Oliver Freudenreich, MD, FACLP Co-Director, Massachusetts General Hospital Psychosis Clinical and Research Program Director, Massachusetts General Hospital Fellowship in Public and Community Psychiatry Associate Professor of Psychiatry Harvard Medical School Boston, Massachusetts
Katherine A. Koh, MD, MSc Co-Chair, Disaster Readiness Committee, Massachusetts Psychiatry Society Assistant Professor of Psychiatry Harvard Medical School Boston, Massachusetts
Elizabeth K. Haase, MD Chair, Climate Committee, Group for the Advancement of Psychiatry Physician Chief, Carson Tahoe Regional Medical Center Behavioral Health Clinical Professor of Psychiatry University of Nevada School of Medicine at Reno Reno, Nevada
Disclosures Dr. Freudenreich has served as a consultant for Alkermes, the American Psychiatric Association, Janssen, Karuna, Neurocrine, and Vida, received research grants from Alkermes, Janssen, Karuna, and Otsuka, received medical education honoraria from Elsevier and Medscape, and received royalties from Springer Publishing, UpToDate, and Wolters Kluwer. The other authors report no financial relationships with any companies whose products are mentioned in this article, or with manufacturers of competing products.
As physicians, we are tasked by society to create and maintain a health care system that addresses the needs of our patients and the communities in which they live. Increasingly, we are forced to contend with an addition to the traditional 5 phases of acute disaster management (prevention, mitigation, preparedness, response, and recovery) to manage prolonged or even parallel disasters, where a series of disasters occurs before the community has recovered and healed. We must grapple with a sense of an “extended period of insecurity and instability” (permacrisis) and must better prepare for and prevent the polycrisis (many simultaneous crises) or the metacrisis of our “age of turmoil”57 in which we must limit global warming, mitigate its damage, and increase community resilience to adapt.
Leading by personal example and providing hope may be what some patients need, as the reality of climate change contributes to the general uneasiness about the future and doomsday scenarios to which many fall victim. At the level of professional societies, many are calling for leadership, including from mental health organizations, to bolster the “social climate,” to help us strengthen our emotional resilience and social bonds to better withstand climate change together.58 It is becoming harder to justify standing on the sidelines,59 and it may be better for both our world and a clinician’s own sanity to be engaged in professional and private hopeful action1 to address climate change. Without ecological or planetary health, there can be no mental health.
Bottom Line
Clinicians can prepare their patients for climate-related disruptions and manage the impact climate change has on their mental health. Addressing climate change at clinical and political levels is consistent with the leadership roles and professional ethics clinicians face in daily practice.
