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.
There are many ways a psychiatrist can professionally get involved in addressing climate change. Table 343-53 outlines the 3 Ps of climate action (taking actions to mitigate the effects of climate change): personal, patient (and clinic), and political (advocacy).
Personal
Even if clinicians believe climate change is important for their clinical work, they may still feel overwhelmed and unsure what to do in the context of competing responsibilities. A necessary first step is overcoming paralysis from the enormity of the problem, including the need to shift away from an expanding consumption model to environmental sustainability in a short period of time.
A good starting point is to get educated on the facts of climate change and how to discuss it in an office setting as well as in your personal life. A basic principle of climate change communication is that constructive hope (progress achieved despite everything) coupled with constructive doubt (the reality of the threat) can mobilize people towards action, whereas false hope or fatalistic doubt impedes action.43 The importance of optimal public health messaging cannot be overstated; well-meaning campaigns to change behavior can fail if they emphasize the wrong message. For example, in a study examining COVID-19 messaging in >80 countries, Dorison et al44 found that negatively framed messages mostly increased anxiety but had no benefit with regard to shifting people toward desired behaviors. The best public health messages are brief, repeated, and delivered by a trusted person.45 Good messages are targeted to a concrete concern and where action would pay off now and not in some distant future.
In addition, clinicians can learn how to confront climate disavowal and difficult emotions in themselves and even plan to shift to carbon neutrality, such as purchasing carbon offsets or green sources of energy and transportation. They may not be familiar with principles of disaster preparedness or crisis communication.46 Acquiring those professional skills may suggest next steps for action. Being familiar with the challenges and resources for immigrants, including individuals displaced due to climate change, may be necessary.47 Finally, to reduce the risk of burnout, it is important to practice self-care, including strategies to reduce feelings of being overwhelmed.
Patient
In clinical encounters, clinicians can be proactive in helping patients understand their climate-related anxieties around an uncertain future, including identifying barriers to climate action.48 Emphasizing that climate action has health benefits for them and their communities now (eg, less polluted air leading to fewer health problems related to pollution) may engage patients unsure about their role in the fight against climate change. This simple message overcomes the human preference for immediate and concrete benefits over investment in long-term gains. Some patients may respond to the suggestion that adopting a plant-based diet is beneficial for their own health as well as for planetary health, given the substantial contribution of animal farming to global warming.49
Continue to: Clinics must prepare for disasters...
