Dr. Lise Van Susteren on How Climate Changes Mental Health

lise_van_susterenDr. Lise Van Susteren is an American psychiatrist in private practice in Washington, DC with a special interest in the psychological effects of climate change. Read her full bio here.
 
Recently, the American Public Health Association and ecoAmerica co-sponsored Making the Connection: Climate Changes Health, a four-part webinar series investigating the health impacts of climate change. In the fourth webinar of this series participants learned how the conditions of climate change can impact mental health and how this presents itself in our communities. You can view a recorded version of the webinar here. Dr. Van Susteren, a panelist from that webinar, joins us in answering participants’ follow-up questions below.
 
What is the role of the State and local Health Departments in helping newly arrived refugees cope with PTSD, depression, the stress of dislocation and the pressures of adaptation to a new culture?
 
They certainly have a role but, let’s face it, the reality is they won’t have the funding, and they won’t have the public’s favor for the funding until after there’s a problem. We know that when it comes to these social needs we get activated when we realize that there’s really big trouble if we don’t. Discretionary funds for programs like these are the first to go when there is any kind of economic challenge to the county or the state. Not to mention the fact that with incoming bills from climate disasters discretionary funds are going to be going down. We’ve seen this in the past with other economic challenges. In 2008, for example, funding was cut in just about every state in the union – and a substantial amount of money was cut to mental health, elderly, and handicapped services, etc.
 
Shouldn’t we acknowledge that the WHO, as part of the UN, HAS acknowledged climate change as a health, equity, and developmental issue – in the form of the Sustainable Development Goals of 2015-2030?
 
We certainly should. It’s absolutely true and it’s very important psychologically to note what positive steps Individuals and institutions are taking. And I think I’m remiss in not addressing and thanking those individuals and institutions on a regular basis. That said, there’s a heck of a lot more work to do, and I understand that it’s easier for a person to stand here as an individual and say what should happen, but when you work in a bureaucracy you are not nimble.
 
I thought WHO already did declare climate change as a public health emergency?
 
They have not. We had approached them through the British medical journal and have entreated them to declare climate change a public health emergency, but they have not. But it’s very important that they would do this because declaring it as an emergency will drive a number of other agencies and individuals to take notice and respond commensurate with what we are facing.
3What will be the “one” action that every citizen of the earth can do to help reverse climate change?
 
The one thing you could do, I suppose, is convince policymakers to write policies that will effectively address our carbon emissions. But that is not a “one thing one person can do,” that is what we do collectively. Looking at where we have impact – is it our neighborhood, our family, our office, our business, our professional sector – and knowing that we are the most effective messengers to people who already like, respect, or know us, should give us somewhat of an idea about the path to take. The ways that we can get everyone to calculate his or her carbon footprint, reduce what we can and offset what we can’t reduce (in addition to being good climate voters) is the one thing that probably could be effective.
 
I’m the sustainability manager at a large university in New Mexico. One of my biggest struggles is to get people to know that climate change is here and we WILL be seeing more dire changes locally. Any tips on how to get people to believe what’s coming and that we need to start planning ahead?
 
In college, many students are aching to feel useful and to invest their life with meaning, and frankly at that age individuals are very idealistic, and there is still kind of adolescent independence that means you are in an especially good position to show the previous generation that you are going to correct for their mistakes. Making the case to students that they have a unique opportunity here, and that they can find reinforcements with other students who like to work together in a social networking opportunity. You can really tap into major forces that are common to people this age and this demographic. You could take a page out of Bill McKibben’s playbook at how he is mobilizing in Vermont, and have a design about how you would do the same in your large university in New Mexico.
 
Do you have any success stories or lessons learned from work with First Nations (American Indians) on social & cultural resilience? (I’m especially thinking of those communities as disproportionately affected by complex physical & mental health impacts of climate change.)
 
It’s really an attitude and a philosophy about nature, Mother Earth and how we fit in as humans. And it’s with anguish that I think to myself of how brilliantly Native Americans lived in harmony with Mother Earth, and they saw her as a generous and loving mother to whom they responded in kind, and we have moved away from this. This philosophy is one that we need desperately to recapture and rekindle.
 
Could you explain why poison ivy will be more toxic with climate change?
 
Yes. I don’t know the chemistry, but uroshiol acid, the active compound in poison ivy, is made more toxic by CO2. So in the presence of increased CO2, poison ivy has a fiercer effect on us.
 
2What is the right language to use that both acknowledges the reality of where we now are with current and inevitable climate impacts, and can still inspire and motivate people to do what they still can? Seems a hard mixed message – avert the very worst seems like a sad compensatory message.
 
This is a very important question that comes up all the time. Using the health model, here’s what we typically do. In order to get patients to take actions when we know that they should for their health and maybe even their lives — two steps. 1. Tell them exactly what they stand to lose. In no uncertain terms. Very specifically. And then, when you give them the unvarnished truth, you segue to step 2: “Here’s what you can do about it.” Ideally, you can put them in contact with other people who are in the same position and can identify with them, who did what was being proposed and saw all the good things that happened as a result. You can’t make the claim that it’s a crisis if you sugarcoat it. If it’s not a crisis, then why were we so worried about it? You’ve got to substantiate it as a crisis.
 
How to we message to children about climate change with the intent of informing without traumatizing?
 
The main issue is that a lot of people are worried about what’s happening to plants and people – that’s the message. The language. This message has to be calibrated for the age of the child. That’s why people are working so hard to make sure that we take action now, while we can. It’s language that’s up or down in terms of the child’s sophistication. We should never suggest that a child is crazy or overreacting. What we can say is that yes, it is worrisome and that’s why we’re doing [this]… The issue may come up a hundred times with kids and they may need to hear the answer a hundred times.
 
How can we educate some politicians at the policy making level to accept the fact that there is climate change and it is a health crisis?
 
We need to do everything because politicians respond to money, grassroots mobilizing, and what other colleagues are doing. Some respond to an education, to fears, to social norms, political parties, their families, etc. So it is no one size fits all approach. I do feel we need to take money out of politics because many opinions have been bought. And, as we often say, “democracy is the best form of government that money can buy.” So this is an issue.
 
The issue is no longer getting the science to people. We realized some time ago that if people needed the science they would have already been convinced because the science is there and it’s indisputable. So it is a mistake to continue to pound the science when that is no longer the demographic that needs to be reached. So the issue is reaching them through other avenues – faith-based messaging, faith leaders talking about the moral aspects of climate change: hurting the poor, vulnerable, elderly, disabled, and children. The moral message is a very important one.
 
The health message is of course critical. Every study shows that people will likely respond to health messages ahead of almost all other messages. It’s a very effective message, and health professionals are the most trusted profession in America, so we do have special privileges and responsibilities. Climate change is definitely a health crisis. Mobilizing individually but mostly on an institutional level Is the upstream impact. We are working very hard to get the American Psychiatric Association and other mental health professional organizations to help them away from their avoidance or denial.
 
What undeveloped resources are urgently needed to make a significant and immediate difference in addressing the mental health impact of climate change?
 
Thought leaders are very important. So are grass-tops and the rumblings of grassroots. The interaction between the two is a critical piece. We need to make action on climate and the realization of the mental health impacts a social norm. It’s imperative that those of us who are aware, passionate, and frantic reach out to leaders of our institutions and let them know the amazing role that mental health professionals have in delivering the social norm messaging and the stories, driving people to look at behaviors that are driving them to make personal decisions. Showing mental health professionals that this is a key contribution they can make to help relieve human suffering, and it’s consistent with who we are and the best we can be. Making this case relentlessly to people in charge is a critical action that we can take.
 
Specifically, we need to advocate that our new leaders embrace taking action on climate as one of their key issues, pointing out to them that nothing touches people more than what happens to us from repeated trauma, and that is what climate change is. It is extreme weather events, food insecurity, loss of jobs, wars, the displacement of climate refugees, it’s a national security issue. In fact, ISIS was born, just as predicted, when there was a vacuum in an unstable government, after drought forced people into cities.
 
This calls upon all of us to recognize that we are in no way prepared to help the people that are constantly being hurt – depression, anxiety, pre-traumatic stress disorders, post-traumatic stress disorders, the rise in domestic abuse that we see after extreme weather events, the increase in drug and alcohol abuse, etc. This is what we do for a living, and everything – even the illnesses that people have as the result of pollution – all of these things have an associated emotional component. This touches what mental health professionals do with patients in every way.
 
We need our leaders embracing this as a key issue in their professional lives, whether it’s transitory or ongoing. We need teams of people dedicated just to climate change. We need CME credits, we need presentations that show our colleagues how important their role is in creating the social norms. We need papers, we need action in the streets, we need psychiatrists calling on our elected officials to focus or confront their foot-dragging and what the consequences are. We need collected action, we need individual action, and all of this within the framework of institutional support makes it all the more effective.
 
1I am wondering how we can best study the links between fitness, recreation and mental health. It may be a good way to connect the conditions outside (both in terms of weather and physiology). Is there a way to study fitness and mental health, while bringing in the climate component?
 
We well know that some of us are just born with a healthy mental state, and some of us grow up an environment that reinforces (or even fixes) that, and we also know there are behavior things we can do to help with our mental health – and one of these things is exercise. We know that being in good physical shape plays a major role in blocking receptor sites that otherwise would accept anxiety-provoking substances from triggering unrest.
 
We also know that pollution is a major factor in whether or not we get outside to exercise. So people don’t bike to work on days of poor air quality, don’t run outside when it’s too hot or if the air is polluted. Sure, we can exercise indoors but then we lose the benefit of being out in nature, and of course we know what affect nature has on us—it reduces anxiety, it lowers our blood pressure. Studies show it even leads us to be more generous. So we have a convergence of all kind of forces and facts that go to acknowledging the more that we change the climate, the more it’s not conducive to how we have evolved, the less likely we’re going to be able to have the resilience and the energy to focus on what we need to do to take action. So it’s imperative that we have clean air and clean water. It’s all interconnected and necessary to address as a system.
 
What does every psychologist or psychiatrist need to know at a minimum about climate change as it relates to their profession and how can it become a greater professional priority? How can they best bring their expertise to advocating for solutions?
 
We have a unique opportunity to establish a social norm that is transformative. We now buckle up. It’s now socially unacceptable to smoke in public places. We’ve done this before. We can do this again. We need to do it.
 
Can you recommend research on why/how we need to be working on climate with youth?
 
We all know that taking action really helps with the pain of what’s happening. Empowering action does offset the sense of grief that can sometimes destroy us. So empowering collective action is one of the greatest gifts we can give to people who are suffering from something alone, lost in their thoughts. Collectively, there is an enormous empowering experience of what we can do together.
 
Capturing the adolescent search for independence – the natural wind in their sails. They are all collected on college campuses and you can reach them. They’re all there together, a natural gathering spot to reach them. They’re open to new messages — they have a history and an openness to acknowledging what’s happening. If you spent a lifetime in a job as a geologist with Exxon, it’s going to be harder than if you’re a newly minted geologist. So these are the very people that are open to the realities in a way that some of us down the road are not.
 
Does anyone know whether these climate change stressors are impacting our national obesity prevalence?
 
Yes, obesity and diabetes are both linked to pollution. Pollution is made worse by hotter temperatures and by burning fossil fuels. All you have to do is Google it and do the math. Not to mention that there are emotional reasons for eating – being anxious and depressed, seeing people suffer from illnesses, etc., and they start eating.
 
To find out more about our Climate for Health program and their diverse network of health leaders, visit www.climateforhealth.org.

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