Confronting An Inconvenient Truth: Consultation-Liaison Psychiatry on the Frontlines of the Climate Change and Mental Health Crisis

Abstract:

Background:

Climate change, including disasters and extreme weather events, is linked with the new onset or exacerbation of existing mental illnesses, including depression, post-traumatic stress disorder, substance use, and suicide. Physiological and psychological challenges due to changing climate cause worsening of physical health and new-onset behavioral symptoms, including cognitive dysfunction, depression, and anxiety; or lead to climate change specific conditions which are not yet captured by the DSM. Minority and vulnerable populations, including patients with mental illness, are most impacted by these consequences. Subsequent rise in healthcare encounters will place consult-liaison psychiatrists in the frontlines.

Approach: This Neuropsychiatry SIG-sponsored general session will explore the impact of climate change on mental health, the challenges it can present in consultation-liaison psychiatry settings, and the proposed solutions to improve mental health care in climate change. Using a didactic presentation, a case scenario, and audience polling, the presenters will engage the participants on the importance of climate change and mental health for consultation-liaison psychiatrists.

Format:

Our presentation will weave around different aspects of a case scenario. Audience polling will be used to guide discussion with participants

2 min: Dr. Badr Ratnakaran will introduce the group and the subject.

15 min: Dr. Shruti Tiwari will highlight how climate change impacts our health care settings. She will review the significance of climate change around the world and in healthcare, including climate change-related disasters, extreme climate change-related events, and an increase in the risk of minority and vulnerable populations to climate change-related consequences.

15 min: Dr. Rabin Dahal will illustrate the importance of climate change and mental health for consultation-liaison psychiatrists. He will summarize the literature on the impact of climate change-related events on mental health and the increase in emergency room visits and hospitalizations for worsening behavioral symptoms about climate change.

15 min: Dr. Soumya Sivaraman will describe the effect of climate change-related events on psychiatric disorders, including physiological changes to climate change-related events and the neurobiological mechanisms related to the development of new or worsening psychiatric symptoms. She will also discuss considerations when prescribing psychotropic medications in the context of climate change.

13 min: Dr. Badr Ratnakaran will discuss strategies for the assessment and management of patients about climate change-related events, including collaborating with other specialty providers, safety planning (psychosocial consideration needed). He will propose solutions that include future models of care and improving education on climate change and mental health in consultation-liaison psychiatry settings.

15 min: Questions and Answers with the audience.



Conclusion:

The effects of climate change on mental health are an increasing reality. As consultation-liaison psychiatrists are the first-line mental health responders to this crisis, we must lead the way with climate-change-aware models of care.