen Robohm, and I’m a Behavioral Science faculty member for the FMR here in Missoula, a Clinical Associate of the UM Department of Psychology, and a licensed clinical psychologist in private practice
I’m really appreciative of the opportunity to speak here today, because mental health is often neglected in discussions about climate change, and yet it needs to be a critical part of the conversation
Mental health and substance abuse concerns are already a significant, leading source of disability around the world, and climate change will only add to that global health burden, posing a significant challenge to our mental health care system and to our adaptive abilities, both as individuals and as communities, in Montana. I hope to raise your sense of urgency around these concerns today.
At the same time, I also want to emphasize that some Montanans will be able to maintain affirmative mental health and emotional resilience, even in the face of climate change. At the conclusion of my remarks, I’ll share some thoughts on ways to promote mental health and resiliency, to help us mount effective responses to the challenges ahead.
I’m going to lump the mental health impacts of climate change into these 4 broad categories and address each one in turn. But before I do, I want to make 2 important points:
First, climate change will be a “threat amplifier,” and these mental health impacts will be inequitably distributed throughout Montana, with the bulk being borne by marginalized and vulnerable populations, including children, the elderly, the poor, Native Americans, those living in rural and under-resourced communities, and those with pre-existing mental health conditions; and
Second, these impacts will be taking place in a state with the highest suicide rate in the nation, in which 55 of 56 counties are already considered “mental health professional shortage areas” according to the Health Resources and Services Administration (HRSA), and in which public mental health funding will be vulnerable to other budget priorities in the face of climate change (as we saw last year in Montana, when the budget was slashed after a severe fire season)
Important backdrop for the remainder of this discussion…
Climate change may affect mental health directly and dramatically, by exposing people to extreme weather events and climate-related disasters (e.g., flooding, hurricanes, wildfires) that have high potential for immediate and severe psychological trauma from personal injury, injury or death of a loved one, damage to or loss of personal property and pets, and disruption in or loss of livelihood and community
This is already happening in Montana (e.g., wildfires near Seeley Lake in 2017 and Lake McDonald in 2018, and flooding of the Clark Fork River in Missoula in 2018), and such experiences are projected to become more commonplace in the not-so-distant future
Important to note that psychological impacts from any form of disaster exceed physical injury by as much as 40-1 (Links, 2017), and between 7-40% of people affected will show some form of psychopathology
The social and mental health consequences will range from minimal stress and distress symptoms to clinical disorders, including depression, anxiety, post-traumatic stress, alcohol abuse, sleep problems, attachment and behavioral disorders in children, and suicidal thoughts and attempts
Disasters can also damage critical infrastructure, which diverts resources from public health and mental health services, puts pressure on individual resources, and impairs social cohesion, all of which can ultimately contribute to negative mental health conditions (9/11 parallel)
Climate change will also affect mental health indirectly, incrementally, or cumulatively over time, in a number of key ways: In Montana, sub-acute climate-related exposures (e.g., rising temperatures, drought, shrinking glaciers) will strain communities dependent on the natural environment (e.g., agriculture, ranching, tourism), which could lead to social and economic instability, loss of personal and professional identity, loss of social support structures, loss of a sense of control and autonomy, displacement and dislocation, and other mental health impacts Earlier snowmelts, rising water temperatures, smoky skies, and shrinking glaciers will also change outdoor recreation opportunities (e.g., skiing and snowboarding, fishing , hunting, hiking), affecting many Montanans’ way of life and sense of place Climate change will also exert more gradual influences on landscapes and ecosystems that may be associated with feelings of loss, particularly for those Montanans with close times to the natural environment Children’s mental health and well-being will also be adversely impacted by chronic stressors that threaten stable families and communities Rising temperatures are also associated with higher rates psychiatric hospital admission and suicide, and as many of you well know, Montana already has the highest suicide rate in the US, at 29.6 suicides per 100,000 individuals (American Association of Suicidology, 2017) Long-term exposure to chronic stress and worsening health problems can lead to anxiety disorders, depression, substance abuse, and higher rates of child abuse Stress and socioeconomic disparities can also elevate hostility and interpersonal aggression, and may lead to conflict and inter-group tensions
Many people still think of climate change as a looming threat, but it's something we're well in the midst of, and many of us in Montana are already experiencing overarching psychosocial impacts, due to:
Vicarious exposures through the media to climate change-related communications and images (Leiserowitz et al., 2013; Reser et al., 2014) that lead to greater awareness of climate change as a global environmental threat (even if we have not experience climate change events per se)
Grief from anticipated loss of physical ecosystems and landscapes, environmental knowledge, valued species, and cultural identity (Cunsolo & Ellis, 2018)
Existential worries about the future for ourselves, our children and later generations, and consequent feelings of vulnerability, helplessness, mourning, grief, and despair
Anger at inertia and inaction by our political leaders, both nationally and worldwide
These feelings of distress, anxiety, and fear are probably familiar to most people in this room, and may well be getting stirred up in you right now, as I’m speaking! They may not reach the level of a diagnosable mental disorder, but they can nonetheless adversely impact our quality of life and our level of functioning.
Which leads to the fourth area of impact…
(Speaking as a clinician, now…)
If you are like me, distress, grief, and fear about climate change are sometimes so significant that they trigger psychological defenses such as denial, avoidance, rationalization, or fatalism: “It can’t be that bad – just look at the snow outside…”
These defenses help us to cope in the short run, by distracting us from anxious or painful thoughts, and protecting us from overwhelming events and feelings
But if our defenses become too strong or get engaged too often, they become counter-productive, and we lose the ability to deal effectively with the causes of our distress
In some ways, these are the most dangerous mental health impacts of all, because our defenses can contribute to apathy and prevent us from taking steps necessary to protect the health of our families and the viability of our planet...
To mount an effective challenge to climate change, we need to recognize our defenses for what they are, and to remember that transformation and resiliency begin with the willingness to face our anxieties and the fear of change and loss. It is only if we choose to engage with the process of change that we will have an opportunity to create solutions. (Even in my clinical practice, I’ve observed that some of the most profound human growth comes at times of crisis and adversity…)
As I said earlier, I want to leave you with a sense of urgency, but also with the sense that there are very real action steps that we can take to reduce our risk of mental health impacts and promote psychological resiliency in Montana. I’d like to make a few recommendations, based in part on psychological research and clinical practice:
At the research and policy level: Continue to make mental health a critical part of the climate change conversation, as it’s a point of significant concern but also an essential source of hope and resiliency Include measures of the psychosocial consequences of climate change in our surveillance systems, so our mental health system and our communities can better plan for them Conduct research on affirmative mental health responses to climate change (e.g., post-traumatic growth; increases in empathy, compassion, and altruism; solidarity with others; emotional resiliency), so we can learn from them
On the front lines: Train our first responders in “mental health first aid” and develop mental health ‘Incident Response Teams’ for climate-related events Integrate behavioral health providers into primary care and other medical settings, to enhance access to mental health services in the years ahead Train our community mental health providers to intervene around the mental health impacts of climate change; and mobilize their expertise to inform our adaptation plans and help build community resiliency
At an individual level: Make time for self-care and reflection, because individual resiliency will be protective in the years ahead Adopt climate-friendly habits with co-benefits for mental health (e.g., biking or walking to work will provide exercise benefits that promote psychological resiliency) Share our feelings with like-minded others, so we don’t feel alone Recognize when our defenses kick in, so we can avoid apathy, denial, or fatalism that we can ill-afford Take active steps to counter despair and paralysis, to maintain motivation and momentum
In our communities: Look for opportunities to foster and cultivate community resiliency, because we will never have enough mental health providers or resources in Montana to meet the projected need. This could include: Building and reinforcing community and social networks that emphasize identity, citizenship, and cohesion, and which empower and support our more vulnerable community members Teaching our children basic resilience and coping skills, and give them an active, meaningful role in the face of adversity to give them a sense of control and power And, finally, engaging in advocacy and meaningful action, anchored in deeply ingrained, shared values, to unites us with a sense of direction and purpose for the challenges ahead
The mental health impacts of climate change in Montana are occurring now, and they will likely be significant in the future. But we have knowledge and expertise that can bolster individual and community resiliency and help us to mount an effective response.
10 minutes is obviously not enough time to discuss these ideas in detail, so here’s my contact information in case anyone would like to continue this conversation.
Thank you for the opportunity to speak to you today.
Attribution related to climate change and mental health can be challenging because: Simultaneous risk of pathologising common transitory distress responses to abnormal events and underdiagnosing mental health effects of a changing climate Wide array of potential climate change and mental health outcomes related to a changing climate There is substantial scope with respect to the timing of the climate change effects on mental health, thus causal links become harder to determine Attribution related to climate change and mental health is not well understood because of the complex interaction between mental health and other social determinants of health
Climate Change and Mental Health in Montana
Jennifer S. Robohm, PhD
Family Medicine Residency of Western Montana
February 29, 2019
Climate Change and Mental Health
(1) Acute and direct impacts
(2) Indirect and incremental impacts
(3) Overarching psychosocial impacts
(4) Psychological defenses
Jennifer S. Robohm, Ph.D.
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