joshua.morganstein@usuhs.edu
http://www.cstsonline.org/
240-381-1192

lvs350@me.com
http://climatepsychalliance.org/
301-787-1780

robincooper50@gmail.com
http://climatepsychalliance.org/
415-642-0144

james.west@usuhs.edu
http://www.cstsonline.org/
760-583-4915

Ideas, attitudes, and opinions expressed herein
are our own and do not necessarily reflect thoseof the Uniformed Services University, the U.S.
Public Health Service, the Department ofDefense, other branches of the US government,or organizations with which we are affiliated. No
financial investment or conflicts of interest
related to thoughts and information shared.

• Didactic Content•

Global Health Effects of Climate Change•

Psychological & Behavioral Responses toClimate-Related Disasters•

Populations with Increased Vulnerability•

Preparing for and Responding to Disasters• Small Group Case Discussions• Mobile & Online ResourcesBethany, 31 y.o., PTSD
Single Family Home, owned

Tom, 26 y.o., Chronic Bipolar
Single Room Occupancy, rented

Angelica, 43 y.o., Depression
Two-bedroom apartment, rented

Lise Van Susteren, M.D.

“Ancient Sunshine”

CO2CH4Extreme weather events
increasing in frequency and intensityHurricanes
Tornadoes
Blizzards
Heat Waves

…Floods

FIRESHEAT WAVESHeat related illnesses
including stroke
Dehydration
Sensitivity to psychotropics

The relationship between hot weather
and crime is linear -- as it gets hotter,
people get more aggressive

4% between individuals

14% between groups

Extreme climate conditions
Global rise in temperature, drought, sea level riseAir pollution linked to…
•Asthma, Autism, Autoimmune disorders•

Dementia and Neurodegenerative diseases:(Alzheimers, Parkinson’s, ALS)

•In the ER: Significant increases in panic attacks
and threats to commit suicide

For a more comprehensive review:
http://www.mdedge.com/clinicalpsychiatryn
ews/article/133804/schizophrenia-otherpsychotic-disorders/hold-your-breathRising temperature and rising CO2:
growing food insecurity•

T: 10% reduction for every 1 degree C•

CO2: associated with declining levels of zinc, iron, andmagnesium in wheat, maize and soy

Infectious Diseases
Zika
Malaria
Lyme Disease
Dengue Fever
Chikungunya
Melting Siberian permafrost…

Impacts on Ecosystems
OceansBiodiversity

Species Loss60,000
50,00040,00030,00020,00010,0000160,000
B.C.

100,000
B.C.

10,000B.C.

7,000 6,000 5,000 4,000 3,000 2,000 1,000 1 1,000 2,000 2,150
B.C. B.C. B.C. B.C. B.C. B.C. B.C. A.D. A.D. A.D.
A.D.

Source: Population Division of the Department of Economic and Social Affairs at the United Nations Secretariat, World Population
Projections to 2150, (United Nations, NY, 1998).

Joshua C. Morganstein, M.D.

Leaning, J., & Guha-Sapir, D. (2013). Natural disasters,
armed conflict, and public health. The New England Journalof Medicine, 369(19), 1836–1842.

DistressResponses• Anxiety• PTSD• Depression• Complex Grief• Change in Sleep• Decreased Sense of Safety• Irritability, Distraction• Isolation, Avoidance

Health Risk
Behaviors
PsychiatricDisorders• Smoking• Alcohol• Over dedication• Change in Travel• Separation Anxiety

Ursano, R.J., Fullerton, C.S., Weisaeth, L., Raphael, B. (Eds.). (2007).
Textbook of Disaster Psychiatry. London, UK: Cambridge University Press

www.samhsa.gov

Robin Cooper, M.D.

VulnerabilityResiliency• Exposure Vulnerability• Population Sensitivity• Adaptive CapacityJoshua C. Morganstein, M.D.

FEMA designated disasters from 1970-2013 visualized byAccenture Technology Labs at http://www.disasterviz.com/

https://health2016.globalchange.gov/

https://www3.epa.gov/clim
atechange/impacts/healthassessment.html

https://ncdmph.usuhs.edu/Documents/BehavioralHealthRecom
mendations-201401.pdf

http://store.samhsa.gov/apps/disaster

Landmark article:
Five Essential Elements of Immediate and Mid-Term
Mass Trauma Intervention: Empirical Evidence
Psychiatry, 70(4), 2007
Authors: Steven Hobfoll plus 19 others
Very diverse/credible authors

The Five Elements:
Sense of Safety
Calming
Sense of Self- and Community Efficacy
Connectedness
Hope / Optimism

https://www.ptsd.va.gov/professional/materials/apps/pfa_mobile_app.asp

Biopsychosocial Interventions

VA/DOD CPG Management of PTSD, 2010 (actively under revision)

Communication is abehavioral health intervention
Disasterbehaviors havevery real lifeand death
implications.
Risk & Crisis
Communication-Open, honest,
timely, ongoing
Build credibility,trust, collaboration

The Science ofScience Communication…
Know your audience. Talk
so people understand.
Covello, V. T. (2003). Best practices in public health risk andcrisis communication. Journal of Health Communication.
Fischhoff, B. (2013). The sciences of science communication.
Proceedings of the National Academy of Sciences of the UnitedStates of America, 110 Suppl 3, 14033–14039.

Individual PatientManagement

Systems of Care

Public HealthAdvocacy

Organizations & Resources
https://www.psychiatry.org/psychiatrists/practice/professional-interests/disaster-and-trauma
https://www.psychiatry.org/about-apa/meet-our-organization/district-branches
https://www.psychiatry.org/File%20Library/About-APA/Organization-DocumentsPolicies/Policies/Position-2017-Mental-Health-Climate-Change.pdf
https://health2016.globalchange.gov/mental-health-and-well-being• https://ncdmph.usuhs.edu/Documents/BehavioralHealthRecommendations-201401.pdf
https://medsocietiesforclimatehealth.org/
https://noharm.org
http://climateforhealth.org
http://www.psr.org
http://www.nature.org/greenliving/carboncalculator/