Text: Rahkia Nance, Managing Editor

As the effects of climate change make themselves become more and more apparent, a growing number of mental health professionals are recognizing its impacts on mental health—and for communities of color, the impacts are wide-ranging and severe.

The Fourth National Climate Assessment, released by the U.S. Global Change Research Program in November 2018, noted that vulnerable populations—including lower-income and other marginalized communities— have lower capacity to prepare for and cope with extreme weather and climate-related events and are expected to experience greater impacts.

It’s a scenario that’s already played out as extreme weather events such as deadly tornadoes and hurricanes have upended lives and obliterated entire communities.  

“I think about Hurricane Katrina and how communities are broken up and dispersed. It’s the poorer communities that often have to build and settle in areas that are considered undesirable by wealthier communities,” said Dr. Karinn Glover, a psychiatrist based in New York. “When poorer people—and usually in the United States, poorer people are of African descent—build and settle in areas that are flood prone and vulnerable,  then as climate change does its thing, it affects weather patterns. Being exposed to severe weather can cause trauma.”

Environmental damage also affects biodiversity, in turn affecting human food supply, diet and nutrition, Glover said. Those impacts have serious implications for pregnant women--incidence of psychotic disorders is strongly tied to maternal starvation and malnourishment.

"What happens to the mother can often be seen in the kid 20 years later, or entire generations," she said, pointing to the Dutch famine during World War II, when food supplies were cut off from the Netherlands.  "It's widely accepted that the Dutch famine caused a higher incidence of schizophrenia spectrum disorders."

A compounded issue

Rapid and severe weather changes can have clinical impacts on those with existing mental health issues, adding to the acute trauma of severe weather events.  For example, after Hurricane Maria devastated Puerto Rico in 2017, its residents were left without power for months. This type of event can trigger or exacerbate existing mental health conditions, said Dr. Carissa Caban, a Miami-based psychiatrist.

"When there is poverty and other social determinants added to a climate change event, then things get more complicated," she said. "There's no water, no power, and if you add poverty and issues with losing jobs, domestic violence, rape, aggression-- all of these things are at risk to go even higher.”

After the storm, patients had difficulty getting to providers, medication and therapy, Caban said.

“People who require psychotropic medication couldn’t maintain their medication or the insurance company wasn’t answering the phone.”

But even without severe weather events, heightened awareness of climate change can exacerbate anxiety, said Dr. David Pollack, of the Climate Psychiatry Alliance. Ecological grief can creep up in response to the change in the way people live. 

“There’s several terms, and one is solastalgia,” Pollack said, referring to the feelings of worry or hopelessness associated with climate change.  

Its symptoms can be subtle, and can mimic other conditions.

“If you don’t screen for it, you’re not going to get information from patients right away,” Caban said. “If you ask someone about their history symptoms are developing after system, obviously there’s a relationship there that needs to be explored.”

Looking ahead

The impacts of climate change are expected to continue and “further disrupt many areas of life,” according to the assessment report. “Prioritizing adaptation actions for the most vulnerable communities would contribute to a more equitable future within and across communities.”

Focusing on actions individuals can take “is probably the best antidote” for some of the anxiety that can arise, Pollack said. “That will allow people to feel like they’re not a passive bystander and have an active impact.”

Pollack said some of those actions could include adjusting the types of crops grown to account for changes in weather or using smaller cars that require less energy.  Even dietary changes, such as eating less meat, helps reduce carbon.

“We have to get people to understand that this is our life from this point forward,” he said. “Not only do we need to have the resilience in our communities to have buildings and housing that are more capable of sustaining wildfires and hurricanes, our energy systems and highways need to be capable of being adapted to this future.”

But as the climate change conversation continues, broadening the narrative to include its impacts communities of color is necessary.  To date, Caban said, little data exist about the effect climate change has had on Puerto Rico.

“I do know that for populations that are not integrated into society, their narratives are not featured or prioritized,” Glover said. “If your life or culture is undervalued or unknown or erased, I do wonder if there are health implications down the line. We don’t have to look very far in history to see what happens when communities are often disregarded in health care. It’s an outgrowth of what existed in society at that time-- a dehumanizing stance toward black patients.”