Climate emergency wreaks havoc on mental health

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As a member of #CancelCoal campaign demanding that the government abandon its plans for new coal-fired power plants, the Center for Environmental Rights ordered a report on the psychological and mental consequences of climate change in South Africa. The report’s findings are clear and sobering: the impacts of climate change are stressful and traumatic and pose a current and material threat to mental health.

International studies on global climate change and trauma have shown that mental health issues such as suicidality, anxiety, depression and post-traumatic stress increase after climate-related events.

Common natural disasters in South Africa, such as droughts and forest fires, have made it difficult for individuals and communities to maintain their way of life and livelihoods in the face of water, food and financial insecurity. Low-income families, especially female-headed households in rural areas, struggle to recover from these socioeconomic losses and are vulnerable to what the report calls ‘climate trauma’, ‘climate anxiety’ and “ecological mourning”. This can manifest as disturbed sleep, sadness, anger, feelings of helplessness and hopelessness, and recurring thoughts of death.

Protesters take part in the global climate strike as they march past Parliament in Cape Town on September 20, 2019 (Photo: EPA-EFE / Nic Bothma)

A critical feature of the climate crisis is anticipated trauma, where individuals are affected by heightened anxiety, panic attacks, and constant worry about situations that are difficult to control – for example, many rural communities lacking or intermittent access to water in areas affected by drought. provinces such as the Eastern Cape. Whether sudden or slow and insidious, ecological degradation contributes to deep psychological distress in the face of the present and the future.

In the report, Dr Garret Barnwell, Johannesburg-based clinical psychologist and author of the report, writes:

“It is extremely difficult for the majority of South Africans to adapt to the advance of climate shocks. The same social conditions that make individuals and communities more vulnerable to climate change are the same that put people at higher risk for mental illness and psychological adversities.

While the consequences of climate change present themselves as a “collective trauma”, the impacts are not equally felt. A 2020 report published by the Lancet medical journal found that women, in a range of social and cultural contexts, are particularly vulnerable to the impacts of climate change, with women more likely to live in poverty than men, as they face discriminatory laws and practices , income insecurity and access to political decision-making spheres. Environmentally induced mental health risks are expressed in women in the form of demoralization, fatalism, depression or passive resignation to fate.

Children and future generations are particularly vulnerable and face additional challenges and affect their emotional well-being. Barnwell’s findings suggest that children turn their feelings of sadness, loss, and helplessness inward or turn these feelings out destructively through resorting to over-medication or heavy drinking.

The traumatic and stressful psychological damage to the majority of people living in South Africa is further compounded by the stories of colonialism and apartheid, which have left a legacy of extreme poverty, inequality and marginalization. The National plan for adaptation to climate change and health 2014-2019 recognizes that current conditions of inequity and vulnerability are set to be exacerbated by the climate crisis and that it is imperative that health programs and systems be strengthened to meet existing mental health needs and future demands.

mental health climate emergency
Hundreds of young people demonstrate on the lawns of Union buildings in Pretoria on March 15, 2019 as part of a global protest to highlight the climate crisis. (Photo: EPA-EFE / Laird Forbes)

“Institutional betrayal” and the government’s shortcomings

Barnwell says the mental health services currently provided by the government are woefully inadequate and contribute significantly to stressors and persistent psychological trauma. To match the most comprehensive mental health systems in the world, countries should allocate at least 5% of the total health budget to mental health. Modeled estimates for South Africa indicate that approximately 0.89% and 7.5% of South Africa’s uninsured population requiring care receive some form of inpatient and outpatient care, respectively.

A 2019 national survey suggests that the ‘treatment gap’ for people with mental disorders, epilepsy and intellectual disabilities in South Africa is around 92%, which means that less than 1 in 10 people with these disorders receives the care she needs.

In a recent Daily Maverick interview, Health Minister Dr Joe Phaahla admitted that insufficient budget allocation for mental health services had led to a shortage of psychiatrists in the public sector. Currently, 25% of psychiatrists are in the public sector while 75% work in the private sector.

A 2020 to study in Limpopo further exposed the poor working conditions of professional nurses in public sector mental health institutions. She found that insufficient resources led to a shortage of running water, poor infrastructure and drug shortages. Due to budget constraints, programs planned to sensitize and support users of mental health services have not been implemented.

The potential impact of climate change, in the context of an already ill-equipped public mental health system, can further perpetuate distress and psychological damage. Barnwell writes that this psychological background and experiences with the health care system contribute to a sense of institutional betrayal. When communities depend on government to meet their needs, they feel betrayed when their government continues to perpetuate the harm by failing to take corrective action or mitigate the harm when these potential harms are well known.

For example, in 2007 the government designated the Highveld as a “priority area” due to its poor air quality, yet more than a decade later with a air quality management plan in place, little has changed for the millions of people in the Highveld. The region, which has been identified as one of the worst places in the world for air pollution, is home to 12 of Eskom’s coal-fired power plants. Every day, the 4.5 million people living and working on the Mpumalanga Highveld breathe this poisonous, polluted and deadly air that harms their health and well-being. In a landmark case, dubbed the Fatal air case, heard earlier this year by the Johannesburg High Court, GroundWork and Vukani Environmental Justice Movement in Action took the important step of challenging the government’s refusal to take adequate action to prevent more than 2,200 premature deaths each year from the atmospheric pollution.

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A woman and her baby in a flooded informal settlement in Bloekombos, Kraaifontein, Cape Town, July 1, 2021. (Photo by Gallo Images / Brenton Geach)

The now expired National mental health policy framework and 2013-2020 strategic plan (according to the Ministry of Health, a new framework policy is underway) did not include an action plan on the impacts of climate change on mental health. The strategic plan simply invokes the language of the Constitution and pretends to say that mental health and environmental rights will be realized over an indefinite period and within the limits of available resources.

However, it is questionable whether the health ministry will have the capacity to provide general mental health services, let alone climate shocks, when the national budget tabled in February of this year planned to cut public health spending by ‘a 50.3 billion rand over the next three years.

Barnwell says, “As we know from the Covid-19 pandemic, preparedness is everything, and in the case of climate change, we know he’s already with us and will decisively affect the most vulnerable people.” South Africa’s health institutions and services at present are not at all resilient to climate change and present many vulnerabilities.

As the climate emergency accelerates, our mental health system needs investments to strengthen and sustain disease surveillance, identification and support of vulnerable communities, preparedness of health facilities and, most importantly, to build public confidence. To achieve this, the new mental health policy framework should include planning for climate change adaptation in the mental health system; initiate community intervention with climate change resilience plans that address psychosocial well-being; provide special training for health care providers and first responders, for example in psychological first aid; and urgently improve access to and funding for mental health care.

#CancelCoal’s demands for a just transition away from fossil fuels must include the establishment of a fair, reliable and prepared health system. If the Covid-19 pandemic has taught us anything, it’s that the health system will often be on the front line of a given crisis. SM / MC

Mbalenhle Baduza is a legal researcher in the Health Rights Program at Section27.

This article is part of the Spotlight Mental Health Series.

Note: This article is written by a Section27 employee. Spotlight is published by Section27 and the Treatment Action Campaign, but is editorially independent – an independence editors jealously guard. The opinions expressed in this article are not necessarily shared by Spotlight.

This article was first published by Projector – public interest health journalism.

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