The Climate Change Challenge for Psychiatry: Education, Career, and Community

Climate change will define the health profile of current and future generations. Already overwhelmed health systems will have difficulty to respond to the challenges that are coming. CL psychiatrists will be at the interface of medical and mental health treatment. Within academic medicine there are calls for preparation and change: Physicians must understand the science of climate. Leaders in medicine must adjust approaches to trainees, colleagues, career development, and community engagement to respond to climate concerns.



The urgency of climate and environmental health knowledge for psychiatric education

Dr. Mary Burke will discuss resources for developing climate curricula and provide a template for training. Consensus among authors on this topic is that physician education should include 6 aspects of environmental damage and how they impact mental health: Environmental justice, Psychological impacts of trauma, Toxic effects, Heat effects, Loss of natural spaces, including displacement, and Impact on water. Each module should focus on: detection and diagnosis in the context of climate change; immediate treatment; patient and family education; and advocacy work. Residents cannot be expected to be experts. However, a broader understanding of patient’s experiences, allows them to provide more informed care. In addition, certain types of therapy have a track record for treating depression associated with catastrophic loss, PTSD, and losses of cognitive function associated with neuropsychiatric conditions. This training can be integrated across PGY2-4 or inserted as Grand Rounds, without disrupting training.



The Impact of Our Changing Climate on the Work and Well Being of the CL Psychiatrist

Dr. Carol Larroque will discuss the ways in which CL psychiatry is likely to be affected by climate disasters. The patients admitted with injury and loss will often be traumatized, anxious, or depressed. The workload of the CL psychiatrist will increase. Compromised supply chain for necessary medication and equipment will lead to greater clinician stress. The emergence of new infectious diseases, especially water-borne and vector-borne diseases, will challenge our diagnostic skills. Dr. Larroque will highlight the importance that medical institutions prepare to care for doctors and other medical personnel. It is vital that CL psychiatrists are protected from compassion fatigue if we are to experience a meaningful and gratifying career.



The Ethics of Climate Change

As the AMA describes the practice of medicine as “fundamentally a moral activity…to alleviate suffering,” physicians must examine their obligations in relation to climate change. Dr. Stephen Nicolson will introduce some ethical dilemmas that we and our communities will face as the impacts of climate change are felt disproportionately by the poor, indigenous, marginalized, those at the extremes of aging, and those with mental illness. He will discuss how CL Psychiatry intersects with environmental justice. Finally, he will consider the role of physician leadership in climate advocacy.