The two great challenges threatening humanity’s very existence are Covid-19 and Climate Change. Are there similarities between the two? If so what kind of linkages? Are there lessons to be learned from the handling of Covid-19 and its impact on mental health? Will these lessons be learnt and help us in dealing with the mental health impact of climate change?
Warnings of science were unheeded for decades in both instances. Scientists had been warning about a pandemic since at-least 2007 and exhorting preventive action and science has been showcasing the precipitous loss of species, rising temperatures and loss of habitat for a number of decades and warning about the threat of Climate Change to both human health and existence. For decades we have watched the rising temperatures, the heatwaves, the increasing frequency of floods and wildfires, in denial of the fast-approaching catastrophe and our role in its causation. There is one crucial difference between the two. Covid-19 soon after its emergence in late 2019 spread like wild-fire and the effects were tangible. The scale of suffering and deaths was hard to ignore. Not so with climate change. It has not yet reached the threshold of tangibility apart for the small island nations!
The saga of suffering, death, the daily media briefings, the lockdowns, the race to develop a vaccine, the protests against loss of freedom and wearing of masks is well known and does not need repeating.
While the press coverage and media stories were highlighting the daily cases and death rates and focusing on saving lives and physical issues and rightly so, another picture in juxtaposition, was emerging in conversations with frontline healthcare workers and social media stories. A story of lockdown loneliness leading to low mood, depression and despair which was borne stoically by the elderly, a spate of theories about the “real cause” of Covid-19, conspiracy/alternative explanation theories with very little evidence spreading like wildfire on social media. Uncertain times are fertile ground for the growth of irrational ideas and instability.
But what has been the effect of two years of uncertainty, which incidentally continues? The fear, anxieties, depression, loneliness, and despair many of us felt both from listening to the stories of suffering and deaths, as well as from the lockdowns and curtailment of freedoms to socialise was nothing short of a collective Neurosis. And our response, Schizophrenic.
Race to develop a vaccine and the campaigns and marches by the Anti-Vaccine Lobby.
Masks and Social distancing vs the backlash against wearing masks and respecting personal space.
The freedom to roam free and the necessity of stopping the spread.
The sudden emergence of “expertise” amongst laypeople and the erosion of trust in experts and people in power.
And the neurosis continues and the Schizophrenia rages unabated with the emergence of yet more virulent strains and controversial reports about how the WHO has avoided naming the new strain as it clashes with the leader of a certain country.
We are not yet out of the woods and Covid-19 is still not conquered. Perhaps, we will never conquer it but come to terms with it and learn to live alongside it.
If that is the case with Covid-19, then what about the Climate Change Challenge?
Writing in the Bulletin of The Atomic Scientists in 2016 Eva Gifford and Robert Gifford commented, “In all of the coverage of climate change in the popular press, relatively little attention has been paid to one aspect: mental health. Rising seawaters, increasingly strong storms, and more ferocious droughts caused by climate change are not only devastating to physical infrastructure but also affect human beings in other ways as well: people lose their homes, their jobs, their family members, and their communities. Researchers have found that climate change can cause not only posttraumatic stress disorder (PTSD) from the trauma of displacement from extreme weather events such as Hurricane Katrina but also “pre-traumatic” stress disorder, or, moderate to extreme anxiety about a looming crisis.”
Nothing much has changed in the last five years. Not only does the coverage in the popular press of the effects of climate change on human health is still heavily weighted towards physical health effects and neglects the impact on mental health and human psychology, even the Environmental Audit Committee report “Our Planet Our Health” highlights physical health issues and barely mentions mental health problems, as follows.
“We are concerned that the NHS and the pharmaceutical industry is not sufficiently resourced to deal with these projected changes. Non-communicable diseases (NCDs) kill 41 million people each year, equivalent to 71 per cent of all deaths globally. We note that more people now die from non-communicable diseases than communicable diseases. We also note the recent stalling in life expectancy in the UK as a result of lifestyle changes with increased pressure for NHS resources. Public Health England should broaden its key performance indicators to include climate resilience and adaptation measures to tackle emerging diseases. These should include guidance to general practitioners and the pharmaceutical industry on Lyme disease, malaria, the zika virus and other emerging tropical diseases. We repeat our recommendation from our toxic chemicals report that Public Health England should introduce a comprehensive UK wide human and wildlife bio-monitoring scheme to measure the effects of toxic chemicals. A focus on lifestyle change means that it does not prioritise the impacts that wider economic and ecological changes will have on human health. Secondly, Public Health England must work across Government to advise local Government on the impacts of heat stress and protecting vulnerable communities, particularly the elderly, people living in care homes and those with kidney failure.”
And as for mental health in this report –
“Eco-anxiety, has emerged as a psychological disorder afflicting an increasing number of people concerned about the environmental crisis and suffering a sense of grief or loss. Eco-anxiety has been described by the American Psychological Association as “chronic fear of environmental doom”.
Our disregard of matters concerning the mind in contrast to our focus on the body is perhaps a reflection of the Cartesian duality which split the mind from the body and scientific materialism which gives primacy to matter and body. Can we deny the effects of bodily ailments on the mental health of a person? Can we brush under the carpet the effect of stress and other mental problems on immunity and other physical parameters? No!
But we do…
The BMA commenting on the autumn budget recently announced by the Chancellor, have highlighted.
- The announcement falls significantly short of the BMA’s call for investment of at least £4.6 billion a year by 2023/24.
- Mental health services for children and young adults – services that were already stretched and struggling, allocated nothing more than the inadequate £500m previously promised in March as part of the mental health recovery plan.
- Given the compounding effect of COVID-19 on the population’s mental health, with a 29% increase in the number of people referred to mental health services for their first suspected episode of psychosis between 2019 and 2021, urgent investment is needed in this area.
So what hope for “Parity Of Esteem”? It morphed into Mental Health Investment Standard.
As chair of a CCG in 2016 I heard quite a bit about the resolve to end stigmatisation of mental health and levelling up of services and resource allocation for mental health in proportion with the problem. Has it remained a pipe dream?
A cursory glance at the NHS Mental Health Dashboard for Q1 2021/22: NHS England » NHS mental health dashboard shows that all 106 CCGs are meeting their MHIS. Is this really true? And, only a few indicators show red dots on the dashboard. So is everything hunky dory?
Perhaps generalisations hide the gaps that granularity would reveal. Don’t we still hear the tales of interminable waits for assessments of children for autism and ADHD? Does the offer of a treatment within two weeks of contact in Psychosis really mean treatment has been started? Are there no loopholes that allow for obfuscation?
But then resources are finite and cannot keep pace with the demand on the NHS for providing the latest services. It might have been possible to provide universal healthcare when the NHS was set up. But medical practice has seen a sea change with technological advances, newer medicines and investigation techniques and it is impossible that any government can provide for all this while also focusing on education, defence etc. So the demands for more money for mental health services will fall on deaf ears.
So, what is the answer? Lockdown has shown us the noble side of humanity, the side that delivered food and shopping to housebound vulnerable individuals, the side that rose up to the challenge of lifting up our spirits and showing appreciation to the brave healthcare workers. A sense of community.
Even if we ignore the concept of quantum entanglement, can we ignore the interconnectedness of our globe as evidenced by the rapid spread of Corona Virus. Will the effects of Climate Change remain isolated to one area of the globe. Will the repercussions not spread throughout the globe? When we can have global corporations, global finance and global cultures, why not global communities? Cohesive, compassionate, caring global communities.
Likewise, we need a bigger role to be played by corporations and big business as part of their corporate social responsibilities.
A call for the Business and Corporate sector to assist in the response to face the climate change challenge at COP26 is very appropriate in these times.
So when the global governments leave gaps, be it with the resources for mental health or meeting the juggernaut of climate change, cooperative endeavours between businesses, government and communities are the solution. Only then can we survive these existential challenges.
Dr Ishak Nadeem was a GP Partner at Grovelands Medical Centre for 16 years. His career comprises of several chapters, after qualification and post graduate training in India he worked for about 6 years in Saudi Arabia, moving to UK in 1994 he trained to become a General Practitioner. Moving on to senior management he was on the Governing Body of South Reading CCG from 2012 till 2016, the last two years as Chair during which he gained experience of the challenges of commissioning and the demands on NHS. He has since moved on to a full time role as Occupational Physician with TPhealth providing occupational health services to the Atomic Weapons Establishment.
His other passions are photography, poetry and writing. He self published a book of pictures and poems – Rhythm Of Life, in aid of Dingleys Promise, and raised £1000.00.
Further he is the founder chairman of OneNature-CommonWealth CIO which aims to raise funds for projects which help build sustainable communities, protect environment and promote biodiversity throughout the Commonwealth. Visit their website at www.onenaturecommonwealth.org