Climate Change and Human Well-Being: Global Challenges and Opportunities

International and Cultural Psychology Series Editor Anthony J. Marsella, Ph.D. For further volumes: http://www.spring...

Author: Inka Weissbecker

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International and Cultural Psychology

Series Editor Anthony J. Marsella, Ph.D.

For further volumes: http://www.springer.com/series/6089

Inka Weissbecker Editor

Climate Change and Human Well-Being Global Challenges and Opportunities

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Editor Inka Weissbecker Washington, DC [email protected]

ISSN 1574-0455 ISBN 978-1-4419-9741-8 e-ISBN 978-1-4419-9742-5 DOI 10.1007/978-1-4419-9742-5 Springer New York Dordrecht Heidelberg London Library of Congress Control Number: 2011931515 © Springer Science+Business Media, LLC 2011 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com)

Preface

Climate change is one of the most significant global challenges facing us in this century and beyond. The work of this volume has been inspired and preceded by various efforts and events, which continue to pave the way for including mental health and psychosocial well-being aspects in the global discourse on climate change. Aspects of mental health and well-being are still largely missing from the global public health agenda, and climate change is no exception. We hope that this volume will contribute to encouraging others to consider multiple and complex effects on climate change on the most vulnerable groups and populations and to provide better-informed interventions and policies that are culturally informed and participatory. This volume grew from different initiatives and events taking place at the United Nations and elsewhere around the topic of global climate change and civil society engagement. The 60th Annual DPI/NGO Conference at the United Nations in New York (September 5 to 7, 2007), had the theme “Climate Change: How it impacts us all.” This conference brought together United Nations agencies with various actors from different civil society organizations across the globe around the common goal of addressing the challenges of climate change. Conference participants included 1726 individuals representing over 500 nongovernmental organizations from more than 62 countries (DPI/NGO Drafting Committee, 2007). I participated in this conference as an NGO representative of the International Union of Psychological Science (IUPsyS) to the United Nations Economic and Social Council and Department of Public Information. I was fortunate to be able to contribute, along with other psychologists and stakeholders, to the drafting of the “60th Annual DPI/NGO Conference Declaration Climate Change Threats – An NGO Framework for Action” (DPI/NGO Drafting Committee, 2007). The declaration affirmed that “climate change is mainly anthropogenic and is one of the most serious threats to humanity and our environment” and recognized “significant psychological and emotional distress to individuals and communities” as one of the many impacts of climate change. The declaration called for working over a period of the next 12 months to elaborate on a “Framework for Action” that would recognize challenges and opportunities and propose NGO solutions to the threat of climate change. The framework discussion was going to “culminate in an internet-based

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progress report to be submitted to the Secretary-General in one year,” with the goal of a more long-term dialogue, which would bring together a network of NGOs that might not otherwise typically collaborate by bridging the spectrum of NGO concerns interconnected by climate change” (DPI/NGO Drafting Committee, 2007). Under the leadership of Larry Roeder (NGO representative and drafting committee member), the DPI/NGO Executive Committee established a working group and then a nonprofit NGO (ClimateCaucus.net), which facilitated online working groups, and a report on climate change from the NGO perspective, which was delivered to the UN Secretary General in December of 2009. I led one of the working groups that produced a chapter on climate change and mental health as part of this report. The chapter was produced together with others from various civil society organizations and academic disciplines and formed one of the starting points for this book. The literature connecting mental health and climate change was scarce at that time, with an electronic database (PsychInfo) only returning one relevant article on the topic (Fritze, Blashki, Burke, & Wiseman, 2008). At the same time, the American Psychological Association (APA, 2009) assembled a task force to produce a report outlining theoretical foundations, potential contributions, and policy recommendations for addressing climate change informed by the field of psychology. Furthermore, the second Annual Psychology Day at the United Nations in 2008 explored climate change as one of the aspects of social justice. As outlined in this volume, climate change is expected to have the most devastating effects on low-resource and developing countries, who contribute relatively little to climate change compared to more wealthy nations. Addressing the threat of climate change is therefore not only an urgent issue but also a social responsibility among more industrialized nations. With the 2009 Copenhagen conference, momentum and discussions around climate change continued to grow. Yet, the implications and impact on mental health and well-being were mostly absent from discussions about climate change (Page & Howard, 2010). However, the literature on climate change and mental health and well-being continues to grow in scope, and it is hoped that such efforts will result in tangible benefits for the most at-risk populations and groups. The purpose of the book is to contribute to such efforts by shedding light on current scientific and empirical evidence on the impact of climate change on psychosocial well-being and mental health from different perspectives. The book is organized into three complementary sections, the first on the impact of climate change, the second on special populations, and the third on specific recommendations. Each of the chapters in this book explores one key aspect of climate change and well-being, which is informed by multidisciplinary perspectives. The chapters comprising this book provide various examples of how collaboration, dialogue, and the synthesis of ideas can happen across different schools and disciplines, resulting in recommendations for research, practice, and policy. Chapter 1 gives a general overview of the projected impact of climate change (climate-induced processes such as temperature rises, climate variability, and extreme weather events) and its relevance for human well-being, including mental health and psychosocial factors. Previous work of psychologists and mental health professionals is discussed and put into context, highlighting social justice aspects

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and the complex direct and indirect effects of climate change. This chapter sets the stage for a more-detailed examination of different aspects and implications for human well-being in this volume. The psychological threat of climate change is examined in Chapter 2, written by Joseph Reser, Shirley Morrissey, and Michelle Ellul at the School of Psychology at Griffith University. Dr. Reser has been part of the task force of the American Psychological Association, and has generated a report on the interface between psychology and global climate change (APA, 2009). Dr. Morrissey is a clinical and health psychologist with extensive experience in the disaster area and anxiety management. This chapter makes clear not only that devastating environmental effects of a changing climate will impact health and well-being but that public perceptions and construction of this threat can have a significant impact with the potential of increasing distress and anxiety. The chapter draws from various interdisciplinary perspectives and examines the social construction and public perception of the climate change threat, concluding with a discussion of potential contributions of psychologists. Chapter 3 is written by Dr. Glenn Albrecht, who is Dean and Professor at the School of Sustainability at Murdoch University in Australia. Dr. Albrecht was the one to first coin the term “solastalgia” to describe the psychological distress caused by climate-related environmental changes and degradation in rural Australia and beyond. It is suggested in this chapter that climate change, which compromises the healthy link between people and their home territory, can increase the prevalence of “psychoterratic illnesses” such as solastalgia or “eco-anxiety”. Dr. Albrecht’s work has contributed to raise awareness of potential psychological effects of climate change, which has been picked up by other scholars and the popular media. The effects of extreme weather-related events such as disaster on mental health in the context of climate change are covered in Chapter 4. Dr. David Simpson is professor of community development and director of the Center for Hazards Research and Policy Development, while Dr. Sandra Sephton is a professor in the Department of Psychological and Brain Sciences at the University of Louisville. This chapter is an example of a collaboration of different disciplines, examining the effects of disaster from biobehavioral and disaster preparedness and response perspectives. The chapter outlines effects of extreme weather events and offers recommendations for policy and practice. Chapter 5 synthesizes the emerging literature on climate change and humanitarian crises with that on mental health and psychosocial support. Jennifer Czincz is currently completing her internship in clinical psychology at Yale University. She has written on the role of psychology in international affairs and completed global projects in different locations such as the Philippines. This chapter discusses shortcomings and challenges in providing psychosocial and mental health interventions during humanitarian crises and outlines current recommendations and best practices based on empirical literature and agency guidelines. The potential implications of climate change for security and violent conflict are critically explored in Chapter 6. This chapter draws on the extensive experience and knowledge of Dr. Chad Briggs who currently serves as Minerva Chair of Energy &

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Environmental Security at the US Air Force. He is also a senior associate at Adelphi Research in Berlin and a Fellow at the Institute for Environmental Security in The Hague. Dr. Briggs was previously senior adviser for International Security Affairs to the US Department of Energy’s Energy and Environmental Security Directorate and professor of International Relations and Environmental Risk at Lehigh University in Pennsylvania. He has also conducted research and field work in eastern and southeastern Europe. This chapter outlines the complexities and controversies surrounding potential links between climate change and conflict and offers perspectives from the field of peace psychology. In Chapter 7, Dr. Anita Wenden explores the role of women as one specific group affected by climate change and as a potential change agent. She is cofounder of Earth and Peace Education International (www.globalepe.org) and director of Peace Education and Research for the organization. She is Professor Emerita of York College, City University of New York, where she cofounded and served as director of the College’s Cultural Diversity Program. She is the main NGO representative for the International Peace Research Association at UN headquarters in New York City, where she established and chairs the NGO Committee on the Status of Women’s Subcommittee on Women and Climate Change. The chapter describes how socially constructed gender roles contribute to the vulnerability of women to climate change and offers perspectives on how adapting to climate change can challenge women to take leadership in their communities. Rising sea levels and coastal flooding as well as other adverse environmental conditions such as droughts or disasters may cause further large-scale population displacement or “environmental refugees.” Chapter 8 offers a multidimensional perspective on the impact on mental health and well-being among such refugees within various theoretical frameworks. Dr. Michael Hollifield has published extensively in the area of refugee mental health and is currently working as a scientist at the Behavioral Health Research Center of the Southwest (a center of Pacific Institute for Research and Evaluation) as well as an adjunct associate professor, at the University of New Mexico and University of Louisville. Dr. Mindy T. Fulllilove is a research psychiatrist at New York State Psychiatric Institute and professor at the Joseph L. Mailman School of Public Health, Columbia University. Dr. Fullilove’s work on the mental health effects of environmental processes, health problems caused by inequity, and the connection between mental health and sense of place is well known and has specific relevance in the context of climate change. Dr. Stevan Hobfoll is the Judd and Marjorie Weinberg Presidential Professor and Chair at the Department of Behavioral Sciences at Rush University Medical Center. He has developed the “conservation of resources” theory and made substantial contributions in the area of stress and trauma. This chapter discusses aspects of the refugee experience such as loss of resources and of a sense of place and identity and concludes with recommendations for preventing and responding to effects on mental health and well-being. In the context of disaster and crises, the emphasis is shifting from identifying vulnerabilities and what is missing in crisis to considering people’s own strategies for coping and adapting. Chapter 9 explores concepts such as resilience,

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posttraumatic growth, and spirituality, which have increasingly been recognized as important to individual and community recovery. This chapter draws on fieldwork conducted by Dr. Tamasin Ramsay after the Orissa cyclone in India and on theoretical foundations of constructing meaning, re-authoring, and posttraumatic growth. Dr. Ramsay, a paramedic and anthropologist, has made contributions to understanding the relationship between faith, response to disaster, and forms of outreach and care. Dr. Lenore Manderson is a medical anthropologist and social historian at Monash University whose research examines social relationships and identity within cross-cultural contexts. This chapter describes emerging concepts of culture, resilience, and spirituality within the context of climate change and offers practical recommendations. Climate change and weather-related events can overwhelm local capacity, especially in settings with lower resources. Chapter 10 provides insight into the concept of community resilience within the context of climate change. Taegen Edawards is a Research Fellow of Climate Change and Social Justice and Dr. John Wiseman is director of the McCaughey Centre, VicHealth Centre for the Promotion of Mental Health and Community Wellbeing at the School of Population Health at the University of Melbourne. The chapter synthesizes evidence about the characteristics that strengthen community resilience to the threats and challenges of climate change and outline locally relevant actions that can help communities reduce risk and adapt. Chapter 11 highlights key aspects of previous chapters and offers conclusions for addressing the global impact of climate change on human well-being, while considering research, practice, and policy implications within a framework of cultural competency. Together, the chapters of this book highlight not only the urgent needs and challenges but also the opportunities for collaboration and for pursuing common goals to reduce the threat of climate change and mitigate effects on mental health and psychological well-being. We hope that this book will benefit mental health professionals such as psychologists, psychiatrists, and social workers, as well as social science researchers, public health professionals, development and humanitarian workers, policy makers, and students from various disciplines. This volume also represents a call for not only joining the global dialogue on climate change but also contributing to specific and tangible actions at the local and global levels, with the aim of improving mental health and well-being and reducing inequities worldwide.

References American Psychological Association. (2009). Psychology and global climate change: Addressing a multi-faceted phenomenon and set of challenges a Report by the American Psychological Association’s Task Force on the Interface Between Psychology and Global Climate Change. Washington, DC: American Psychological Association DPI/NGO Drafting Committee. (2007). 60th Annual DPI/NGO Conference Declaration. Climate Change Threats – An NGO Framework for Action. Final Declaration, New York City, September 6th, 2007. Retrieved November 15, 2007, from http://www.climatecaucus.net/ images/Final_Declaration.pdf

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Fritze, J. G., Blashki, G. A., Burke, S., & Wiseman, J. (2008). Hope, despair and transformation: Climate change and the promotion of mental health and wellbeing. International Journal of Mental Health Systems, 2(1), 13. Page, L. A., & Howard, L. M. (2010). The impact of climate change on mental health (but will mental health be discussed at Copenhagen? Psychological Medicine, 40(2), 177–180.

Acknowledgments

The completion of this volume would have not been possible without the invaluable support of various individuals. First, I would like to acknowledge the hard work and dedication shown by each of the authors and coauthors who have contributed chapters to this volume. All of them have brought a valuable and unique perspective to this book, which together sheds light on various aspects and facets of climate change and well-being. They have also bridged divides among several disciplines, making a valuable contribution for promoting a better and more detailed understanding of the complexities of climate change and possible solutions. I am deeply thankful for their efforts. I also want to express my appreciation and gratitude to the series editor, Dr. Anthony Marsella, who has been extremely supportive, patient, and resourceful throughout the process. This work would also not have been possible without the support and editorial work from Ms. Anna Tobias, Associate Editor in Psychology at Springer, throughout the publication process. I also want to thank my friends and family who have been a constant source of encouragement and motivation.

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Contents

1 Introduction: Climate Change and Human Well-Being . . . . . . . Inka Weissbecker Part I

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The Impact of Climate Change

2 The Threat of Climate Change: Psychological Response, Adaptation, and Impacts . . . . . . . . . . . . . . . . . . . . . . . . Joseph P. Reser, Shirley A. Morrissey, and Michelle Ellul

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3 Chronic Environmental Change: Emerging ‘Psychoterratic’ Syndromes . . . . . . . . . . . . . . . . . . . . . . Glenn Albrecht

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4 Extreme Weather-Related Events: Implications for Mental Health and Well-Being . . . . . . . . . . . . . . . . . . . . . . . . . David M. Simpson, Inka Weissbecker, and Sandra E. Sephton

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5 Humanitarian Crises: The Need for Cultural Competence and Local Capacity Building . . . . . . . . . . . . . . . . . . . . . Inka Weissbecker and Jennifer Czincz

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6 Security and Conflict: The Impact of Climate Change . . . . . . . Chad Michael Briggs and Inka Weissbecker Part II

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Specific Populations

7 Women and Climate Change: Vulnerabilities and Challenges . . . Anita L. Wenden

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8 Climate Change Refugees . . . . . . . . . . . . . . . . . . . . . . . Michael Hollifield, Mindy Thompson Fullilove, and Stevan E. Hobfoll

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Part III

Guidance and Recommendations

9 Resilience, Spirituality and Posttraumatic Growth: Reshaping the Effects of Climate Change . . . . . . . . . . . . . . Tamasin Ramsay and Lenore Manderson

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Climate Change, Resilience and Transformation: Challenges and Opportunities for Local Communities . . . . . . . Taegen Edwards and John Wiseman

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Conclusions: Implications for Practice, Policy, and Further Research . . . . . . . . . . . . . . . . . . . . . . . . . Inka Weissbecker

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Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Contributors

Glenn Albrecht Institute for Sustainability and Technology Policy (ISTP), Murdoch University, Perth, WA, Australia, [email protected] Chad Michael Briggs Air University, USAF, Maxwell Air Force Base, AL, USA, [email protected] Jennifer Czincz Yale University School of Medicine, New Haven, CT, USA, [email protected] Taegen Edwards Melbourne Sustainable Society Institute, University of Melbourne, Melbourne, VIC, Australia, [email protected] Michelle Ellul School of Psychology, Griffith University, Gold Coast, Queensland, Australia, [email protected] Mindy Thompson Fullilove Community Research Group, New York State Psychiatric Institute, New York, NY, USA; Joseph L. Mailman School of Public Health, Columbia University, New York, NY, USA, [email protected] Stevan E. Hobfoll Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA, [email protected] Michael Hollifield The Behavioral Health Research Center of the Southwest, Pacific Institute for Research and Evaluation, Albuquerque, NM, USA; University of New Mexico, Albuquerque, NM, USA; University of Louisville, Louisville, KY, USA; Program for Traumatic Stress, The VA Long Beach Healthcare System, Long Beach, CA, USA, [email protected] Lenore Manderson Social Sciences and Health Research Unit, Faculty of Medicine, School of Psychology and Psychiatry, Monash University, Caulfied East, VIC, Australia, [email protected] Shirley A. Morrissey School of Psychology, Griffith University, Gold Coast, Queensland, Australia, [email protected]

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Contributors

Tamasin Ramsay Social Sciences and Health Research Unit, Faculty of Medicine, Nursing and Health Sciences, School of Psychology and Psychiatry, Monash University, Caulfied East, VIC, Australia, [email protected] Joseph P. Reser School of Psychology, Griffith University, Gold Coast, Queensland, Australia, [email protected] Sandra E. Sephton Department of Psychological and Brain Sciences, J.G. Brown Cancer Center, University of Louisville, Louisville, KY, USA, [email protected] David M. Simpson Department of Urban and Public Affairs, Center for Hazards Research and Policy Development, University of Louisville, Louisville, KY, USA, [email protected] Inka Weissbecker Washington, DC, [email protected] Anita L. Wenden Earth and Peace Education International (EPE), Rego Park, NY, USA; NGO/CSW Subcommittee on Women and Climate Change, New York, NY, USA, [email protected] John Wiseman Melbourne Sustainable Society Institute, University of Melbourne, Victoria 3010, Australia, [email protected]

Chapter 1

Introduction: Climate Change and Human Well-Being Inka Weissbecker

Introduction Climate change has been called the greatest challenge currently faced by humanity (Ki-moon, 23 June 2009). Our world is becoming increasingly interconnected and interdependent, which brings not only complex challenges but also new opportunities for collaboration in working toward common goals. There is scientific consensus that climate change is caused by human activity, which brings with it the burden of responsibility and the opportunity to take measures of mitigation. However, climate change is also a reality that will require adaptation. Researchers around the world have been engaged in investigating how climate change has and will continue to impact the world (IPCC, 2007b). Climate change is expected to increase the severity of disasters and adverse weather conditions worldwide, with particularly devastating effects on developing countries and individuals with lower resources. The literature on climate change is rapidly expanding in scope, covering a wide range of topics and scenarios. Various researchers, groups, and agencies have started to investigate the impact of climate change on issues such as health (Costello et al., 2009), security and conflict (Smith & Vivekananda, 2007), and human development (United Nations Development Programme, 2007), as well as on groups such as women (Aguikar, 2009; Carvajal-Escobar, Quintero-Angel, & Garcıa-Vargas, 2008) and children (Shea, 2007; UNICEF, 2007). It has been recognized by several authors that climate change has the potential to profoundly impact human well-being, and that individuals and communities play an important role in responding and adapting to climate change (Fritze, Blashki, Burke, & Wiseman, 2008; American Psychological Association, 2009; Berry, 2009). However, potential contributions from the field of psychology are often missing from discussions about climate change, and possible impacts on mental health and psychosocial well-being are rarely discussed. Contributions of psychologists and mental health professionals

I. Weissbecker (B) Washington, DC e-mail: [email protected]

I. Weissbecker (ed.), Climate Change and Human Well-Being, International and Cultural Psychology, DOI 10.1007/978-1-4419-9742-5_1, C Springer Science+Business Media, LLC 2011

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in the context of climate change are now beginning to emerge (Morrissey & Reser, 2007; Fritze et al., 2008; Gifford, 2008; American Psychological Association, 2009; Kazdin, 2009; Berry, 2009; Nolan, 2009; Psychologists for Social Responsibility, 2010; Berry, Bowen, & Kjellstrom, 2010; Nurse, Basher, Bone, & Bird, 2010; Page & Howard, 2010). In 2009, the American Psychological Association (APA) task force, which has been formed to examine the “interface between psychology and global climate change,” released a comprehensive report, which reviewed psychological research on perceptions and conceptions of global climate change, human activities that drive climate change, the psychosocial impacts of climate change, barriers to responding to climate change, and human responses to climate change via adaptation and mitigation (American Psychological Association, 2009). The task force concluded that psychology had much to offer in assisting policy makers, governments, and various organizations, but that there was also a strong need to more fully engage the psychology community in climate change discussions (American Psychological Association, 2009). Indeed, former APA president Alan Kazdin has identified climate change and environmental degradation to be one of society’s great challenges and has called upon psychologists to take on this challenge, with the aim of having a visible and tangible impact (Kazdin, 2009). In the following sections, I will review current predictions and the projected impact of climate change, discuss who will be most affected by climate change, and explore ways in which psychologists and mental health professionals can contribute to a more comprehensive understanding of climate change impact and responses.

What is Climate Change? Climate Change Predictions Projected manifestations of climate change include wide-ranging changes in weather patterns, higher temperatures, rising ocean levels, shifts in climatic zones and ecosystems, increased pollution, and more weather fluctuations (IPCC, 2007a). Climate change has been defined by the Intergovernmental Panel on Climate Change (IPCC) as “any change in climate over time, whether due to natural variability or as a result of human activity” (IPCC, 2007b). The IPCC is an international panel of over 2,000 leading scientists around the world from over 130 countries that was established by the World Meteorological Organization (WMO) and the United Nations Environment Program (UNEP) in 1989 (IPCC, 2007c). In 2007, the IPCC published its Fourth Assessment Report and received the Nobel Peace Prize along with Al Gore for “their efforts to build up and disseminate greater knowledge about manmade climate change, and to lay the foundations for the measures that are needed to counteract such change” (IPCC, 2007c). The IPCC is currently working on its Fifth Assessment Report, which is expected to be finalized in 2014. Findings from the Fourth IPCC report have been widely publicized and also form part of the scientific foundation of this book.

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The Greenhouse Effect Climate change is the result of rising greenhouse gas emissions, which are a product of increasing industrialization (IPCC, 2007b). The main greenhouse gas is CO2 , followed by methane, nitrous oxide, aerosols, and others such as ozone-forming chemicals (IPCC, 2007b). Greenhouse gases can stay in the atmosphere for many years and trap solar radiation, which causes a warming of the earth’s surface and the troposphere, referred to as the “greenhouse effect” (IPCC, 2007b). Concentrations of CO2 in the atmosphere have been estimated to have increased by 31% since 1750 (IPCC, 2007b). The major contributors to greenhouse gases include the burning of fossil fuels, changes in land use such as deforestation, and agriculture (IPCC, 2007b). Climate change is the result of complex processes that impact the atmosphere, land surface, oceans, and cryosphere (snow, ice, and permafrost). Climate scientists predict a continuing rise in global temperature as well as sea level and changes in precipitation. The IPCC has developed a range of possible scenarios for the progression of climate change over the coming decades, which are dependent on different factors such as economic growth, changes in population size, and future greenhouse gas emissions (IPCC, 2007b). Based on these scenarios, predictions include various possible changes with wide-ranging implications detailed in the next section. Temperature Increase Global surface temperatures have already increased by 0.74◦ C between 1906 and 2005, which is partially attributable to human activity (IPCC, 2007b). Furthermore, eleven of the 12 years from 1995 to 2006 ranked among the twelve warmest years on the record since 1850 (IPCC, 2007b). The IPCC predicts that temperatures will continue to increase about 0.2◦ C per decade, considering various emission scenarios. Even if the concentrations of all greenhouse gases had been kept constant at year 2000 levels, a further warming of about 0.1◦ C per decade would be expected. At the end of the 21st century, the global mean temperature is projected to be between 1.1 and 6.4◦ C higher than the temperature in 1980–1999, with a best estimate between 1.8 and 4.0◦ C (IPCC, 2007b). Fewer cold days and more hot days as well as more frequent heat waves are likely to result (IPCC, 2007b). Average temperature increases are going to be greatest in the northern regions of North America, Europe, and northern and central Asia (IPCC, 2007a). Sea Level Rise Sea levels have already risen about 17 cm (12–22 cm) during the 20th century (IPCC, 2007b). Increases in average ocean temperature, losses in ice sheets, as well as decreases in glaciers and icecaps are expected to continue, contributing to further sea level rise (IPCC, 2007b). Taking into account the melting ice from Greenland and Antarctica, a rise of 28–79 cm is expected by 2100 (IPCC, 2007b). However,

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the complete melting of the Greenland and the West Antarctic ice sheets would lead to a contribution to sea level rise of up to 7 m and 5 m, respectively (IPCC, 2007b). This could have catastrophic effects for many human settlements along coastlines and in low-lying areas (IPCC, 2007b). Precipitation Scientists predict changes in rainfall patterns, which will differ, depending on the region of the world (IPCC, 2007b). There has been increased rainfall in eastern parts of North and South America, northern Europe, and northern and central Asia. On the other hand, drying has been observed in the Sahel, the Mediterranean, southern Africa, and parts of southern Asia (IPCC, 2007b). These trends are expected to continue, which also has implications for droughts and floods. An increase in droughts, especially in the tropics and subtropics, has already been observed since the 1970s (IPCC, 2007b). More intense and longer droughts are expected due to higher temperatures, decreased precipitation, changes in ocean temperatures, different wind patterns, and diminishing snow and snow covers (IPCC, 2007b). Regions in Africa, China, India, Australia, Southern Europe, and North America (Southwestern and Great Plains regions, California, and the Pacific Northwest) will most likely be affected by drought conditions (IPCC, 2007b). At the same time, warming temperatures and subsequent increase in atmospheric water vapor have already resulted in more heavy rainfall, which is expected to lead to higher flood risks, especially in low-lying and coastal areas (IPCC, 2007b). Tropical Storms Rising temperatures can also affect storm severity. Storms are strengthened by particularly warm waters, from where they draw both energy and moisture. It has been suggested that the increase in intense tropical cyclone activity in the North Atlantic over the past 40 years is correlated with increases of tropical ocean temperatures. According to the IPCC, it is likely that tropical cyclones (typhoons and hurricanes) will become more intense, with larger peak wind speeds and heavier precipitation (IPCC, 2007b). Biosphere It is also very likely that climate change will impact a wide range of plant and animal species. Changes in the timing of spring can affect plant growth, life cycles of various animals, and migration patterns. Animals may migrate to different regions, which can have wide-ranging effects on other plant and animal species (Confalonieri et al., 2007; IPCC, 2007a). Mosquitoes, for example, are expanding to higher-lying areas, which increases the incidence of malaria (McMichael, 2003). Furthermore, approximately 20–30% of plant and animal species are at risk of extinction if increases in global average temperature exceed 1.5–2.5◦ C (IPCC, 2007a).

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Complex Changes It should be noted that although there is consensus about the phenomenon of climate change, predictions about the exact extent and speed of changes vary, depending on IPCC climate change scenarios as well as on different methods and emerging scientific studies. According to warnings by some authors, changes can happen abruptly and some of the current IPCC predictions are considered too conservative (Hansen, Sato, & Kharecha, 2008; Rahmstorf, 2007). The possibility of sudden changes and the complexity of many interdependent factors currently limit the predictive power of climate change models. The concept of tipping points, which refer to “critical thresholds that can dramatically alter the state of a system” (Lenton, Held, & Kriegler, 2008), also applies to climate change. The complete melting of the arctic sea ice and the Greenland ice sheet would be an example of such a tipping point, which could rapidly accelerate global warming with irreversible consequences (Lenton et al., 2008). Climate change policies and reductions in greenhouse gases in the coming years will be key determinants of our future, because worse scenarios and more severe impacts are expected with higher greenhouse gas emissions. Indeed, the IPCC states that “many impacts can be avoided, reduced, or delayed by mitigation.” Despite the significance of mitigation, climate change is unlikely to be stopped in the near future. It has been estimated that the “safe” threshold for global warming is about 2◦ C above preindustrial average temperatures. While some regions can benefit from an increase in temperature of up 2◦ C, an increase of 2–3◦ C is thought to result in adverse consequences for all regions of the globe (Schellnhuber, Cramer, Nakicenovic, Wigley, & Yohe, 2006). However, temperature rises are likely to exceed this threshold, as a rise of 0.76◦ C has already occurred. Even if all emissions had stopped in the year 2000, another 0.6◦ C rise would be expected by 2050 (IPCC, 2007b; Schellnhuber et al., 2006). Consistent with this, the IPCC notes that “anthropogenic warming and sea level rise would continue for centuries due to the time scales associated with climate processes and feedbacks, even if greenhouse gas concentrations were to be stabilized” (IPCC, 2007a). Considering the projected impact on individuals and societies, strategies for adaptation and coping with climate change are needed in the near and the long term (IPCC, 2007a; Solomon, Plattner, Knuttic, & Friedlingstein, 2009).

The Projected Impact of Climate Change While the direct consequences of climate change are relatively open to measurement, the indirect social and economic impact is more difficult to foresee or quantify (Confalonieri et al., 2007). However, climate change is expected to have wideranging and complex effects with important implications for natural resources and social and economic development. Rising temperatures, coastal flooding, and variable precipitation patterns are expected to significantly reduce agricultural land and water resources and may result in major economic losses and threats to livelihoods, mostly in developing countries (Parry, Canziani, Palutikof, van der Linden, &

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Hanson, 2007). More variable rainfall patterns leading to both flooding and droughts can compromise the supply of drinking water (Confalonieri et al., 2007) and result in poor sanitation and hygiene (Patz, 2001). The availability of freshwater is expected to decrease in many areas, which, together with continued population growth, is likely to result in shortages of drinking water and reduced agricultural productivity in some areas (IPCC, 2007a). Not all regions will be affected equally. Initially, North America and Northern Europe will have an increased potential for agricultural productivity. Other areas will experience more floods or droughts. Heavy rainfall can lead to soil erosion and damage to crops while droughts can result in increased wildfires, lower crop yields, and the death of livestock (IPCC, 2007a). Areas already affected by food insecurity are expected to be affected the most (World Health Organization, 2003). Climate change will have an effect on both urban and rural areas, including increased heat stress, damage of infrastructure by storms and floods, increased demand for energy, and air pollution (IPCC, 2007a). The impact of extreme weather events as well as migration and social and economic stressors can fragment community and social networks. Cascading and wide-ranging effects on human health have already been described and include higher rates of deaths and injuries, malnutrition, food- and waterborne diseases, and psychological distress (IPCC, 2007a; Patz & Kovats, 2002). Effects on human health in developing countries are likely to be exacerbated by weak health care infrastructure and poor access to health care. Rising sea levels and coastal erosion and flooding as well as other adverse environmental conditions such as droughts or disasters may cause further large-scale population displacement or “environmental refugees” (see Chapter 8, this volume). It has been predicted that climate change may lead to large scale migration, although the extent of this is difficult to foresee (Brown, 2008). The Red Cross estimates that more people are now displaced by environmental disasters than by war (International Federation of Red Cross Red Crescent Societies, 2002). An increase in armed conflict and instability has also been recognized as another potential outcome of climate change triggered by scarcity of resources, crop failures, economic losses, and population displacement (e.g. Busby, 2007). Regions that are already struggling with preexisting unrest, poverty, unequal access to resources, and weak governmental institutions are at the greatest risk (Stott, 2007; Chapter 6, this volume). As United Nations Under-Secretary-General for Humanitarian Affairs John Holmes recently put it, “climate change is not a future concern but a current danger to millions of people, including many of the most vulnerable groups in the world” (Holmes, 5 June 2009).

Who Will Be Affected by Climate Change? It has become clear that climate change does not affect everyone equally. The effect of global climate change on specific countries and communities does not only depend on geographical vulnerability but also on underlying socioeconomic vulnerabilities and adaptive capacities (IPCC, 2007a). The capacity to adapt to and cope with manifestations of climate change such as droughts, flooding, and natural

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disasters depends on factors such as local and national resources as well as individual and community capacities including governance, income, livelihoods, social capital, and individual ways of coping. The vulnerability to climate change and the capacity to adapt are much lower in developing countries, many of which are expected to be affected the most. Furthermore, many developing countries depend on resources sensitive to climatic changes such as local water sources and food supplies (IPCC, 2007a). It is likely that climate change will continue exposing and exacerbating existing political, economic, social, and heath inequities, thereby increasing the gap between rich and poor even further (Friel, Marmot, McMichael, Kjellstrom, & Vagero, 2008). Interactions of regional impact, high local vulnerability, and low adaptive capacity can have cumulative and devastating consequences for communities with low resources. It is predicted that the loss of healthy life years as a result of climate change and other global environmental changes will be 500 times greater in some African regions than in Europe (McMichael, Friel, Nyong, & Corvalan, 2008). This health discrepancy is the result of differences in the type and severity of climate change, differing underlying vulnerabilities (e.g. heat stress, food insecurity, disease vector exposure), and differences in the capacities to adapt (e.g. governance, national resources, individual incomes; see Campbell-Lendrum, Corvalan, & Neira, 2007). Such interactions can also result in humanitarian crises, which can feed back into increased vulnerability and lower adaptive capacity, thereby compromising human health and development even further (McMichael & Butler, 2004; United Nations Development Programme, 2007). Social Justice Considerations Climate change forces us to face fundamental questions about social justice and responsibility in aiding those who are already affected and will continue to be affected for the coming decades and possibly even centuries. Psychology has a history of taking up social justice issues and has much to contribute in global efforts to create more just and equitable societies and to promote peace and human wellbeing (Kazdin, 2009; Marsella, 2006). Inequalities and questions of social justice become even more apparent when considering the question of responsibility for climate change. Countries that contribute the largest emissions of greenhouse gases include the United States, countries of Western Europe, as well as rapidly industrializing countries such as China and India. Very poor and many developing countries, however, have contributed relatively little to climate change. With only about 5% of the world’s population, the United States is currently contributing about 25% of worldwide CO2 emissions (World Resources Institute, 2008). On the other hand, the carbon footprint of the poorest 1 billion people is estimated around 3% of the world’s total footprint (Commission on Social Determinants of Health, 2008; Patz, Gibbs, Foley, Rogers, & Smith, 2007). Countries that are expected to be impacted less by climate change may have less of an incentive to take mitigative action, while other more vulnerable and poor countries are the most threatened and the least able to adapt (American Psychological Association, 2009; Kasperson & Dow, 1991). This gross inequality becomes visible when comparing countries with the highest

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amounts of greenhouse gas emissions and those who will suffer the highest mortality due to climate change (Patz, Gibbs, Foley, Rogers, & Smith, 2007). Ethical Issues Some have argued that psychologists have an ethical obligation and responsibility to take action on the issue of climate change (Miller, 2007). The recent APA report on psychology and climate change has suggested that APA ethical standards can serve as a framework and an imperative for action to psychologists across different disciplines (American Psychological Association, 2009). Ethical principles such as “beneficence and nonmaleficence,” “fidelity and responsibility,” “fairness and justice,” as well as “respect for people’s rights and dignity” are consistent with psychologists’ active participation in tackling the issue of climate (American Psychological Association, 2002, 2009). Ethical standards developed by other national psychological organizations and international associations are consistent with this. The International Union of Psychological Science, the International Association for Applied Psychology, and the International Association for Cross-Cultural Psychology have drafted a “The Universal Declaration of Ethical Principles for Psychologists,” with input from psychologists from diverse parts of the world (Gauthier, 2008). This declaration recognizes that “the lives and identities of human beings both individually and collectively are connected across generations, and that there is a reciprocal relationship between human beings and their natural and social environments.” The declaration “reaffirms the commitment of the psychology community to help build a better world where peace, freedom, responsibility, justice, humanity, and morality prevail” (Gauthier, 2008). Principles such as respect for dignity, competent caring of persons and peoples, and professional and scientific responsibilities to society are also outlined (Gauthier, 2008). It appears that the advent of climate change presents a moral imperative as well as an opportunity for psychologists to use their knowledge for protecting and promoting the well-being of individuals, communities, and societies. Social justice issues and ethical implications of climate change have also been noted with concern by various other disciplines including medical professionals (Costello, Grant, & Horton, 2008), which could foster interdisciplinary collaboration and collective action.

Potential Contributions of Psychologists and Mental Health Professionals to Addressing Climate Change Impact and Adaptation Psychologists and mental health professionals can make important contributions to understanding the impact of climate change and to developing ways in which individuals, communities, and societies can adapt and respond. Psychologists who have written about climate change have largely discussed the issue in the context

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of changing attitudes, leading to more environmentally friendly behavior. This has led to highlighting the contributions of psychological theories about public risk perception, changing attitudes and behaviors, social marketing, diffusion of information, and worry about climate change in primarily Western countries (Gifford, 2008; Spence, Pidgeon, & Uzzel, 2009; Kazdin, 2009). Those constitute timely and promising contributions. However, it should also be considered that climate change is already taking place, and that adaptation will require collaboration among various disciplines (IPCC, 2007a; Solomon et al., 2009). Psychologists and mental health professionals have a window of opportunity to join the global dialogue about climate change and to demonstrate that their professions can make tangible contributions in addressing this complex issue (Kazdin, 2009). This book is an attempt to start exploring the impact of climate change on mental health and psychosocial wellbeing and to suggest ways in which psychologists and mental health professionals can assist individuals and communities in adapting to climate change. It has been widely recognized that human health will be impacted by climate change, and there is an increasing amount of literature on this topic (Costello et al., 2008; McMichael et al., 2008; World Health Organization, 2008). A chapter on health was also included in the latest 2007 IPCC report (Confalonieri et al., 2007). Climate scientists predict that the impact of climate change on human health will be mostly negative (Confalonieri et al., 2007), posing “substantial risks to human health, particularly among the poorest populations” (World Health Organization, 2003). However, discussions and projections of the effects of climate change on human health have primarily focused on physical health threats such as deaths from natural disasters and heat waves, or the shifting geographic distribution of infectious disease vectors such as mosquitoes (Costello et al., 2009). The World Health Organization has defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (World Health Organization, 1948)”. Yet, issues of mental health are frequently left off the global public health agenda, and current discussions about health and climate change are no exception (Page & Howard, 2010). Several documents mention mental health effects as possible outcomes of climate change, but there is typically no specific discussion of such effects (Confalonieri et al., 2007; World Health Organization, 2003). The psychology and mental health communities have a unique opportunity to offer their expertise in this area. Mental health and psychosocial well-being are likely to be impacted both directly and indirectly via multiple pathways (Fritze et al., 2008; Berry, Bowen, & Kjellstrom, 2010, Howard & Page, 2010), thereby increasing the global burden of mental illness and psychosocial problems. The threat of climate change has the potential to lead to significant anxiety and worry among the general population, which has been increasingly discussed among researchers (see Chapters 2 and 3, this volume; Moser, 2007) and picked up by the public media (New York Times, 2008; Boston Globe, 2009). Such perceptions are mediated by media images and social constructions of the climate change threat (see Chapter 2, this volume). Climate change may also lead to more gradual effects on mental health and psychosocial well-being, which have received little attention thus far, but are likely to pose new challenges (see Chapter 3).

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Recently, the term “solastalgia” has been coined to describe the psychological distress caused by climate-related environmental changes and degradation in rural Australia (Albrecht et al., 2007). Furthermore, it has been predicted that individuals, and especially children, may experience some anxiety over the ongoing threat of climate change (American Psychological Association, 2009; Fritze et al., 2008). The word “eco-anxiety” has been used to refer to worry and anxiety over environmental problems including climate change (Evitts-Dickinson, 2008, Albrecht Chapter 2, this volume). Environmental events such as natural disasters have well-documented effects on the mental health and well-being (Norris et al., 2002). Much remains to be learned about such effects and about evidence-based interventions and best practices, especially in low-resource countries and diverse cultural settings (Inter-Agency Standing Committee, 2007; van Ommeren, Morris, & Saxena, 2008). The advent of climate change brings new urgency to addressing the impacts of natural disasters and humanitarian crises on mental health and well-being (see Chapters 4 and 5, this volume). Furthermore, both laboratory and field research have found associations between higher temperatures and increased violence and aggression, which may have implications for areas with less resources to adapt to hotter climates (Anderson, 2001; DeWall & Bushman, 2009; Rotton & Cohn, 2004). Studies also suggest that individuals living in poor countries report less happiness in very cold or very hot climates (Van de Vliert, Huang, & Parker, 2004). Exploring underlying mechanisms of those relationships, projecting possible impacts on society, and advocating for climate adaptation are ways in which psychologists can contribute. Research fields such as peace psychology similarly have the potential to apply their expertise, given projected risks of increased violent conflict due to factors such as diminishing resources and large-scale migration which can also provide opportunities for common goals and collaboration (American Psychological Association, 2009; Chapter 6, this volume). Conflict and environmental factors have already led to the displacement of millions of people, which continues to be a global concern. Displacement carries various risks to both physical and psychological health. Indeed, several studies have reported a high prevalence of domestic violence, suicide, substance abuse, and depression among people living in refugee camps (Porter & Haslam, 2005; World Health Organization, 2008; Chapter 8). Several publications of scientists and different agencies outline potential impacts of climate change on specific populations such as women, children, indigenous people, and those living in poverty or having poor access to resources (Aguikar, 2009; Balbus & Malina, 2009; Shea, 2007). It is important to investigate the specific vulnerabilities, adaptive capacities, and coping resources of these and other groups with regard to mental health and psychosocial well-being (see Chapter 8 on women and climate change). It should also be considered that different populations and individuals impacted by climate change are not passive victims but actively make sense of and cope with changes to the environment and extreme environmental events. The ways in which individuals and groups from different backgrounds and cultures engage in the construction of meaning of climate change and its consequences is another promising area of inquiry (American Psychological Association, 2009;

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Chapter 9, this volume). Furthermore, concepts such as individual and community resilience, which have already been used in the disaster preparedness and response literature hold promise for helping affected communities adapt and cope with climate change (Bonanno, 2004; Norris, 2008; Chapter 10, this volume). Joining the dialogue about the impact of climate change and possible responses also requires thinking creatively about ways to measure its impact. Contributions from the fields of environmental psychology, cognitive psychology, and other disciplines such as disaster mental health may prove fruitful in this endeavor. The importance of cross-cultural competence runs like a thread through every aspect of climate change adaptation, response, and impacts. Climate change is a global problem that will affect a diverse range of people from numerous countries and cultures. Yet, the majority of research relevant to the intercept between psychology and climate change has taken place in North America, Western Europe, and Australia (American Psychological Association, 2009). Finding ways to understand and respond to the impact of climate change will likely require psychologists to actively seek out knowledge and establish collaborations with people of nationalities and cultures that are different from their own. Climate change also presents new opportunities for interdisciplinary collaboration. The field of psychology is unique in that it has been identified as a “hub discipline” that has multiple connections and overlaps with various other fields within the sciences (Boyack, Klavans, & Borner, 2005; Kazdin, 2009). It is now up to psychologists and mental health professionals to take action and join the global community in addressing the urgent issue of climate change. Our professions have the skills and responsibility of turning this challenge into an opportunity. This book is an attempt to shed light on the complex and interrelated impacts of climate change on mental health and well-being and to provide recommendations for research, policy, and practice. It is also intended to result in dialogue about the contribution of psychology with representatives from several disciplines, including eco-psychology, anthropology, medicine, hazards research, political science, and sociology. Understanding and responding to climate change requires the active collaboration of multiple stakeholders working in academic, policy, nonprofit, and multilateral organizations, as well as civil society. This book hopes to spark new discussions and collaborations among people from various backgrounds, who share the goal of protecting and promoting the well-being of individuals and communities affected by climate change, within a framework of social justice and cultural competence.

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Norris, F. H. (2008). Community resilience as a metaphor, theory, set of capacities, and strategy for disaster readiness. American Journal of Community Psychology, 41, 127–150. Norris, F. H., Friedman, M. J., Watson, P. J., Byrne, C. M., Diaz, E., & Kaniasty, K. (2002). 60,000 disaster victims speak: Part I. An empirical review of the empirical literature, 1981–2001. Psychiatry, 65(3), 207–239. Nurse, J., Basher, D., Bone, A., & Bird W. (2010). An ecological approach to promoting population mental health and well-being--a response to the challenge of climate change. Perspectives in Public Health, 130(1), 27–33. Page, L. A., & Howard, L. M. (2010). The impact of climate change on mental health (but will mental health be discussed at Copenhagen?) Psychological Medicine, 40(2), 177–180. Parry, M. L., Canziani, O. F., Palutikof, J. P., van der Linden, P. J., & Hanson, C. E. (2007). IPCC, 2007: Climate Change 2007: Impacts, adaptation and vulnerability. Contribution of working group ii to the fourth assessment report of the intergovernmental panel on climate change. Cambridge, UK: Cambridge University Press. Patz, J. (2001). Public health risk assessment linked to climatic and ecological change. Human and Ecological Risk Assessment, 7(5), 1317–1327. Patz, J. A., Gibbs, H. K., Foley, J. A., Rogers, J. V., & Smith, K. R. (2007). Climate change and global health: quantifying a growing ethical crisis. EcoHealth, 4, 397–405. Patz, J. A., & Kovats, R. S. (2002). Hotspots in climate change and human health. BMJ, 325(7372), 1094–1098. Porter, M., & Haslam, N. (2005). Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: a meta-analysis. JAMA 294(5), 602–612. Psychologists for Social Responsibility. (2010). Letter to congress on mental health impacts of climate change. Retrieved November 6, 2010, from http://www.psysr.org/about/programs/ climate/projects/letter/ Rahmstorf, S. (2007). A semi-empirical approach to projecting future sea-level rise. Science, 315, 368–370. Rotton, J., & Cohn, E. G. (2004). Outdoor temperature, climate control and criminal assault: The spatial and temporal ecology of violence. Environment and Behavior, 36(2), 276–306. Schellnhuber, H. J., Cramer, W., Nakicenovic, N., Wigley, T., & Yohe, G. (2006). Avoiding dangerous climate change. Cambridge: Cambridge University Press. Shea, K. M. (2007). Global climate change and children’s health. Pediatrics, 120(5), e1359–1367. Smith, D., & Vivekananda, J. (2007). A climate of conflict: The links between climate change, peace and war international alert by International Alert. Printed by Jason Print. Solomon, S., Plattner, G. K., Knuttic, R., & Friedlingstein, P. (2009). Irreversible climate change due to carbon dioxide emissions. Proceedings of the National Academy of Sciences, 106, 1704–1709. Spence, A., Pidgeon, N., & Uzzel, D. (2009). Climate change: Psychology’s contribution. The Psychologist, 22(2), 108–111. Stott, R. (2007). Climate change, poverty and war. Journal of the Royal Society of Medicine, 100, 399–402. The Human Security Network (HSN). (2007). Retrieved November 6, 2010, from http://www. humansecuritynetwork.org/menu-e.php UNICEF. (2007). Climate change and children. New York: United Nations Children’s Fund (UNICEF)o. (Document Number) United Nations Development Programme (2007). Human development report 2007/2008. Fighting climate change: Human solidarity in a divided world. New York: UNDPo. (Document Number) Van de Vliert, E., Huang, X., & Parker, P. M. (2004). Do colder and hotter climates make richer societies more, but poorer societies less, happy and altruistic? Journal of Environmental Psychology, 24(1), 17–30. van Ommeren, M., Morris, J., & Saxena, S. (2008). Social and clinical interventions after conflict or other large disaster. American Journal of Preventive Medicine, 35(3), 284–286.

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World Health Organization. (1948). Preamble to the constitution of the World Health Organization as adopted by the International Health Conference, New York, 19 June–22 July 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948. World Health Organization. (2003). Climate change and human health: Risks and responses. Summary. Geneva, Switzerland: World Health Organization. World Health Organization. (2008). Protecting health from climate change – World Health Day 2008. Geneva, Switzerland: World Health Organization. World Resources Institute. (2008). CAIT energy information administration reference scenario, energy emissions only. Washington, DC: World Resources Institute.

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The Threat of Climate Change: Psychological Response, Adaptation, and Impacts Joseph P. Reser, Shirley A. Morrissey, and Michelle Ellul

This chapter examines the existing social and health science literature addressing the psychological impacts of the threat of climate change. The exercise reflects a convergent environmental, social, and health psychology perspective, informed by those interdisciplinary bodies of work relating to the social construction and representation of environmental threat; psychosocial environmental impact assessment and monitoring; public and mental health; risk communication and perception; and disaster preparedness and response. Attention is also paid to public understandings of the phenomenon and threat of global climate change and popular culture discourse and reflections about the psychological and mental health responses to and impacts of ‘climate change’. The chapter indirectly addresses the unfolding physical environmental impacts of climate change and corresponding psychological, social, and societal consequences, but the principal focus is on public exposure and response to the phenomenon of climate change through multimedia representations of this phenomenon and limited direct experience. The larger context of this chapter and the present coverage is the post–Intergovernmental Panel on Climate Change [IPCC] focus on climate change adaptation and mitigation and the continuing neglect of the psychological, social, and cultural in research and policy considerations and initiatives addressing human and environmental quality, sustainability, and health. The chapter concludes with a brief consideration of what psychology has and can contribute in addressing psychological adaptation to the threat of climate change.

What Is Encompassed by ‘Climate Change’? In the wording of the original United Nations Framework Convention on Climate Change (UNFCCC), endorsed at the Earth Summit in Rio de Janeiro in 1992, the specified meaning of climate change was: “‘Climate change’ means a change of

J.P. Reser (B) School of Psychology, Griffith University, Gold Coast, Queensland, Australia e-mail: [email protected]

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climate which is attributable directly or indirectly to human activity” (in Kolbert, 2006, 153). In most discussions of climate change, it is anthropogenic climate change that is intended and meant, as it is this human contribution and ‘forcing’ that may provide some scope for correction and mitigation, and that addresses implicit questions of causal explanation and responsibility. But the continual shifting between lay use and reference and more specialised use in both scientific discussions of climate change and media coverage of climate change science means that meaning is often less than clear, such that reference to ‘climate change’ is typically to considerations very different from “the totality of the atmosphere, biosphere, and geosphere and their interactions” (UNFCCC, 1992) (in Kolbert, 2006, 153). In most instances ‘climate change’ also implicitly includes reference to the consequences of global weather pattern changes on local and global environments and ecosystems, that is, to climate changes and their physical environmental impacts, which are actually the more noticeable changes taking place in our environments. But there is, of course, another ‘environment’, the human psychological, social, societal, and cultural environment, where important and dramatic changes and impacts relating to climate changes and consequent biophysical environmental changes are taking place. These human environment changes and impacts are less likely to be explicitly mentioned or even implicitly referred to in discussions of ‘climate change’ or appropriate policy responses, but they are profoundly important, not only in terms of human health and well-being (e.g., Clarke & Bourke, 2005; Martens & McMichael, 2002; Millennium Ecosystem Assessment, 2005; Patz, Engleberg & Last, 2000) but in terms of fully appreciating the scope and challenges of the global climate change phenomenon facing human society (Gifford, 2008; Moser & Dilling, 2007; Uzzell, 2008; Vlek & Steg, 2007). This fuller realisation that “climate change” is far more than climate change immediately follows any consideration of just what these cascading impacts of direct climate change influences the human environment encompass. In what follows reference to climate change almost always refers to the perceived threat and unfolding environmental impacts of climate change, as it is these facets of the larger phenomenon that are of particular relevance to public understandings and responses, psychological and social impacts, and planned change. These perceived threats and impacts can be based on either direct experience and encounters or indirect, virtual, experience through social representations and media coverage. This matters greatly, as it is virtual and vicarious exposure to climate change that currently characterises climate change encounters for most people in the urbanised world.

Is ‘Climate Change’ Different from Other Perceived Threats? In surveying the research and discursive literature on public risk perceptions and psychological responses to the threat of climate change, there would appear to be a growing consensus and mounting evidence that the threat and risk domain of

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global climate change is in fact rather different from other perceived threats and sources of anxiety and concern. Climate change is increasingly a substantially constructed and socially represented phenomenon, environmental problem, threat, and narrative of environmental and societal risk and change. As well, in psychological terms, climate change is more of a chronic environmental stressor (e.g., Evans, 2001; Evans & Stecker, 2004), which is constant but uncertain, of possibly perilous consequence, and with a high dread risk, not dissimilar to that found for some ‘technological risk’ domains (e.g., Lewis & Tyshenko, 2009). It seems increasingly clear that those research and professional practice literatures that are most relevant to addressing the impacts of the climate change threat are the areas of work relating to the nuclear threat, terrorism, and natural disasters. In each of these contexts, there are strong common denominators relating to a condition of continuous environmental threat, high uncertainty, and the possibility of profound and highly adverse consequences for future as well as present human communities and the earth’s as well as humanity’s life support systems. The differing nature of these risk domains as contrasted with more conventional psychological sources of concern and anxiety should not preclude conventional interventions and strategies in terms of assisting individuals in managing their responses, but psychologists are at least raising this matter of continuing threat, particularly in the wake of 9/11, in the context of disasters such as Hurricane Katrina and flooding, heat wave, and cataclysmic wildfire events worldwide, with respect to continuous conflict and political instability and, more encompassingly, in the context of global climate change (e.g., Linden, 2006; Marshall et al., 2007; Oppenheimer & Todorov, 2006).

Threat Representations as Distinct from Physical Environmental Impacts It is noteworthy that, for most people, their perceptions and experience of climate change are primarily indirect and virtual, mediated by media images, technologies, and reporting, by social constructions and representations of events and impacts in very distant parts of the planet (e.g., Boykoff, 2008; Trumbo, 1996; Wilson, 1995). This largely indirect experience is nonetheless very powerful; these media images, television documentaries, and climate change-themed films would appear to generate considerable concern and often distress and very directly influence understandings, preparedness, and adaptive responding (e.g., Corner, 2000; Gamson, Croteau, Hoynes, & Sasson, 1992; Leiserowitz, 2006; Smith, 2005; Smith & Joffe, 2009). A critical and strategic focal point for preparedness and planned change initiatives and interventions is at this interface where risk appraisals, sense making, and psychological responding takes place and where behavioural responses are primed and strongly influenced by media coverage and risk communications. A three-decade research investment by social science risk researchers has examined what has come to be known as the ‘social amplification of risk’ (e.g., Flynn, Slovic & Kunreuther, 2001; Pidgeon, Kasperson & Slovic, 2003). This research

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on how individual and social factors act to both amplify and dampen perceptions of risk is particularly important as it focuses not only on how individuals think and feel about risk messages and particular risk domains but also on those social processes relating to sense making and media communications that influence how communities and societies perceive and understand and respond to global risks such as terrorism, the nuclear threat, GM food, and climate change. (e.g., Bauer & Gaskell, 2002; Bohm, Nerb, McDaniels, & Spada, 2001; Etkin & Ho, 2007; Joffe, 2003; Kasperson & Kasperson, 2001; Lorenzoni, Pidgeon, & O’Connor, 2005; Slovic, Finucane, Peters, & MacGregor, 2004). These convergent psychological and social science research and practice domains encompass individual and societal awareness, risk appraisal and assessment, public understanding of science, environmental concerns, sense making, and individual and collective response to this environmental phenomenon, threat, and problem. These perspectives also make specific reference to how ‘climate change’ has been presented, imaged, and explained by journalists, scientists, government bodies, and others with vested interests. Further important considerations have included the extent to which human response to these media-based risk representations and communications are implicated in adequately understanding individual and community responses to directly experienced impacts and primary evidence of climate change.

Risk and Concerns: Risk-as-Analysis and Risk-as-Feelings There are multiple psychological literatures relevant to the psychological response to the threat of climate change. These include environmental perception and evaluation; decision making under stress; risk communication, perception, and appraisal; threat appraisal and response in the context of stress and coping; environmental stress; and environmental concern. The theoretical and research literatures addressing risk perception, which substantially draw from the interdisciplinary risk and cognitive science literature, place somewhat more emphasis on those cognitive processes involved in appraising the risk phenomenon, whereas environmental concern perspectives, coming predominantly from environmental and social psychology, tend to emphasize one’s psychological response to an appraisal of potential risk or harm to the environment (Reser, 2010). These perspectives tend to differ from personality- and motivation-based models of ‘stress and coping’, which privilege appraisals of environmental and/or social threats to oneself (and others), with the weighting on the psychological response to the judgement rather than on the threat and the judgement process. But the new face of psychology-based risk research, particularly in the context of environmental risks and climate change, has been to acknowledge the reality that two pathways are involved in risk perception and response, or sense-making, in the face of threat: a more cognitive-based risk-as-analysis pathway and a simultaneous and more instantaneous emotion-based pathway (e.g., Bohm, 2003; Lowenstein, Weber, Hsee, Welch, 2001; Slovic et al., 2004; Slovic, 2010). Given the origins of

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risk and decision making research in cognitive science (e.g., Kahneman, Slovic & Tversky, 1982; Slovic, 1987), the risk-as-feeling approach is arguably somewhat newer, but, in reality, these intersecting perspectives have been a hallmark of adaptation, motivational, and stress and coping models for well over half a century. The relevance of these two pathways to understanding psychological response to a risk domain such as climate change is that this response is much more than a rational, cognitive appraisal of a potential threat. Such risk evaluation and sense making also rely strongly on an immediate and visceral appraisal that has more to do with evolutionary hardwiring and symbolic and associative meaning responses to a multifaceted risk domain. It must also be appreciated that individual responses to a risk such as climate change are typically based on one’s encounter with a ‘risk communication’ in the form of a ‘social representation’ (image, text, warning message) of the phenomenon and associated risk, itself reflecting a social and cultural ‘construction’ of this environmental threat or problem (e.g., Adam, 1998; Grauman & Kruse, 1990). Hence individual responses to often highly charged risk communications are informed by social processes appraisals and an unparalleled new world of information and communication technologies and media coverage and reporting (Bartsch, Vorderer, Mangold, & Viehoff, 2008; Gifford, Steg & Reser, 2011). But such media images, the gravity of the problem and threat, and the tragic circumstances of those communities in the world already experiencing what are seen and presented as the environmental impacts of climate change are powerful, emotion eliciting, anxiety inducing, and impactful (e.g., Joffe, 2008; Nabi & Wirth, 2008). The nonstop media coverage of the climate change threat, its often apocalyptic portrayal, its media reach across news programming, commercial films, documentaries, and the blogosphere (Facebook and Twitter), and ubiquitous images in posters and magazine covers and advertisements have all given the phenomenon and threat of climate change a very substantial virtual and psychological reality, quite apart from its objective reality and status, which itself is arguably alarming and distressing. Hence climate change and its impacts are very real in human terms and with respect to these very strong and incessant risk communications and prognoses regarding an uncertain and very frightening future world.

Social Constructions, Social Representations, and the Nature and Role of Media It is important to seriously consider the nature and content of the media coverage the public has been exposed to over the past several years with respect to global climate change. The probable events and environmental changes that are presented through images and interviews, sound bites, and popular films are about very largescale and catastrophic changes, from the melting of polar icecaps and glaciers (the life source for the Asian subcontinent) to desertification of much of Africa and the United States, to acute water and food scarcity in many parts of the world, to mass

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migrations, resultant international conflict, devastating biodiversity loss, and so on. These scenarios, often epilogue to scientific documentaries about global environmental change, are given further and graphic virtual reality through the coverage of unprecedented natural disasters that have occurred globally over the past decade (e.g., Hurricane Katrina, Asian Tsunami, Australian Black Saturday bushfires) and in the context of commercial films such as An Inconvenient Truth, The Day After Tomorrow (2004), State of the Planet BBC series (2006); Six Degrees (2008), The 11th Hour (2007), and The Road (2009) (e.g., Lowe et al., 2006). These documentaries and films of course resonate with classic, and now remarkably current nuclear threat images and films, such as The Day After (1983) and Nuclear Tipping Point (2010), which themselves tapped into widespread societal anxieties and fears, dread relating to nuclear winter, a dying planet, and apocalypse (e.g., Eckersley, 2008).

Psychological Responses, Adaptations, and Impacts The language, constructs, and underlying processes involved in addressing the human response and impacts side of perceived threat and risk differ depending on framing, discipline, and indeed subdiscipline (e.g., social, environmental, cognitive, health psychology) and the extent to which an initiative is applied and/or is multidisciplinary, at individual, community, or system level. These matters are brought to the fore in the context of the threat of climate change. As the phenomenon is dauntingly complex and global, it is engaging the efforts of many sciences and disciplines, and these initiatives straddle biophysical and human environments and landscapes, and their respective health and well-being status. As noted, the emergent language of climate change adaptation and mitigation within the climate change science discourse, and those more physical and natural environmental sciences involved with risk assessment and disaster management, has largely bypassed the extensive and nuanced work in the health and social sciences relating to psychological adaptation and related constructs (coping, vulnerability, resilience). But within the context of psychological understandings and approaches to the threat of climate change, and at the level of individual functioning, it is important to note that all psychological responses to perceived threat or changing environmental circumstances constitute adjustments and adaptations, and that these primarily reflect intra-individual appraisal, sense making, and coping processes, collectively referred to as ‘psychological adaptation’ (e.g., Reser & Swim, 2011). In the health psychology literature (e.g., Aspinwall, 2005; Taylor, 1983; Taylor, 2009), these processes are often termed ‘cognitive adaptation’, as it is often the case that interventions are premised on assisting individuals to reframe or change their thinking about the nature, causes, or consequences of their distress. In the related stress and coping literatures, the emphasis is on both the more analytic appraisal of not only the threat but also one’s own resources, and the simultaneous management of one’s emotional responses to the threat or situation or to fear or anxiety itself.

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It is not surprising that psychological adaptation in the context of climate change has strong affinities with stress and coping perspectives (e.g. Lazarus, 1991; Zeidner & Endler, 1996), with a number of authors framing climate change adaptation as ‘coping with global environmental problems and global environmental change’ (e.g., Homburg, Stolberg & Wagner, 2007). The question of coping with a global phenomenon such as climate change has of course multiple problems of scale and specification if taken literally or when speaking of individual or collective response, but limiting the expression to individual and community coping with the threatened and environmental impacts of climate change allows for more realistic consideration and conceptualisation. Global and regional environmental changes and the continuing threat of climate change can and arguably are creating situations of high and often chronic environmental stress, which in turn are eliciting adaptation and coping responses (e.g., Bell, Greene, Fisher, & Baum, 2001; Homberg & Stolberg, 2006; Lepore & Evans, 1996). There are also the intertwined matters of the psychological and social costs of particular coping strategies and their cumulative psychological and mental health impacts. Attempts to adequately conceptualise, measure, and address psychological coping and adaptation strategies and responses to climate change at an individual and psychological level have to date been largely unsatisfactory (Reser & Swim, 2011). It is worth noting that the recent American Psychological Taskforce on Psychology and Climate Change (APA, 2009) spent considerable time and thought in attempting to achieve a more helpful and strategic integration of convergent perspectives within psychology relating to the psychological impacts of the threat of climate change (e.g., risk perception, environmental stress, stress and coping, psychological adaptation, anticipatory coping), with the hope that this crucial body of psychological work might be more widely appreciated and utilised.

Health and Mental Health Perspectives In-depth ‘health and social science’ perspectives on how individuals and communities are being affected by the threat of climate change are not very easy to find. Those sources addressing climate changes and impacts on human environments across the world tend to be more descriptive, speculative, and interpretive, with little reference to objective data bases or systematic monitoring outcomes or state of the human environment reporting. While convergent research evidence is only now coming in, there is a strong professional consensus that ubiquitous media coverage and representations of climate change threat are causing appreciable concern, alarm, and distress for many. These are, after all, global disaster warnings and highly charged risk communications about what is happening to the planet, to our life support systems, to the world as we know it. Climate change already appears to be having devastating environmental effects in the U.S. . . . The psychological responses to those effects can also be devastating. Many Americans are already anxious about what climate change portends. The greater risk is that millions of

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J.P. Reser et al. people will develop severe and persistent anxiety, depression, post-traumatic stress, aggression, and other troubled behaviour if the U.S. does not quickly lead the way to dramatically reduce carbon emissions. Without such action, the impact of heatwaves, extreme storms and floods, droughts, and water shortages, food production problems, lessened air quality, sea level rise, and displacement from homes and communities is likely to pose significant mental-health challenges to millions of Americans and billions of others worldwide. (Psychologists for Social Responsibility, 2010, pp. 2–3).

That literature which one might think would address the health, mental health, and psychological well-being implications of the threat of climate change would logically fall under the heading and search terms of ‘climate change’ and ‘health’. But this is not the case, with the health literature retrieved being almost exclusively a public health literature. There is very little reference to psychological, social or mental health impacts, or quality of life or environment considerations, other than direct physical health problems such as disease vectors, food and water shortages, essential services, and the envisioned humanitarian plight of increasing numbers of climate change refugees (e.g., IPCC, 2007; Jackson & Shields, 2008; Myers & Patz, 2008; St Louis & Hess, 2008). In marked contrast, there exists a growing psychology science-based literature that squarely addresses the psychological and societal impacts of climate change and unmet needs for the more general audience (e.g., APA, 2009; APS, 2010; Kazdin, 2009; Lertzman, 2008; Linden, 2006; Stokols, Misra, Runnerstrom, & Hipp, 2009; Swim et al., in press). While many of these sources are written by psychologists and other mental health professionals, a number of these authors are, ironically, natural and physical scientists and philosophers associated with climate change research (e.g., Flannery, 2006; Hamilton, 2010; Hulme, 2009). Although the literature addressing the psychological and mental health impacts of the threat of climate change is modest, it is particularly relevant, given the substantially psychological nature of public risk perceptions and threat appraisals (e.g., Doherty & Clayton, 2011; Gifford, 2007). This literature is itself diverse, including perspectives from health and clinical psychology, psychiatry, disaster mental health, a multidisciplinary risk communication and response literature, and environmental phenomenology (e.g., APA, 2009; Marshall, 2009; Pidgeon, 2010; Roszak, Gomes & Kanner, 1995; Stefanovich, 2000; Vlek & Steg, 2007). A number of recent articles and research reviews on climate change and mental health have addressed various direct and indirect pathways through which the threat and physical environmental impacts of climate change may lead to adverse psychological and social impacts of concern, mental health, and well-being (e.g., Berry, Bowen & Kjellstrom, 2010; Doherty & Clayton, 2011). Climate change has the potential to lead to adverse mental health outcomes through a number of pathways. First, there is an established body of literature outlining the adverse mental health impacts of natural disasters (such as floods, cyclone events, droughts, and fires) and the factors that can modify the risk of poor mental health outcomes in the event of such disasters. . . . The threat of climate change and its consequences may have wider psychological and social effects on communities through the impact on perceptions of safety, security and fears regarding the future. The methods and tenor of communication regarding the

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actual or potential health and social risks associated with climate change will be important determinants of community emotional and behavioural responses. (NCCARF, 2009).

While the impacts of a changing climate taking place in biophysical environments and human settlements, and in the context of more structural social and governance systems, are being closely monitored and, to the extent possible, addressed, there are few corresponding evaluation or monitoring exercises taking place with respect to the human landscape of individual and community experience, risk perception, sense making, and psychological and behavioural responses. This is, unfortunately, a much neglected focus in climate change science and in general considerations of climate change adaptation and mitigation. The impacts of natural environmental changes and associated environmental consequences on individuals and communities are an integral part of environmental impact assessment and environmental protection legislation (e.g., Barrow, 1997; Reser & Bentrupperbäumer, 2001). Very little research and monitoring has been undertaken with respect to what is taking place at the level of individual experience, sense making, and psychological and behavioural response. Similarly, very little hard data exist with respect to the likely impacts of the threat of climate change on individual and community well-being, quality of life, perceived environmental quality, and mental health. Psychological responses to the phenomenon of climate change are posing particular challenges for psychological understandings of fear, anxiety, and worry. Typically fear is related to something tangible, for example, one can be afraid of the dark, or of spiders, or of being alone, or of being in crowds. Fear is usually understandable, and many individuals would report having been frightened or of being fearful of something at some time in their life. Responses to fearful situations or stimuli are usually individualistic, and it is rare that a mass fear response is documented. Only in the case of extreme fear, such as a phobia, does a person usually seek help. Anxiety on the other hand, is considered to be more ‘clinical’, one may suffer with an anxiety disorders (e.g., social anxiety, health anxiety, panic disorder, posttraumatic stress disorder, or generalised anxiety disorder). These ‘disorders’ are often considered something to be managed, something to be overcome; they are considered treatable, with cognitive and behaviour therapies providing a suite of evidence-based individual and group protocols for helping anxious individuals learn to cope with and manage (and reduce) their anxiety. While worry is typically seen as more pervasive and similar to an enduring personality trait there are now evidence-based psychological therapies designed to assist worriers to manage to control and reduce their worrying (e.g., Davey & Wells, 2006, Leahy, 2005). Anxiety disorders all share features of threat-relevant responding (e.g., Barlow, 1988; Beck & Emery, 1985; Craske & Waters, 2005), with components of anxious apprehension, fear, and avoidance present to a larger or lesser extent. While there has been considerable advances in the clinical psychology field with respect to the development, assessment, and treatment of threat in the context of anxiety disorders, less is known about how individuals manage anxiety in the face of threats that are far removed from everyday life, or in the context of continuing threat such as the threat

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of climate change (e.g., Diamond, Lipsitz, Fajerman, & Rozenblat, 2010; Marshall et al., 2007; Oppenheimer & Todorov, 2006). There are also those who deny the reality of climate change, and some who are still turning a blind eye to it. This is, of course, understandable. People are motivated to avoid ambiguity and uncertainty, and they can be seen to be more pessimistic when faced with ambiguous risk information. Similarly, psychologists acknowledge that in the face of overwhelming fear and anxiety about the future, denial is a common psychological defence mechanism. What better way to prevent being afraid, than to avoid? Avoidance is well documented as one of the most important factors that prevent individuals from dealing with and overcoming their fears. Defending against anxiety in the first place provides a perfect avoidance strategy for ‘not dealing’ with it. In addition, years of research into depression has indicated that when individuals feel a sense of helplessness to make any real changes in their lives, they refrain from doing anything. However, while avoidance-oriented coping has been associated with positive psychological outcomes in the short term, avoidant coping has also been related to increased distress in the longer term (Taylor & Stanton, 2007). Anxiety is both protective and adaptive, and it can motivate people. An optimal level of anxiety is required in order for the fight and flight response to be activated (Selye, 1973) and appropriate responses to threats be made. As Epstein says, “living with risk can lead to anticipatory feelings such as anxiety that the eventual outcome will be bad, or hopefulness that it will be good” (2008, p. 1121). While the concept of threat is central to theories of stress as well as to theories of anxiety, the management of stress has been on events in the past or occurring currently. While anxiety management programs acknowledge anxiety for future events – these events are usually in the near future, rather than being in the distant future. With climate change, global warming and environmental threat, future-oriented proactive coping strategies such as building a reserve of resources in order to “mute the impact of events that are potential stressors” are required (Aspinwall, 2005; Folkman & Moskovich, 2004, p. 757). As with the nuclear threat, we are dealing with a planetary and human consequence and meaning scenario that is genuinely anxiety inducing if not terrifying for many. There is a tendency in the climate change science discourse to not only overlook an individual level of analysis and human experience but also ignore the import, meaning, and significance of climate change representations and risk communications. Indeed the rather terrifying state of felt helplessness in the face of dire threat is often interpreted as apathy, and the raising of the mental health consequences of climate change can often be met with incredulity and scorn by some science-based colleagues. But what if the ways we are thinking about apathy and denial are themselves misguided, and potentially damaging? What if the issue is not about caring too little, but perhaps too much? Is it possible that our anxieties about ecological problems, and the existential dilemmas they raise regarding how we are to live, can be so great as to be unmanageable or unthinkable? Might we unconsciously deny what is staring us in the face because what is at stake is too painful to consider? (Lertzman, 2008, p. 16)

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According to Lertzman, lessons can be learned from the psychoanalytic perspective by “finding ways to inform and inspire, and stimulate action rather than paralysis” (p. 17). Somewhat similarly, a psychological perspective on managing anxiety taken from an acceptance and commitment approach (Hayes, Strosahl, & Wilson, 1999) suggests that negative reactions to one’s thoughts, feelings, or bodily sensations, as well as fusion with internal experience, lead to difficulties in monitoring, accepting, and interpreting emotion. As a result, the individual engages in experiential avoidance in an attempt to avoid these experiences, both behaviourally and cognitively. This avoidance reduces distress in the short term; however, in the long term it reinforces behavioural restriction as the individual becomes less engaged in valued activities (Roemer & Orsillo, 2002). In working with worried individuals, therapists can assist clients to accept the uncertainty, the fear, and the anxiety, while committing to activities that will be consistent with valued living (e.g., caring for the environment). In the last year or so, there is the appearance of a growing number of concerned and anxious individuals presenting to therapists. In a recent report on the Columbia News Service, a therapist (eco-therapist) in Santa Fe, USA, reported seeing between 40 and 80 eco-anxious clients per month (Nobel, 2007). Albrecht at the University of Newcastle in Australia has introduced the term “solastalgia” (Albrecht, 2006, Albrecht et al., 2007) to describe the distress that is produced by environmental change (see Chapter 2, this volume). He argues that solastagia exists “when there is recognition that the beloved place in which one resides is under assault” (2006: p. 32).

Climate Change and Place Meaning, Connection, and Identity Many have argued the case that adverse environmental changes and progressive environmental degradation can lead to substantial environmental concern, distress, and both psychological and physical health consequences. A disparate set of literatures have addressed these matters, with particularly powerful accounts and discussions found in the natural and technological disaster literatures (e.g., Cvetkovich & Earl, 1992; Reyes & Jacobs, 2006), the contaminated environments literature (e.g., Adeola, 2009; Edelstein & Makofske, 1998), the psychosocial environmental impact assessment literature (Reser & Bentrupperbämer, 2001), the environmental concern literature (Schmuck & Schultz, 2002; Gifford, 2007), the place attachment literature (Altman & Low, 1992; Groat, 1995), the ecopsychology literature (Randall, 2009; Roszak et al., 1995), and other discussions of encounters with dramatically altered and/or adversely impacted natural environments. The issue and threat of climate change and its psychological significance and impacts relate to place in multiple ways. People’s connections to ‘where they live’, their ‘home’, backyard, street, neighbourhood, and region are typically very important, emotionally charged, and indeed an integral part of who they are. These connections and attachments are different from national or ethnic identity in that these feelings and sentiments are much more intimate, experiential, familiar, and

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personal. The place where we live, or have lived, is backdrop to our lives in many ways, as silent witness, memory frame, ubiquitous companion, and view from the kitchen window. It is an encompassing ‘material self’. The sights, sounds, and smells of ‘our places’ are evocative, restorative, and comforting. Equally, disturbance and change can be very disquieting, threatening, and disorienting. Clearly the unfolding impacts of climate change will mean that many of the natural and built environments in which people live will undergo dramatic and, in most cases, adverse change. These changes will in many cases be accompanied by increasingly severe and consequential extreme weather events and natural disasters such as severe storms, cyclones, flooding, bushfires, and prolonged drought. These environmental impacts will mean and have already been the cause of community relocations and forced migration and the associated human impacts of such relocations. The majority of people will see and experience environmental changes in familiar landscapes and natural areas along with seasonal weather pattern changes, often with associated biodiversity and agricultural productivity losses, and a very visible and symbolic ‘environmental’ deterioration. Such changes and impacts can be very personally salient and impactful, particularly in the case of one’s garden, neighbourhood park, or a familiar and restorative place frequently visited.

An Australian Perspective Modest research data exist on the psychological and societal responses of Australians to global or local climate change and climate change impacts. In contrast there exist a substantial and growing body of survey research data and more in-depth research findings on the perceptions, understandings, risk appraisals, thoughts and feelings, anxieties and concerns, and motivational and behavioural responses to climate change in North America and Europe. There are many reasons for thinking that public response to climate change in Australia might differ in important respects, given the unique nature of the Australian continent, its global location, geography and climatic systems, its history and experience with climate change-related natural disasters, its current exposure to climate change impacts, its differing media coverage, and its cultural contexts and perspectives with respect to environmental issues and challenges (e.g., Garnaut, 2008). Hence studying the psychological and social impacts of unfolding biophysical environmental impacts and weather-related natural disaster incidence and intensity is crucial to effectively addressing the human side of climate change impacts and adaptation strategies. What particularly characterises the Australian geographic, climatic, and cultural contexts, however, is the dramatic presence of the full spectrum of natural disasters (e.g., Pittock, 2009). As well, Australia is deemed to be the inhabited continent most exposed to the potential ravages of global climate change, with a current public discourse and understanding that would appear to see and understand current natural disaster events and impacts as clear manifestations of unfolding climate change (e.g., Steffen, 2009; Garnaut, 2008). Given the predictions being made with respect to global warming and climate change, and the consequences of these

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environmental changes on weather patterns in Australia, substantial concerns with respect to extreme weather events and an increased frequency and intensity of natural disasters exist. As discussed previously, the issue of the mental health impacts of climate change has had particular resonance in Australia. Rural Australians live with various systematic disadvantages and many feel marginalised; climate change, especially drought, has worsened this. With drier conditions and more severe droughts expected in much of southern and eastern Australia over coming decades, and the demands for change and adaptation that this will present, we urgently need to understand the likely consequences for the mental health and well being of people in rural Australia. . . Australian communities and environments are diverse and climate change will have a variety of emotional and social impacts... It can be expected that the same loss of people, property, and possessions, dislocation from community and disruption of key social connections that precede or amplify the development of psychiatric disorders following acute disasters would apply equally in response to chronic disasters of equivalent magnitude. (Berry et al., 2008, pp. 3–6).

The circumstances of drought provide a useful window on the psychosocial and possible mental health impacts of global climate change in Australia (e.g., Morrissey & Reser, 2007; Satore et al., 2008). Australia has, of course, a recurrent history of prolonged drought-affecting extensive areas of the continent. Drought is a natural disaster with particular affinities with the projected manifestations and impacts of climate change. It takes the form of a ‘slow emergency’ and a pervasive condition of unrelieved environmental stress, with imperceptible beginnings and often no clear end point. From a rural and remote community perspective, sustained drought dramatically alters the appearance of landscape and country, as does dryland salinity. Gardens die, stock and crops die, water is rationed, and livelihoods are lost. In Australia the symbolic and socioeconomic impacts of the most recent decadelong drought for many have been interlinked with a very visible and dramatic rural decline across much of Australia, at the same time that global climate change has emerged as a salient and contested environmental, social, and political issue. The discourse of distress and mental health problems in rural and remote communities has been a collective conversation and shared experience in which depression, suicide, broken hopes, torn families, and dying towns have coincided with seemingly profound ‘environmental’ changes and the ever-present environmental problem and threat of climate change (e.g., Centre for Rural & Remote Mental Health [CRRMH], 2010). Australia has until recently been in the grip of a decade-long nationwide drought, has in the past several years experienced bushfires of unprecedented extent and intensity, and as this chapter is being written, is facing the worst nationwide floods in recorded history. Can these quality of life and environment impacts of drought and parallel but possibly coincidental societal changes in the Australian economy and agricultural sector, and accompanying demographic redistributions, be considered psychosocial and mental health impacts of climate change? This is not a question that can be readily or clearly answered at this point in time. However it is clear that public understandings and ‘idioms of distress’ on the part of those living in areas dramatically altered by severe drought, bushfires, and floods, have embraced and implicated

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‘climate change’ in a very noteworthy and consequential way. Rural and remote health workers themselves appear to have accepted this emergent and collective sense making narrative as a helpful framing of what is happening which is understandable, meaning-conferring, local and personal in terms of one’s own experience and place, and possibly both adaptive and therapeutic (e.g., Morrissey & Reser, 2007).

Current Available Resources and Advice Psychology has much to offer in developing evidence-informed resources and materials that can be disseminated to the general public and for use by health professionals and others in the context of disaster threats. The American Psychological Association (APA) has been very active, especially since 9/11 and Hurricane Katrina in developing resources relating to coping with disasters. In Australia, The Australian Psychological Society (APS) has also developed a suite of materials to assist individuals and communities to understand psychological response to and impacts of both the threats of natural disasters and more recently the threat of climate change. The APS ‘Tip Sheets’ generally incorporate some information about the phenomena (e.g., climate change or psychological preparedness for cyclones or bushfires), as well as some tips for identifying the common reactions (emotional, cognitive, and behavioural) and some strategies for managing the feelings and behaviours that might result from the worry and concern that the particular impending threat is evoking. These Tip Sheets may be downloaded free of charge from the APS website: https://www.psychology.org.au/publications/tip_sheets/climate/ and https://www.psychology.org.au/publications/tip_sheets/disasters/ Other government and nongovernment agencies such as state governments, emergency management agencies, and the Red Cross in Australia also provide helpful information and advice, which includes psychological advice on their websites. In addition, a number of authors have also provided some general information (e.g., APS, Doherty & Clayton, 2011; Fritze, Blashki, Burke & Wiseman, 2008; Mainteny, 2002; Victorian Local Governance Association, 2009). In general, one might expect such psychological advice to include the following: • Provide tips to assist more accurate assessment of the climate change risks. • Provide Information relating to probable (likely) reactions (emotions, cognitions, and behaviours). • Suggest effective management of emotions and problem solving, including a focus on pro-social outcomes, and engagement in actions that have a reasonable chance of mitigation. • Suggest and encourage action, providing an opportunity to ‘respond personally’, increase self-efficacy, participation, and competence, and help move individuals from despair and hopelessness.

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• Direct people to appropriate resources to become more informed about problems and solutions (e.g., The Weather Makers, An Inconvenient Truth), as well as environmental websites, books, or magazines. • Suggest that support groups are another way for people to improve their preparedness for climate-related impacts providing not only support but hope and positivity. • Emphasise the notion of shared responsibility and the importance of collective action. • Remind the individuals to be mindful of the amount of exposure to the radio, TV, Internet, and so on. Sometimes taking a break can be helpful and can provide a welcome relief. The information provided should be appropriately optimistic about the future and reinforce that the future is not all bleak. It is helpful to acknowledge that there are many people who share similar concerns, who are working on protecting the environment and encouraging others to change their behaviour.

Concluding Observations The psychological and well-being impacts of the threat and physical environmental impacts of climate change have been largely ignored in the climate change science discourse, in adaptation and mitigation policy discussions, in risk communication and management deliberations, and, ironically, in the dramatically expanding climate change and public health literature (Morrissey & Reser, 2007). There are many reasons why this is the case: the system, structures, and population levels of impact and mitigation considerations; the natural and physical science (and very selective social science) underpinnings of climate change science post IPCC; the challenges in distinguishing the psychological, mental health, and quality of life impacts of the threat of climate change from a dynamic and interacting set of other specific background threats, stressors, social and personal circumstance issues; and the dearth of appropriate and sensitive measures and monitoring systems in place to document important changes and impacts in the human environment and landscape as distinct from physical environments and ecosystems. But perhaps the most important reason why psychological responses and mental health impacts generally have not been on the radar of climate change science is the fact that the psychological, social, and cultural realities and consequent impacts of the threat and risk domain of climate change have simply not been seriously factored into impact analyses and discussions, other than in terms of strategic behaviour and lifestyle changes and adjustments, and public health, safety, and security considerations and risk management procedures. While the media coverage and representation of the phenomenon, the science, the politics, and reported public response to global climate change has been everyone’s distorting window on ‘climate change’, the psychological impact, adaptation, and well-being implications of such an indirect, virtual, socially constructed, and mediated encounter

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with climate change for much of the developed, urbanised world have not been seriously considered or addressed. As well, of course, many countries and communities have been directly experiencing the physical environmental consequences of climate change for several decades, with the threat of climate change being much more of a here and now objective reality in terms of natural disaster intensities and extent, changing regional climate regimes inimicable to already-marginal agricultural and pastoral economies, severe water shortages, consequent social unrest and upheavals, and the growing numbers of climate change refugees. But what remains a basic and underlying reality in the context of climate change is that public risk perceptions, understandings, and responses to the threat of climate change are not only crucially important psychological and social realities, they themselves constitute critically significant and determining impacts of the threat of climate change. There is increasingly little ambiguity in the survey research evidence respecting public concern levels about climate change. They are very high and have indeed been very high for the past decade, though competing concerns, major events of the day, and some degrees of apocalypse fatigue (Nordhaus & Shellenberger, 2009) and finite worry capacity (Weber, 2006) have eventuated in temporary falls in reported relative concern levels (Villar & Krosnick, 2010). But many have seen strategic opportunity in a populace very concerned about an environmental issue such as climate change, with these analysts ranging from journalists to commercial marketers, to political analysts and strategists, to social change agents, to public health, to environmental organizations, and to prospective researchers looking for funding. This interest in (and possible exploitation of) salient public concerns is an important and complex issue, with perceived media exaggeration, for example, being seen by many as substantially eroding public concern and adaptive action (e.g., Spence & Pidgeon, 2009). It may well be that public concerns and very genuine and associated psychological and mental health impacts of the threat of climate change are at the same time being ‘oversold’ and ‘undersold’ despite climate change’s unequivocal status and importance as a profoundly important and urgent environmental and social issue, risk domain, and psychological as well as physical health and sustainability challenge. As well, perhaps, the complexity of this objective phenomenon and its equally challenging socially constructed and represented ‘environmental problem’ character have confused and splintered societal and policy focus and resolve, as well as reflecting the reality of powerful and undercutting political and economic interests and tensions. The absence of clear and convincing data with respect to adverse psychological as well as social impacts of this still-virtual-for-many global threat has not assisted in bringing mental health implications and optimal psychological functioning ‘in from the cold’ with respect to public health and planning and policy deliberations. Notwithstanding the largely self-evident character of this clear and present global and societal danger and case, there has not been the transdisciplinary conceptual and paradigmatic scaffolding necessary to put psychological adaptation and the mental health impacts of climate change on the radar of governments, funding bodies, and climate change science. Hence we urgently need to

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better communicate and collaboratively share this convergent body of work relating to the impacts of the global climate change on the human environment, and how these impacts both mediate and determine whether climate change adaptation and mitigation initiatives and policies in more conventional terms have any prospect of success. While this chapter has focused on a more individual level, experience-based consideration of psychological responses and impacts to the threat of climate change, in keeping with our objective of addressing this area of crucial neglect, it is incumbent that we remind ourselves and our readers that in this context of environmental risk and change, apocalyptic scenarios, and human sense making and response, we cannot neglect that underlying change agent, adaptation process, and collective sense making apparatus that informs all individual experience, culture itself. Indeed cultural foundations and differences with respect to natural environmental connections, worldviews, and response to change have informed the social sciences from their inception. That literature specifically addressing culture and risk is of central importance to public understandings of and responses to ‘climate change’. But ironically there is little clarity, particularly in our contemporary ‘globalised’ world of information technology–mediated social and environmental ‘realities’, with respect to where and how differing assumptive worlds are entering the equation regarding this global challenge requiring global human responses. It is clear that ‘public’ risk perceptions and understandings of climate change do not equate with climate change science accounts, even in those countries and cultures where such science enjoys reasonable public respect and trust. Yet effective interventions in the case of adverse psychological and social impacts are premised on an informed understanding of prevailing environmentallived experience, narratives, and values. It is noteworthy that those social psychological and risk perspectives within psychology that have played a leading role in better understanding the underlying cognitive science, and the social cognition, construction, representation, and social amplification and attenuation of risk (e.g., Pidgeon et al., 2003), have been more recently re-evaluating the very central nature and roles of cultural beliefs and values and associated affect in climate change adaptation and response (e.g., Kahan, 2010; Slovic, 2010). Australia is recognised as having an indigenous people who have been addressing and adapting to dramatic climate sequences for possibly 60,000 years. Traditionally oriented communities retain a literal identification and relationship with their natural environment, with the quality of this relationship being the touchstone and foundation for interdependent health and well-being (e.g., Rose, 1996). But indigenous communities in Australia, as throughout the world (e.g., Leduc, 2011), are well aware that destabilising environmental changes of profound consequence have been underway for at least several decades, with these changes and encompassing risk having genuinely cataclysmic implications in the context of cultural meaning systems and beliefs. In such communities, and indeed in more rural and remote subsistence communities throughout the world, the threat and environmental stress of climate change would appear to be exacting very real though largely undocumented human costs.

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Postscript: Australian Survey Results At this point in completing our chapter we have been analysing the results of a substantial national survey in Australia, undertaken in conjunction with Cardiff University’s Understanding Risk Centre and a corresponding British national survey. The focus of the Australian survey was public risk perceptions, understandings, and responses to climate change and natural disasters in Australia (Reser et al., 2011). This survey specifically addressed levels of concern and reported psychological distress in the context of climate change, with multi-item scales utilised for these and a number of other parameters (e.g., psychological adaptation, direct experience, objective knowledge, self-efficacy, residential exposure). While a final analysis of this survey data has not been completed, initial findings are very relevant to matters canvassed in this chapter. The study included a geographically stratified sample of 3096 Australian respondents and 1822 from Britain residing specifically in England, Scotland, and Wales. This study provided a unique opportunity to document and monitor important psychological and social changes and impacts in the human landscape in relation to global climate change, with this important study to be replicated in Australia in June 2011. The research found high levels of climate change concern with a composite measure including seriousness of the problem, sense of urgency to reduce the problem, personal and societal concerns, and perceived importance of the issue. Several single comparison items were used to assess general levels of concern relating to climate change for both Australia and Britain with very similar results found for both countries. Respondents overall were ‘very’ or ‘fairly’ concerned about climate change, 66 and 71%, respectively. (Response format was a four-point scale, with two additional options of ‘don’t know’ and ‘no opinion.) The Australian survey additionally sought to address psychological distress with a seven-item measure designed by the research team. Across all respondents the averaged results indicated moderate levels of distress when thinking about and responding to the threat of climate change. More specifically, when reviewing each of the items individually, it became clear that a large proportion of respondents indicated very strong levels of distress relating to specific aspects of the climate change threat. A large number of respondents, for example, were very or fairly worried about what the world will really be like for future generations because of climate change (38%), with a further 24% experiencing some distress each time they saw or read media coverage as to the likely impacts and consequences of climate change. Other respondents were upset that there seemed to be so little that they could do to address environmental problems such as climate change (23%). Respondents were less likely to endorse items such as ‘climate change is affecting my quality of life and my assessment of environmental quality more generally’ (9%) and ‘I feel some sense of loss because of the climate change impacts that are becoming apparent in my area’ (12%). These results suggest appreciable psychological distress as well as concern at the nature and implications of the threat of climate change. Initial correlation analyses indicate that this psychological distress in the context of climate change measure correlated strongly with measures of climate change concern

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(r = 0.84), risk perception (r = 0.73), and psychological adaptation (r = 0.78), further suggesting important mediating roles and outcomes with respect to climate change distress. It will be important to compare and contrast the results of programmatic national survey and monitoring exercises such as this with more focused psychosocial impact assessment and community health and mental health studies in specific regions with differing notional exposures to the impacts of climate change, extreme weather events, and/or other salient environmental changes.

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Randall, R. (2009). Loss and climate change: The cost of parallel narratives. Ecopsychology, 1(3), 118–129. Reser, J. P. (2010). Public understandings of climate change: Reflections and reframings. In N. Pidgeon (Ed.), Climate change perceptions, risk communication and public engagement: Windsor park roundtable proceedings. Cardiff, UK: Understanding Risk Research Centre, Cardiff University. Reser, J. P., & Bentrupperbämer, J. M. (2001). Reframing the nature and scope of social impact assessment: A modest proposal relating to psychological and social (psychosocial) impacts. In A. Dale, N. Taylor, & M. Lane (Eds.), Social assessment in natural resource management institutions (pp. 106–122). Collingwood, VIC: CSIRO Publications. Reser, J. P., & Morrissey, S. A. (2008). Situating and framing individual and community experience and response: A psychological perspective. In K. Gow & D. Paton (Eds.), The phoenix of natural disasters: Community resilience (pp. 47–72). New York: Nova Science Publishers. Reser, J. P., Pidgeon, N., Spence, A., Bradley, G., Glendon, I. A., & Ellul, M. (2011). Public risk perceptions, understandings and responses to climate change in Australia and Great Britain: Interim report. Gold Coast, QLD: Griffith University, School of Psychology. Reser, J. P., & Swim, J. K. (2011). Adapting to and coping with the threat of climate change. American Psychologist, 66(4), 277–289. Reyes, G. & Jacobs, G. A. (Eds.). (2006.) Handbook of international disaster psychology (Vols. 1–4). Westport, CT: Praeger. Roemer, L., & Orsillo, S. M. (2002). Expanding our conceptualisation of and treatment for generalised anxiety disorder: Integrating mindfulness/acceptance-based approaches with existing cognitive-behavioral models. Clinical Psychology: Science and Practice, 9, 54–68. Rose, D. B. (1996). Nourishing terrains: Australian aboriginal views of landscape and wilderness. Canberra, ACT: Australian Heritage Commission. Roszak, T., Gomes, M. E., & Kanner, A. D. (1995). Ecopsychology: Restoring the earth, healing the mind. San Francisco: Sierra Club Books. Satore, G. M., Kelly, B., Stain, H., Albrecht, G., & Higginbotham, N. (2008). Control, uncertainty, and expectations for the future: A qualitative study of the impact of drought on a rural Australian community. Rural and Remote Health, 8, 1–14. Schmuck, P., & Schultz, W. P. (2002). Psychology of sustainable development. Boston: Kluwer. Selye, H. (1973). The evolution of the stress concept. American Scientist, 61, 692–699. Slovic, P. (1987). Perception of risk. Science, 236, 280–285. Slovic, P. (2010). The feeling of risk: New perspectives on risk perception. London: Earthscan. Slovic, P., Finucane, M. L., Peters, E., & MacGregor, D. G. (2004). Risk as analysis and risk as feelings: Some thoughts about affect, reason, risk and rationality. Risk Analysis, 24, 311–322. Smith, J. (2005). Dangerous news: Media decision making about climate change risk. Risk Analysis, 25, 1471–1482. Smith, N. W., & Joffe, H. (2009). Climate change in the British press: The role of the visual. Journal of Risk Research, 12(5), 647–663. Spence, A., & Pidgeon, N. (2009). Psychology, climate change and sustainable behaviour. Environment, 51(6), 8–18. St. Louis, M. E., & Hess, J. J. (2008). Climate change: Impacts on and implications for global health. American Journal of Preventive Medicine, 35(5), 527–538. Stefanovich, I. L. (2000). Safeguarding our common future: Rethinking sustainable development. Albany, NY: State University of New York Press. Steffen, W. (2009). Climate change 2009: Faster change & more serious risks. Barton, ACT: Department of Climate Change. Stokols, D., Misra, S., Runnerstrom, N. G., & Hipp, J. A. (2009). Psychology in an age of ecological crisis: From personal angst to collective action. American Psychologist, 64(3), 181–193. Swim, J. K., Stern, P. C., Doherty, T., Clayton, S., Reser, J. P., Weber., et al. (in press). American Psychologist, 66(4), 241–250.

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Chapter 3

Chronic Environmental Change: Emerging ‘Psychoterratic’ Syndromes Glenn Albrecht

Introduction Humans are now by far the most powerful change agent on the planet, and their impacts are fundamentally transforming the face of the physical landscape of the earth, altering natural patterns and rhythms, and, now, warming its climate. Under the influence of increasing anthropogenic environmental pressures I describe earthrelated physical and mental health impacts due to environmental and climate change. In what follows, I shall focus on the mental health impacts that arise from negatively perceived environmental change. A typology of emergent earth-related or psychoterratic syndromes and conditions is presented to assist in the understanding of and response to chronic environmental change.

The Loss of Regularity Humans are extremely versatile and adaptive animals. They have colonised virtually all parts of the planet and have successfully inhabited all types of climes and topographies including the Arctic, deserts and tropical rainforests. While humans may have originated from the African savannah, we are so adaptable as a species that we now even live on a semi-permanent basis in inhospitable places like Antarctica. Despite our ability to tolerate a wide variety of biophysical conditions for social life, like other species, we rely on pattern and regularity in nature to offer us a reasonable degree of predictability in a sea of change and possibilities. Such pattern and regularity are substantially due to the fact that the earth spins on its axis whilst revolving around the sun. Day and night and the seasons are the result of our constant relationship to the sun. The sun itself provides a relatively constant supply of warmth and energy so that life exists within thermodynamic limits. In addition, the rotation G. Albrecht (B) Institute for Sustainability and Technology Policy (ISTP), Murdoch University, Perth, WA 6150, Australia e-mail: [email protected]

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of the moon around the earth gives us two tides a day on every ocean shore in the world. The regularity of solar energy, the seasons, prevailing winds and the tides are expressions of a pre-existing pattern and order that predates human emergence by millions of years. Phenology, the long-term study of seasonal rhythms and patterns in nature, is a scientific discipline that systematically studies this foundation of life. Once the short- and long-term patterns in nature are understood, the biological and ecological responses to such foundational order begin to make sense. The daily circadian rhythms, our sleep and wake patterns, the very idea of a breeding ‘season’ in some species, the timing of insect and animal migration, the human menstrual cycle, biochemical patterns (e.g., melatonin levels) and the spawning of corals are all tied to the foundational pattern and order as described by phenology, biochronology and other fields of knowledge. While the drivers of natural patterns and rhythms such as the earth, sun and moon remain relatively constant at a cosmic level, increasing temperature due to anthropogenically induced climate change in the form of global warming is altering the very character of long-term climate, the annual seasons and weather worldwide (IPCC, 2007).

Climate Stress on Non-human Beings As a result of these long-term climatic and immediate weather changes, ecosystems and their endemic biodiversity are also experiencing change. Some species are favoured by warmer temperatures while others are disadvantaged. However, in general, under the chronic change agent of global warming, climes and ecosystems are no longer synchronised with the seasons and their inhabitants are under pressure to move to more favourable habitats. For example, in Australia we have the critically endangered mountain pygmy possum (Burramys parvus) that has evolved to live in alpine regions in the mountains of eastern Australia (Department of the Environment and Heritage, 2005). It has survived for millennia by hibernating under a regular thick cover of snow during the winter, but now the snow is melting earlier and the critically endangered survivors (less than a few thousand in total) emerge too early to exploit food reserves that would normally sustain them. They die of starvation because the normal rhythms and patterns of place have been disturbed by changes to their climate and there is nowhere for them to go to remain in their preferred habitat. They cannot go up into higher and more suitable ecosystems because they are already perched on the top of mountains. The mountain pygmy possum could be the first of many more species to become extinct due to global warming and its impact on habitat. In Australia, there is also the possibility of the loss of the Great Barrier Reef, a World Heritage area, due to climate change. Already damaged by coral bleaching, warmer and more acid waters will not support coral and the foundations of the ecosystem will collapse. There are many other examples worldwide of ecosystem and species distress at the warming and subsequent changing of the climate. From what at first sight

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appears to be only a slight increase in temperatures, less than one degree Celsius over the last century, there are already discernable effects that are profoundly desolating landscapes. The suggestion that the world and its inhabitants could tolerate a 2 degree or higher temperature increase under global warming ignores the distress and damage already caused with one degree. I suggest that the urge to remain in environments that are within the evolutionarydefined limits of organisms is powerful and the pressure to move because of climate change is likely to be extremely disturbing. Due to trophic mismatches (Post & Forchhammer, 2008), predator–prey relationships will no longer remain in balance and herbivores will be unable to time their migration with the availability of grasses that flourish either too soon or too late within migration routes to support their needs and those of their offspring. Disease patterns will also change with emergent diseases driving new epidemics of disease and death in non-human beings. Such change pressures demand of all species extreme resilience with the very possibility of life played out at the margins of evolutionary limits. Pushed beyond such tolerances, specialised and non-adaptable species face extinction or continued existence only in zoos. While we are just beginning to think about how climate change will affect the mental health and well-being of humans, virtually no research has concentrated on the likely impact of climate change on the health and well-being of wild animals. I have argued that non-human beings will be most likely extremely stressed by the imposed changes of global warming (Albrecht, 2009b). Territorial issues for animals are crucial to their survival. As their home habitats move, they too face the imperative to move. However, the freedom to move is blocked by competition from fellow non-human beings, human development pressures in the form of habitat fragmentation and massive infrastructure such as cities and their urban complexes, auto freeways and railway lines. I argue that animals will experience chronic place-based stress as the ability to respond to instinctual (genetic) instructions about ‘home’ is thwarted by climate-induced pressure to move.

Climate Stress and Human Beings Chronic stress on ecosystems and home environments is likely to produce a similar chronic stress in humans as in other sentient animals. For human beings, one of the most understated, but potentially powerful of all, relationships is the one we have to our home environment. Our physical and mental health, our total sense of wellbeing, is tied to this vital territorial relationship, and when it is threatened, we can become distressed and diseased (Albrecht, 2005; Albrecht et al., 2007). As with other species, as phenological and other rhythms and patterns in the home environment change, so too does the way Homo sapiens relates to its home environment. I maintain that the phenology of place has its correlates in the phenology of culture and the mind. Pattern and regularity in nature are reflected in pattern and regularity in all human activity. Our endemic sense of place, belonging and our existential well-being are vitally connected to the rhythms and patterns

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of our home environment. The seasonal weather, the play of light, the ability to plant and harvest food, the breeding of domestic animals, the cultivation of food and gardening for pleasure, our sleep and rest patterns, outdoor sports and myriad other typically human activities are vitally linked to a reliable and predictable environment, including its climate. Without being deterministic, a reliable and predictable environment and climate is powerfully connected to the very possibility of a distinctive culture (and agriculture). Long-established cultures located in geologically stable parts of the planet are now experiencing significant change to their once characteristic climes. For example, in the UK, under a 100-year warming period, the growing season for plants in central England has lengthened by about one month, heatwaves have become more frequent in summer and there are now fewer frosts and winter cold spells (UK Climate Impacts, 2010). At the rate the UK is warming, in about 70 years the people of Wales will be living in a clime similar to that of present-day west coast Portugal (3 degrees warmer). The Western European heatwave of 2003 and ongoing bushfire crises in Greece, Spain and Italy are poignant reminders that the climate of Europe is changing. Physical health impacts are manifest as excess morbidity and mortality related to extreme high temperatures. It is a similar story in the southern hemisphere with heatwaves, catastrophic fires and drought. In the Australian Spring of 2009, record high temperatures were broken by large margins. Drought has become a semipermanent feature of the food bowl of the Murray-Darling River basin in Eastern Australia. Both physical and psychological limits are tested in such circumstances, and water shortages in Eastern Australia have affected the long-term viability of rural economies and security of water supply in large towns and whole cities such as Perth, Brisbane, Melbourne and Adelaide. As an indication of just how disruptive climate change will become to connections to home, in my former home state of New South Wales in Australia, right now, I would have to live 150 km farther south from my present location in order to replicate the temperatures and climes of only 50 years ago. In 2070, I will (theoretically, since I would be 117 years old) have to be living over 1000 km farther south in Southern Tasmania in order to keep within my present climate zone. In one hundred years’ time, our children and grandchildren will have to move even farther north or south of the equator to maintain their historical eco-climatic sense of place. Unfortunately for Australians, once you get south of Tasmania, it is difficult to find good land until you get to the Antarctic landmass. Under worst-case scenarios, there is a very real prospect of Australia becoming uninhabitable in the foreseeable future, with mass migration to cooler and wetter parts of the world the only option available. In addition to extreme heat, the collapse of agriculture and impacts of drought and wildfire will be enough to force people to migrate to more hospitable climes and ecosystems. While migration itself is a very serious existential stress burden on people, remaining in places that are being devastated by the effects of climate change such

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as persistent drought might be an even greater source of stress. In Africa, research is now under way on how those who remain in the zones of high-impact climate change such as drought-affected areas will cope with a desolated home environment and a cultural context that is fragmenting (Tschakert & Tutu, 2010). The research suggests that the protection of vulnerable people who remain emplaced in a home environment that is changing both physically and culturally is an important task for policy makers. With the example of the Inuit, we have some early warning signs about the impact on climate change on the mental health of people. People who still live close to the earth and its elements and begin to experience long-term or chronic change to their home environment and its climate respond in ways that reflect their intimacy with the earth. Indigenous cultures at the front line of climate change have already responded with new concepts in their language to describe the unwelcome disruptions to the patterns of life. The Inuit of the Arctic Circle, where temperatures are rising at twice the global average, have applied a word, ‘uggianaqtuq’ (pronounced OOG-gi-a-nak-took), which once was used to describe a friend who was acting strangely or in an unpredictable manner, to the way climate change is now impacting on their environment and culture. A whole traditional way of life tied to the patterns of a long-term relationship to a particular type of clime and landscape is threatened, with activities such as transport on melting ice impossible, traditional food sources disappearing, house foundations destabilised and whole landscapes transformed. For the Inuit and many other peoples of the Arctic, a fossil fuel–generated wave of change called global warming is invading the cryosphere and turning what was once reliable into uggianaqtug (Albrecht, 2008). The distress at the transformation of their home environment comes on top of enormous pressures delivered by continued development. As is the case in remote parts of Australia, much of the Arctic region is now seen as a hotspot for minerals, gas and oil. As the ice and snow disappear, many anticipate even more opportunities for mineral and oil exploration in the new polar frontier. Of course, if new oil reserves are found and exploited, they will only add further to the warming and the climate chaos. All over the world, in the face of changing weather patterns, record high temperatures, more frequent and severe drought and fires and shifting rainfall patterns, people are responding with forms of place-based distress. Under the driver of climate change, our endemic sense of place is being challenged, and all the signs, signals and markers that define our biophysical home are changing and moving. Old earth wisdom, tried and true for millennia, now becomes redundant knowledge in the new climate, and the wisdom of the elders and their power to hold communities together begin to evaporate. Instead of regularity and the ability to plan ahead, people are now anxious about an unreliable future and what it might hold for them, even in the relatively short term. They are asking legitimate questions about the current and future impacts of climate change. Will the sea level rise and by how much? How hot will it get? Is storm frequency and severity going up? Is water supply secure?

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Am I at risk of wildfire? Will eco-refugees overwhelm my country? Will famine increase as the climate changes, and will new diseases threaten me?

Psychoterratic and Somaterratic Syndromes As we carefully examine the responses to changing home environments, a range of ‘psychoterratic’ (Albrecht et al., 2007; Albrecht, 2009a) or earth-related mental health syndromes are thus revealed. These syndromes are suffered in addition to the ‘somaterratic’ or body burden of illness created by, for example, exposure of the body to extreme heat or toxic chemicals released into the biophysical environment. People aware of the potentially serious implications of climate change are also likely to be anxious about possible harm that might fall on their children into the future and, further, the fate of all future generations. People such as climate scientists and those who choose to be fully informed about climate science and its dire predictions about the future might be even more anxious than other people in society. Their knowledge is a burden they carry with them on a daily basis and, as more and more news enters the public arena, there is no escape. As uncertainty rises, I suggest that anxiety might turn into a form of helplessness or paralysis with the inability to make definitive decisions about what to do next entrenched in a non-predictable world. I argue that it is not that people are unconcerned about changing environments; it is just that they are unable to translate their concerns into any meaningful action. Changing light bulbs is, for them, not an adequate response to escalating greenhouse gas concentration in the atmosphere and subsequent global warming. While paralysis might be the result for some, others might embrace activism and get more motivated to bring about the fundamental changes needed to avoid a runaway greenhouse and catastrophic climate change. Table 3.1 provides my overview of established and emergent conditions that are physical and psychological responses to negative changes to the state of the earth (terra). More research is needed on the interaction of the somaterratic and the psychoterratic since we know that synergistic interactions occur between persistent extremely high ambient temperatures, organic pollutants, volatile organic compounds, endocrine disrupters and stress in humans as measured by the levels of stress hormones such as cortisol. Hence, internal physical environments (the body), internal mental environments (the mind) and external environments (changing and polluted ecosystems) might be caught in an escalating cycle of stress.

Table 3.1 Environmental change: Somaterratic and Psychoterratic syndromes Somaterratic (Body-Earth)

Psychoterratic (Psyche-Earth)

Heat stress Environmental cancers Endocrine disruptors (feminization) Seasonal affective disorder (SAD)

Ecoanxiety Ecoparalysis Solastalgia Econostalgia/nostalgia

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The domain of somaterratic illness has received relatively little attention as an ‘upstream’ source of human disease. Global warming, heat stress in heatwaves and connections to mental health conditions have occasionally been written about by journalists in countries such as India (Jayan, 2008). Even less attention has been paid to the impact of psychoterratic syndromes as components of the total burden of mental health issues. Such neglect is hard to explain, given that the WHO has pointed out that depression is currently the “leading cause of disability as measured by Years Lived with Disability (YLDs) and that by the year 2020, it is projected to reach 2nd place of the ranking of Disability Adjusted Life Years (DALYs) calculated for all ages and both sexes” (WHO, 2009). In Australia, suicide is the number one cause of death for men and women aged 15–34 (Lifeline, 2009). In other words, while the contribution of environmental distress to the total burden might in itself be currently small, the overall problem we are dealing with is very large. Psychoterratic conditions are likely to become more significant components of the causes of mental health problems as climate change impacts more severely on the home environments of vulnerable people. The impact of negatively changing climates and environments on the poor is likely to be more devastating than on those who are wealthy and have access to support and alternative accommodation and safer environments. However, those in rich countries, unaccustomed to major disruption to their normal lives from weather and climate-related events, will also suffer from psychoterratic shocks. Given that global warming is set to continue and have serious consequences for climate and the environment, it is worthwhile to more carefully examine the range of psychoterratic syndrome conditions likely to be experienced by humans.

Ecoanxiety As indicated above, anxiety related to a changing and uncertain environment is now being widely discussed. The amount of information (and misinformation) available about dangerous climate change and distressed ecosystems has increased exponentially over recent decades. The Internet in particular has seen an explosion of eco-information available to billions worldwide. The bad news often associated with eco-information is itself a source of anxiety. People become overwhelmed by the sheer scale, complexity and ‘wickedness’ of the problems we are facing. A form of ecologically induced dread most likely affects many people and leads to their becoming distressed. Many people become anxious about what to do in the face of accumulating evidence of non-sustainable pathways. Their concern about the fate of their own children intensifies as the pace of change telescopes into decades rather than centuries and many see major difficulties for future generations as the ability to predict what the world will be like evaporates. In recent years there have been a number of feature articles in major national newspapers devoted to the topic of ecoanxiety (Dickinson, 2008), and it is now a legitimate area of research on a legitimate human experience in the

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face of negatively felt environmental and climatic change (Physicians for Social Responsibility, 2009; Psychologists for Social Responsibility, 2009).

Ecoparalysis As indicated above, the inability to meaningfully respond to the climatic and ecological challenges that face us is not always an expression of apathy. The intractable nature of the problems, the fact that they are tied to the very foundations of our present economy, generates dilemmas not seen before in human history. People appear apathetic and disengaged with reality as it unfolds, but their detachment might be ecoparalysis rather than apathy or avoidance. As we learn more about our carbon footprint, it seems that every option to retain life as usual ends in contradiction. Even the idea that we save energy and hence carbon emissions by doing business and personal communication electronically runs into the uncomfortable truth that the annual amount of energy required to run the World Wide Web is roughly equivalent to the annual energy use and carbon emissions of global air traffic. Not many people in rich, technologically sophisticated parts of the world are prepared to embrace the full implications of a severely greenhouse gas-constrained world. While many now clearly see the extent and nature of the problem, future negative events, even those that will impact on their own children, are insufficient to change behaviour as usual. I suggest that such gaps between knowledge, values and behaviour are now sources of ecoanxiety and causes of ecoparalysis worldwide.

Solastalgia Beyond the relatively benign psychoterratic conditions of ecoanxiety and ecoparalysis, I have created a new psychoterratic concept that describes a form of distress that can have quite serious existential and psychological consequences. I have developed the term ‘solastalgia’ to describe the lived experience of negatively perceived change to a home environment (Albrecht, 2005; Albrecht, 2006; Albrecht et al., 2007). More precisely, ‘solastalgia’ describes the distress or desolation caused by the gradual removal of solace from the present state of one’s home environment. Solastalgia exists when there is recognition that the place where one resides and that one loves is being subject to chronic physical desolation. Solastalgia can be contrasted to the spatial and temporal dislocation and dispossession experienced as the traditionally defined concept of nostalgia. Solastalgia is the existential and emplaced experience of the loss of the value of the present as manifest in a feeling of being dislocated within a home location that is undergoing chronic change. One reason for creating the concept of solastalgia was that, unlike in traditional cultures and their languages, there are few words in English that make the connection between psychological and environmental states. The term ‘nostalgia’ has traditionally been used to refer to distress or melancholia connected to being

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absent from the homeland and a desire to return. However, a concept that relates to the present, to the lived experience of emplaced change within the home environment, had no obvious expression in English. In particular, the existential feeling that a home environment provided much diminished comfort or solace seemed central to many of the core themes I wished to express in a language of place. To be homesick within a home environment is now a common experience as familiar home environments, under powerful change agents such a global warming, inexorably move away from their owners. Solastalgia has its origins in the concepts of nostalgia, solace and desolation. Like the older meaning of nostalgia as melancholia or homesickness, solastalgia has connections to both psychological and physical contexts. Solace is derived from the Latin verb solari (noun solacium or solatium), with meanings connected to the alleviation or relief of distress or provision of comfort or consolation in the face of distressing events. It has one emphasis that refers to the comfort one is given in difficult times (consolation), while another refers to that which gives comfort or strength. A person or a landscape might give solace, strength or support to other people. Special environments might provide solace in ways that other places cannot. If a person lacks solace, then they are distressed and in need of consolation. If a person seeks solace or solitude in a much loved place that is being chronically desolated, then they will suffer distress. The other root word, ‘desolation’, has its origins in the Latin solus (noun desolare), with meanings connected to devastation, deprivation of comfort, abandonment and loneliness. It too relates to both psychological and physical contexts – a personal feeling of abandonment (isolation) and to an environment or landscape that has been devastated. In addition, I constructed the concept of solastalgia so that it has a ghost reference or structural similarity to nostalgia, thereby ensuring that a place reference is imbedded. Hence, solastalgia has its origins in the New Latin word ‘nostalgia’ (and its Greek roots nostos and algos); however, it is based on two Latin roots, ‘solace’ and ‘desolation’, with a New Latin suffix, ‘algia’ or pain, to complete its meaning. In my own part of the world, Australia, there is a case study of chronic environmental stress that provides a graphic analogue of future climate-induced phenological and place-based change. As a result of my personal engagement with citizens and their regional landscape desolated by open-cut coal mining in the Hunter Valley of NSW, I could see that psychoterratic conditions were serious components of overall psychic identity and well-being. Such observations were reinforced when, with colleagues Nick Higginbotham and Linda Connor, we began a funded investigation of the impact of coal mining and power station pollution on people in the Hunter Valley. By using qualitative research methods (Connor et al., 2004; Albrecht, 2005) complemented by the Environmental Distress Scale or EDS, an empirical measure of solastalgia, (Higginbotham et al., 2006), the relationship between ecosystem distress and human distress was given a foundation based on a study of the lived experience of people in the Hunter Valley. As an indication of the depth of feeling about these issues, an Indigenous man we interviewed, when asked for his reaction to the mined landscape, expressed

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his disgust about the massive changes to his traditional lands. He explained that he drives hundreds of unnecessary miles to avoid directly witnessing the mined areas because it upsets him so much to see the desecration and the desolation. He exclaimed that seeing the mined area “makes him wild” (Albrecht et al., 2007). Many of the early settler families of the Hunter Valley escaped the brutality and pollution of the Industrial Revolution of Britain, only to find it reappearing generations later in the dust, noise and pollution of contemporary coal mines and power stations. An exasperated farmer told the research team about his battle with a coal mine close to his property, “The industrial revolution has caught us again; we’ve got the same trouble. Where do we go, Patagonia or somewhere?” A female grazier fought the mine next door to her property for some time, but the relentless assault on her quality of life finally became too much for her. She described her state of being as “a real mess” and that her physical and mental health was seriously affected by the mining. Another woman stated that “she is almost reduced to tears thinking about it” and exclaimed that when the mining is finished in the region, the land will be useless for rural production and that people will be left with nothing but the emotionally distressing legacy of a desolated landscape and large hole in the ground or “the final void” (Connor et al., 2004). The empirical research supported such graphic personal testimony in that it showed “. . . as measured through the EDS, the concept of solastalgia appears to give clear expression, both philosophically and empirically, to the environmental dimension of human distress. This has not been achieved previously” (Higginbotham et al., 2007). Despite solastalgia having its origins in the context of mining-induced chronic environmental change, I argue that any context where place identity is challenged by pervasive change to the existing biophysical order has the potential to deliver solastalgia. In addition to large-scale development pressures, natural disasters, climate change and emergent disease (for human and non-human life) have been shown to generate unwelcome change to built and natural environments. While some might respond to such change with nostalgia and want to return to a desired past place or time, others will experience solastalgia and express a strong desire to sustain those things, both now and into the future, that provide comfort, consolation and solace. Natural change agents such as drought, fire and flood can be the immediate cause of place-based distress; however, it is the slow-onset or chronic stress of the ongoing loss of the markers of a familiar home environment delivered by those change agents that is most characteristic of solastalgia. Psychiatrists and psychologists deal with post-traumatic stress disorder (PTSD) as an acute condition following disaster and desolation, but they have not as yet come to grips with the post-PTSD period where there is ongoing chronic stress from an utterly transformed home environment. In the aftermath of dramatic and acute place-based distress caused by natural forces such as hurricanes, earthquakes, tsunamis and volcanoes, there is often an extended period of time in which victims directly experience a negatively transformed home environment. It often takes time before the physical and psychological reconstruction needed to repair desolated landscapes and people can take place. In these circumstances, solastalgia is a likely response that could be recognized and

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addressed by professionally trained support personnel. Such a solastalgic response may also be present in those who were voluntarily displaced before the disaster, but then return ‘home’ to a desolated environment. In late 2009, four years post-Katrina, whole neighbourhoods of New Orleans still remained desolated but with many people trying to live within them. I suggest that their chronic place-based distress most likely was connected to feelings of solastalgia. One report on the situation in New Orleans in 2009 suggested that a place-based stress was pervading the city: In a city that has famously grappled with mental illness for decades, caregivers on the front lines say the problem has grown exponentially since Katrina — and that the number of sufferers still in need of help easily runs into the thousands. Despite the rising scourge, the number of available hospital beds to treat the mentally ill in New Orleans has decreased by more than half. Locals have coined their own name for the mostly silent crisis: post-Katrina stress disorder. (Hudson et al., 2009)

At a less directly traumatic level, witnessing environmental desolation such as the removal of much-loved trees for new development in an urban environment can be the cause of a profound psychoterratic distress that can manifest as intense visceral pain and mental anguish. The gradual loss of iconic trees in any landscape turns this momentary acute distress into longer-term chronic solastalgia about the transformation of a loved element of the total environment. In Australia, under the combined impacts of a drying and warming climate, insect attack, fungal attack and human intrusion, native hardwood forests are suffering from a condition known as ‘die-back’. In particular, the iconic trees, those that are the tallest and largest, are the ones that die first. People living in these forested landscapes are now likely to be experiencing solastalgia at the lived experience of the loss of ‘their’ trees. Similar situations are unfolding worldwide for similar reasons. In addition to anthropogenically induced global warming, other forms of chronic change to home environments are clearly connected to human actions and agency. These include, for example, the elements of chronic stress regionally connected to war, terrorism, land clearing, mining, rapid development and the gentrification of older parts of cities. In all cases, solastalgia is characterised by identifiable negatively perceived changes to the ‘biophysical’ environment where people live. Changes to the cultural environment of people due to inward or outward migration might also be causes of stress, but that type of stress or potential distress is not conceptually or etymologically related to the concept of solastalgia unless it relates specifically to the structure and form of the biophysical environment. The concept of solastalgia has relevance in any context in which there is the direct experience of negative transformation or chronic desolation of the biophysical environment (home) by forces that undermine a personal and community sense of identity, belonging and control. While closely connected to research on the psychological impacts of displacement (Casey, 1993; Lowenthal, 1985; Relph, 1976; Fullilove, 2004; Fullilove, 1996; Read, 1996), the focus of my research on solastalgia is the distress of people who are not technically being displaced but are experiencing an emplaced, chronic and negatively perceived change to their home environment. They feel as if they are displaced within their home environment.

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Econostalgia The most popular meaning of the word ‘nostalgia’ in the contemporary world is a yearning to return to a past time and its corresponding place where things are perceived to be better than they are in the present. A feeling of nostalgia might, for example, be expressed as an urge on the part of some people to relocate to the 1950s when Elvis was ‘King’ and people and their values were seen to be more admirable than those of the present. For people experiencing this kind of nostalgia, there is a temporal and physical separation from a culturally defined period deemed to be more valuable than the present. There is no necessary connection to a lived experience of the loss of the value of the present environment (solastalgia); it is simply that the past contained elements that are felt to be better. An earlier definition of nostalgia involved a physical separation from a real and present home and feelings of sadness or melancholia about the separation. Especially evident in soldiers fighting on foreign shores, many medical experts assessed nostalgia to be a potentially life-threatening condition. Soldiers could die of the distress and melancholia, and repatriation or return to the fatherland was the only sure cure. What is clear again is the physical separation of a person from his or her home and a cure for the melancholia or homesickness dependent on being able to return to a familiar home environment. In the context of environmental and climate change, nostalgia once again could manifest itself as a serious psychoterratic condition. As indicated above, under the driving force of climate change, whole landscapes are altered beyond historical recognition and the inhabitants of ecosystems feel the imperative to move. In such circumstances, people who have been absent for some time from their historical home habitat might wish to return. However, if during their absence, distinctive features of home environments such as glaciers and iconic species completely disappear, people coming home will experience a new dimension of nostalgia, one not connected to their absence but tied to vital features of the home environment disappearing during their absence. In the past people who moved away from their home environment could suffer the separation distress of nostalgia. However, econostalgia will be connected to situations where people return to a biophysical location that is ‘home’ in name only, but one that has been totally transformed in their absence by development or climate change. They have no ‘lived experience’ of the change process so do not suffer from solastalgia; however, their nostalgia for a past reality that they were once intimately connected to will produce serious melancholia.

Conclusion It is unfortunate but psychoterratic syndromes are likely to become more common in the future. The factors that cause them, such as large-scale development pressure and climate change, are becoming more pervasive and powerful. To recognize these syndromes now and prepare in advance for their expression is prudent. As we saw with Hurricane Katrina and the people of New Orleans, being unprepared for the

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aftermath of acute disaster is itself disastrous. To be unprepared for the impact of chronic environmental change, especially when it is a known risk and global in its scale, is inviting further human desolation. By making a preliminary assessment of the different types of psychoterratic distress, we are forearmed; however, much more research is required to adequately define the field. Being largely existential and not biomedical in their origins, psychoterratic syndromes will require intensely compassionate and humanistic responses on the part of mental health and other caring professions (Smith, 2010). Moreover, the synergy between psychoterratic and somaterratic factors may well exacerbate an already-complex scenario. Here, the biomedical approach will need to collaborate in transdisciplinary (Albrecht et al., 2008) ways with humanistic traditions to overcome this emergent threat to the well-being and health of people in their shared home, the Earth.

References Albrecht, G. (2005). Solastalgia: A new concept in human health and identity. PAN (Philosophy, Activism, Nature), (3), 41–55. Albrecht, G. (2006). Environmental distress as Solastalgia. Alternatives, 32(4/5), 34–35. Albrecht, G. A. (2008). Solastalgia. In H. Gage (Ed.), Ice: A passage through time. Alaska: Ampersand Press, 55–58. Albrecht, G. A. (2009a). Environmental change and Psychoterratic syndromes. The Resilient People + Climate Change Conference, Fostering Psychosocial Resilience Among Human Populations, Vancouver, Canada. Albrecht, G. A. (2009b). Animal nostalgia and solastalgia: The animal mind and psychoterratic distress. The Minding Animals International Conference, Newcastle, Australia. Albrecht, G., Higginbotham, N., Connor, L., & Freeman, S. (2008). Human health and ecosystem health: A social perspective. In K. Heggenhougen (Ed.), Encyclopaedia of public health. San Diego, CA: Elsevier, 57–63. Albrecht, G., Sartore, G., Connor, L., Higginbotham, N., Freeman, S., Kelly, B., et al. (2007). Solastalgia: The distress caused by environmental change. Australasian Psychiatry,15(Special Supplement), 95–98. Casey, E. (1993). Getting back into place: Toward a renewed understanding of the place-world. Bloomington: Indiana University Press. Connor, L, Albrecht, G., Higginbotham, N., Smith W., & Freeman, S. (2004). Environmental change and human health in upper hunter communities of New South Wales, Australia. EcoHealth,1(Supplement 2), 47–58. Department of the Environment and Heritage. (2005). Mountain Pygmy-possum (Burramys parvus) Threatened Species Day fact sheet, Retrieved February 2010, from http://www. environment.gov.au/biodiversity/threatened/publications/tsd05mountain-pygmy-possum.html Dickinson, E. (2008). The green issue. The New York Times Magazine. Retrieved February 2010, from http://www.nytimes.com/2008/04/20/magazine/20Live-a-t.html?pagewanted=3. Fullilove, M. T. (1996). Psychiatric implications of displacement: Contributions from the psychology of place. American Journal of Psychiatry, 153, 1516–1523. Fullilove, M. T. (2004). Root shock: How tearing up city neighborhoods hurt America and what we can do about it. New York: Ballantine Books. Higginbotham, N., Connor, L., Albrecht, G., Freeman, S., & Agho, K. (2006). Validation of an environmental distress scale (EDS). EcoHealth, 3(4), 245–254.

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Hudson, A., Carpenter, A., & Lamkey, R., Jr. (2009, August 3). Mentally ill struggle in post-Katrina New Orleans. The Washington Times. Retrieved December 20, 2009, from http://www.mhsdla. org/docs/Washington%20Post%20Article.pdf IPCC. (2007). Synthesis report. Retrieved December 20, 2009, from http://www.ipcc.ch/ publications_and_data/publications_ipcc_fourth_assessment_report_synthesis_report.htm Jayan, T. V. (2008). Hot? You’ll go mad. The Telegraph, Calcutta, India. Retrieved December 20, 2009, from http://www.telegraphindia.com/1080427/jsp/7days/story_9194152.jsp Lifeline. (2009). Suicide leading cause of death in Australia. Retrieved December 20, 2009, from http://www.lifeline.org.au/learn_more/media_centre/media_releases/2009/suicide_ leading_cause_of_death_in_australia Lowenthal, D. (1985). The past is a foreign country. Cambridge: Cambridge University Press. Physicians for Social Responsibility. (2009). Health implications of global warming: Be mindful of mental health. Retrieved December 20, 2009, from http://www.usclimatenetwork.org/resourcedatabase/Mental%20Health%20Implications%20of%20Global%20Warming.pdf Post, E.,& Forchhammer, M. C. (2008, July 12). Climate change reduces reproductive success of an Arctic herbivore through trophic mismatch. Philosophical Transactions of the Royal Society London B: Biological Sciences, 363(1501), 2369–2375. Retrieved December 20, 2009, from http://www.ncbi.nlm.nih.gov/pubmed/18006410 Psychologists for Social Responsibility. (2010). Climate change and mental health: Evidence for action. Retrieved December 20, 2009, from http://www.psysr.org/about/programs/climate/ PSYSR_Climate_Change_and_Mental_Health-References_for_Action.pdf Read, P. (1996). Returning to nothing: The meaning of lost places. Melbourne, VIC: Cambridge University Press. Relph, E. C. (1976). Place and placelessness. London: Pion. Smith, D. (2010). Is there an ecological unconscious? Retrieved February 2010, from http://www. nytimes.com/2010/01/31/magazine/31ecopsych-t.html Tschakert, P., & Tutu R. (2010). Solastalgia: Environmentally-induced distress and migration due to climate change among Africa’s poor. In T. Afifi & J. Jäger (Eds.), Environment, forced migration and social vulnerability. Heidelberg, Springer, 57–72. UK Climate Impacts. (2010). Retrieved February 2010, from http://www.ukcip.org.uk/index.php? id=\&option=com_content\&task=view WHO Mental Health Home; Depression. (2009). Retrieved October 2009, from http://www.who. int/mental_health/management/depression/definition/en/

Chapter 4

Extreme Weather-Related Events: Implications for Mental Health and Well-Being David M. Simpson, Inka Weissbecker, and Sandra E. Sephton

Introduction This chapter examines research on the potential mental health effects of climate change–induced natural disasters. Specifically, we will discuss how extreme weather-related events can affect psychosocial well-being and mental health. Even when victims of a natural disaster suffer no physical harm, the experience can provoke a great deal of psychological distress that may manifest as anxiety, sleeplessness, recurring intrusive thoughts, and mood changes. Over weeks to months, these responses often settle into symptom patterns indicative of clinical syndromes such as posttraumatic stress disorder (PTSD), depression, and substance use. Unexplained somatic complaints increase after disasters, suggesting a psychological origin. Vulnerable populations such as children and those with low resource levels suffer disproportionately high levels of psychpathology after such events. For example, research has shown that anxiety, aggression, and behavior problems are more likely to be observed in children than in adults after exposure to a disaster. Disaster events are expected to increase in both scope and number as climatic changes increase. In turn, geographic areas at risk for damage from natural disasters are increasingly being developed by emerging nations and underserved communities. There is an urgent need for development of strategies to alleviate the mental health effects of disaster. Disaster response is extremely challenging from both research and practice perspectives; however, this work may bring large-scale benefits to affected individuals and communities.

D.M. Simpson (B) Department of Urban and Public Affairs, Center for Hazards Research and Policy Development, University of Louisville, Louisville, KY 40208, USA e-mail: [email protected]

I. Weissbecker (ed.), Climate Change and Human Well-Being, International and Cultural Psychology, DOI 10.1007/978-1-4419-9742-5_4, C Springer Science+Business Media, LLC 2011

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Framing Extreme Weather Events Description of Extreme Weather Events Extreme weather events are meteorological, hydrological, climatological, or related incidents that cause widespread damage, either in terms of human lives, property damage, or both. These events range in effect and scope. Some examples of extreme weather events can be listed as winter weather, heat waves, floods, drought, dust storms, wildfires, tropical cyclones, hurricanes, and tornadoes. These events are relatively commonly occurring events. What makes them extreme is the severity of their impact. Uncommonly large incidents in terms of spatial effects, the increased frequency of what might normally be an infrequent event, and the increased intensity of a particular event can make a more common weather event into an “extreme” weather event. For the purposes of this chapter, an extreme weather event is described as one that is considered a “disaster.”

Defining Disaster Defining an extreme weather event as a “disaster” helps to provide an idea of impact, but still leaves some ambiguity, as there is not a clear-cut definition of disaster. Quarentelli (1982, p. 457) addresses this issue by stating there are “at least seven different major ways in which disasters have either implicitly or explicitly been conceptualized.” Those methods deal with important constructs, such as how we describe disaster agents, impacts, social disruption, political framing of the event, among others. One method of defining a disaster is based on the notion that a disaster is only a “disaster” if the demands created by the event exceed the community’s capacity for dealing with it. Quarentelli calls this an “imbalance in the demand-capability ratio in a crisis situation” (1982, p. 464). For most situations, the definition of disaster implies a requirement for external assistance, and the more widespread the need for assistance, the larger the scope of the disaster. The Center for Research on the Epidemiology of Disasters (CRED) in Brussels, Belgium, uses the following definition: a disaster is a “situation or event which overwhelms local capacity, necessitating a request to a national or international level for external assistance; an unforeseen and often sudden event that causes great damage, destruction, and human suffering” (Below, Wirtz, & Guha-Sapir, 2009, p. 16).

Natural Versus Technological Disasters An important distinction exists in the disaster literature between natural and technological disasters (Baum, Fleming, & Davidson, 1983 ; Baum & Fleming, 1993; Bell, Greene, Fisher, & Baum, 2001; Quarantelli, 1998). Natural disasters are more sudden, cataclysmic, uncontrollable, acute (as distinct from chronic), and characterized by enormous destructive power and magnitude. Technological disasters, on the

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other hand, can be attributed to human activity rather than the product of natural forces, and are less predictable. The events are typically accompanied by little or no warning, are often chronic, less familiar, and are more likely to threaten feelings of control and to have complex impacts. They are less likely to elicit supportive and cohesive community response, more likely to foster anger, frustration, resentment, and helplessness, among other effects (Bell et al., 2001). Man-made disasters, including events resulting from deliberate attacks, raise uncertainty about the future and lead to a greater incidence of psychological symptoms than do natural disasters (Norris et al., 2002). More severe outcomes are noted across symptom categories including mild (e.g., sleep disturbance, fear, anger, sadness), moderate (e.g., insomnia, anxiety, reduction of functional capabilities), and severe symptoms (e.g., PTSD, major depression; Benedek et al., 2007). A current example of this range of responses has taken place with the Deepwater Horizon oil spill (also called the BP Oil Spill, which started on April 20, 2010) that leaked oil for months into the Gulf of Mexico.

Global Climate Change The understanding of natural versus technological disasters leaves global climate change somewhere in between these two classifications. The effects of forcing of naturally occurring climate change is largely the product of technological processes and products, though the consequent meteorological and climate change phenomena can manifest as natural disasters. Notably, climate change effects can elicit some of the same responses found in the case of technological disasters, including distrust of government, corporations, regulatory authorities, and science itself (Earle, 2004; Earle & Cvetkovich, 1995; Lang & Hallman, 2005). Global climate change is somewhat unique in that it creates multifaceted global impacts that will likely be chronic and not easily solved through conventional national or jurisdictional agencies, or ‘disaster’ policies and procedures (Marshall et al., 2007).

Framing Global Climate Change in Disaster terms A number of authors have suggested that framing global climate change in global disaster terms provides a clearer and more realistic picture of the interacting processes and impacts, their true magnitude and extent, the nature and scale of human impacts, and the imperative to take immediate disaster mitigation and preparedness measures (Spratt & Sutton, 2008; American Psychological Association, 2009). Some authors are proposing that there is a link between global climate change and the impact of extreme weather events and, therefore, an increase in disasters. For example, Hoyos, Agudelo, Webster, and Curry (2006) suggest an increase in category 4 and 5 hurricanes as a result of increases in global sea surface temperatures, while Knutson and Tuleya (2004) stated that warming induced by greenhouse gas may lead to increasing occurrence of highly destructive category 5 storms.

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Whether there is definitive causality or not for the connection between human activity and climate change, trend data support that the number of extreme weather events is increasing in absolute terms (Peduzzi, 2005). Peduzzi notes that while the number of earthquakes has remained relatively steady state, the number of hydrological and meteorological events have increased substantially. The increase is partially due to the increased development of coastal areas, but Peduzzi poses the questions as to how much of the increase is due to development and how much is attributed to global climate change. The increase in extreme weather events is also noted by the Intergovernmental Panel on Climate Change (IPCC), in which it is pointed out that the number of hydrometeorological extreme events has doubled in the last 5 years, while geologic hazards have remained the same (IPCC, 2002).

Extreme Weather Events and Differential Effects No one disaster is the same as the next, with each disaster having unique impacts based on the characteristics of the event. While there is not a unified consensus of how events are defined, there are several ways to define the disaster in terms of general characteristics. The disaster agents differ in terms of frequency, speed of onset, spatial impact (scope), impact duration, and the destructive potential. Similarly there are aspects of warning, and in some instances whether impacts can be prevented or mitigated.

Disaster Agents and Aspects The type of extreme weather event will have its own set of defining characteristics. While not exhaustive, a sample list of the more common extreme weather events is indicated in Table 4.1, with aspects of the particular disaster agent, all of which are influenced to some degree by climate change. The impact of a given event, in terms of lives lost and damages inflicted, will depend more upon the location of those impacted. This will be contextual in that it will depend on whether the event takes place in a developing area, whether any protective actions have been taken, and the intensity of the event. With this in mind Table 4.1 Characteristics of extreme weather events Event type

Onset

Scale

Duration

Warning period

Flood Flash flood Hurricane/cyclone Drought Wildfire Heat/cold wave

Slower Rapid Slower Slower Rapid Rapid

Regional Local Regional Regional Local/regional Regional

Days to weeks Hours Days Months to years Days to weeks Days to weeks

Yes No Yes Yes No Yes

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it is difficult to generalize the impact of any given event. Some aspects will drive behavior and response more than others. For example, the higher the frequency of a type of event, the more likely there will be adaptive and mitigative behaviors on the part of individuals and the community. One characteristic that has held true across disasters and across cultures is the fact that the disasters disproportionately affect the most vulnerable populations of the community. The most vulnerable tend to have fewer resources, may have substandard shelter, include the very young and the very old, and have less access to resources needed to survive and recover following a disaster. The same factors that create vulnerability in community populations also influence the choice of spatial location for development, often in riskier areas. Some must live near their place of work, as in the case of fishermen living on the beach, exposing themselves to tsunamis and flooding. Others might live where there is access to resources, such as near a river, and exposed to flooding and, in some cases, landslides. Still others might live where the land is more affordable, perhaps at the base of a volcano. In each of these cases the same factors that drive vulnerability – development in risk-prone areas, poverty, limited community resources, and other similar factors – are also true in the understanding of climate change induced risk and extreme weather events. Extreme weather event disasters, now on the increase, will continue to disproportionately affect those least able to withstand their impact.

Impacts on Physical and Community Systems Extreme weather events affect all levels of a community, from the individual and family to and including community systems of physical and social infrastructure. Depending on the scale of the event, it may also affect the region, state, and nation. The effects of a disaster can vary considerably at the community level. Poorer communities will tend to have far fewer resources to begin with, making survival and recovery that much more difficult. These aspects are described in the following sections that address community physical infrastructure, social systems, and community resilience.

Effects on Community Physical Infrastructure Core services of a community can be severely impacted by a disaster. In some cases, cascading infrastructure failure is possible, where once powers is lost, then too is the ability to continue water treatment, use communications technology, or operate transportation facilities. Basic lifeline provision (power and water) may be disrupted for weeks or destroyed completely. Extreme weather events such as hurricanes can have an associated storm surge (water wave) of 30 feet or more, which effectively “scours” all residential construction from the surge line (as happened in Hurricane Katrina, or as in the Indian Ocean tsunami of 2004).

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Power distribution networks can be severely damaged, and restoration can take extended periods (months to years). For poorer communities, risk to infrastructure tends to be even higher, as infrastructure elements may meet less than desired construction standards, roads and bridges may be constructed out of whatever materials are locally available, and secondary hazards such as structural collapse and fire may exacerbate problems in the response and recovery. Communities may not have adequate resources to have warning systems in place, because of lack of community infrastructure, communication systems, or technology. Lack of functioning water systems may also lead to secondary hazards such as the spread of disease and other issues in which insufficient sanitation may be evident. Clinics and other care-providing structures may have been lost in the event, making treatment difficult without outside assistance. The scale of the event may also have affected the community’s ability to respond with its emergency response capabilities. Lack of communication technology can delay the ability to contact the rest of the region or nation to request assistance and report the extent of the damage. The loss of basic infrastructure services as the result of an extreme weather event creates impacts beyond just the operation of community systems and directly affects each individual and family that has survived. Individual and family impacts are discussed below. In the next section, it is noted that other basic social infrastructures are affected by a disaster event.

Impacts on Community Social Systems Extreme weather events not only damage physical infrastructure but also damage and sometimes destroy basic social infrastructure systems. If school buildings are damaged, this not only disrupts the school system but may also impact the location and provision of shelter site services, as many schools are the designated shelter sites in the event of a disaster. Churches, mosques, temples, and other religious buildings may have also experienced damage, and this will impact routine community gatherings. The disruption is true of any community network or system of interaction, as day-to-day routines are disrupted, and the attention is focused first on rescue, then survival, and then the process of recovery. In addition to community and social networks being disrupted, basic financial transaction networks will also be impacted. In more developed areas this will mean that banks and electronic transactions are not possible, while in other areas it will mean the disruption of daily trade markets. If transportation hubs and access points are inaccessible, then it becomes difficult to bring in goods and services that are needed by the community. In some cases it is necessary to bring in supplies by helicopter, by boat, or by foot. For larger-scale events, communities will be without outside aid for an unknown amount of time. If communication networks are not functioning, that gap will be longer. If surrounding areas are equally and negatively affected, then there will be competing needs for any outside aid, and reaching all areas in need will take

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more time. The ability of a community to better withstand and be prepared for these extreme events has been called resilience, and will be discussed in the next section.

The idea of Community Resilience Manyena (2006) examines the concept and evolution of the term resilience as it applies to communities in the context of disasters and extreme events. He notes that the term has a Latin root resilio, meaning to ‘jump back.’ More recent discussions of the concept have used the word resilience in a similar way, identifying the capabilities of a community to “bounce back” from an adverse event or disaster. The less time it takes to restore some level of normalcy in the community, the more resilient the community is thought to be. There are not absolute means of measuring and identifying the qualities of resilience. Community resilience is described in more detail in Chapter 9 of this book. Within the framework of natural disasters, efforts are under way in many areas of disaster research (Chang & Shinozuka, 2004, Simpson & Katirai, 2006, Cutter et al., 2008, Simpson, 2008, Shaw, no date) to quantify such characteristics and thereby enable approaches that can be applied in more universal settings. Often these efforts seek to measure qualities of the community that seem to enable the “bounce back” to occur faster or places where outside assistance can be inserted to accomplish the same results. The wide variance in cultures, disaster impacts, and other contextual factors makes this process difficult at best. Approaches to understanding and promoting resilience evaluate key dimensions of a community and its functionality: physical, social, economic, governmental/institutional, and natural environmental factors. More successful efforts build on existing community networks and strengthen those aspects of the social capital that would help in the aftermath of an extreme event (UNDP, 2007). The guiding framework principles for these efforts are found in the Hyogo Framework for Action (HFA), and the “Global Platform for Disaster Risk Reduction” with priorities that focus on risk reduction through local community efforts. The overall goal is to achieve “disaster resilience for vulnerable communities” (ISDR, 2007a, b). Resilience is promoted, among other efforts, through the priority of building local understanding and awareness based on existing knowledge and expertise that are in the community. The concept of community resilience is crucial when considering the impacts of extreme weather events, because it encompasses not only the built environment and social infrastructures but is also found from within individuals and families, and their ability to respond and recover from the stressors of a disaster event. The Hyogo Framework addresses, in particular, the mental health outcomes of disaster: its fourth priority includes a mandate to enhance “psychosocial training programs to mitigate the psychological damage of vulnerable populations, particularly children, in the aftermath of disasters.” Further, the Pan-American Health Organization

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purports that “natural disasters and emergencies not only cause death physical illness and economic loss but also seriously affect people s mental health” (Hyogo Framework for Action, 2005–2015).

Extreme Weather Events and Impacts on Families Natural disasters may severely disrupt relationships between family members, including both parent–child and partner relationships. Relationship disruption can result from physical separation or psychological stress. For example, poorly coordinated evacuation can lead to separation of family members over long distances lasting days or weeks, such as that occurred in the aftermath of Hurricane Katrina. Even when family members continue to live together after a disaster, relationships can become disrupted as members cope emotionally with the aftereffects of traumatic disaster exposure or stress related to the sequelae of a disaster. “Stress” may be defined as a perception that events or circumstances tax or exceed one’s resources to cope (Lazarus & Folkman, 1984). Victims of extreme weather-related events frequently suffer psychological stress related to losses of loved ones, loss of health, damage to or loss of their home, or the loss of financial and material resources. While coping with the aftereffects of a natural disaster, parents may have less emotional energy for their children and may experience significant psychological distress and partners may have less ability to support one another.

Disaster-Related Stress Weather-related disasters initiate a series of subsequent stressors that can last from months to years (Oliver-Smith, 1998). Factors that most significantly impact symptom prevalence are the proximity, duration, and intensity of disaster exposure and the severity of losses experienced (Benedek, Fullerton, & Ursano, 2007). Families may suffer the loss of parents or children, injury, loss of home and material possessions, change of vocation or school, loss of friends and pets, financial loss, or relocation (Silverman & La Greca, 2002). For example, after Hurricane Katrina, stressors suffered by families included damage to their place of residence (experienced by over 90%), multiple relocations (moving occurred an average of 3.5 times in the first year after the disaster), loss of personal belongings (63%), separation of children from their primary caregiver (34%), seeing family members or friends injured (21%), separation from pets (20%), and, most severe, seeing a family member or friend killed (14%) (Osofsky & Osofsky, 2006). While traumatic exposure has severe psychological sequelae, seemingly more innocuous stressors such as multiple relocations frustrate the process of regaining education and employment and undermine the capacity of families to restore normal routines (Larrance, Anastario, & Lawry, 2007).

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Family Relationships in the Context of Disaster Children are among the most vulnerable to disasters, as processes of mental, social, and physical development are highly sensitive to stress. Shortly after experiencing a disaster, children frequently evidence regression, behavioral difficulties, and social withdrawal (Madrid & Grant, 2008). Many exhibit moderate PTSD symptoms 3–4 months after an event (Vernberg, Silverman, La Greca, & Prinstein, 1996). For some children, effects that persist for years can include depression, anxiety, and impaired functioning in family, school, and social environments (Lubit, Rovine, DeFrancisci, & Eth, 2003). Orphaned children and youth are especially at risk. Research on resilience in the face of chronic adversity suggests that children who have a positive relationship with a competent adult fare better in the long run (Masten, Best, & Garmezy, 1990). After the Indian Ocean tsunami of December 2004, thousands of children were orphaned (United Nations Office for the Coordination of Humanitarian Affairs, 2006). Family tracing and reunions can take months after a disaster occurs. Highlighting the importance of quickly reuniting separated families, the mere presence of a parent can shield a child from developing mental health problems, while secure attachment with a parent may protect children from the long-term effects of disaster-related stress. Research shows that even very young children in secure-attachment relationships readily signal their caregiver when needing attention (e.g., by crying) and at the same time display low physiologic stress responses. In contrast, children in insecure relationships are less likely to seek care and more likely to exhibit physiological stress responses (Nachmias, Gunnar, Mangelsdorf, Parritz, & Buss, 1996). However, parents and partners who are suffering from their own response to traumatic events, evacuation, relocation, loss of property, and other stressors may perform more poorly as caregivers. Parents may have reduced abilities to attend to and respond to children’s needs. Furthermore, parental reactions to a disaster are models for their children’s reactions. A child’s response to disaster may be inversely related to the availability and quality of their relationships with their parent or caregiver.

Impacts on Individuals Just as families and family relationships are impacted, individuals are also affected by extreme weather events. Individuals who are particularly at risk for severe outcomes of disasters include children, the elderly, people with ongoing medical or psychological illness, and those with poor social support networks (Fullerton, Fullerton, Ursano, Norwood, Holloway, 2003). It is anticipated that climate change will lead to flooding in some areas. In 2000, the town of Lewes in Southern England experienced severe river flooding. A cohort study was conducted by telephone interview for new episodes of illness in all age groups and for psychological distress in adults (Reacher et al., 2004). Two hundred and twenty-seven residents of 103 flooded households and 240 residents of 104

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nonflooded households in the same postal district were recruited by random selection. Having been flooded was associated with earache, and a significant increase in risk of gastroenteritis with depth of flooding. Adults had a four-time higher risk of psychological distress. Associations between flooding and new episodes of physical illness in adults diminished after adjustment for psychological distress. Flooding remained highly significantly associated with psychological distress after adjustment to physical illnesses. Psychological distress may explain some of the excess physical illness reported by flooded adults and possibly by children as well. Policies to promote population resilience to flooding where flood prevention has failed must include practical support for flood victims and provision of appropriate psychological support. These results for flooding and its associations with physical illnesses affirm the need for advice and assistance with individual, household, and environmental hygiene and access to medical services, including training of health care professionals in concepts of mental health and psychosocial support and in recognizing anxiety, depression, and unexplained somatic complaints that are more common after disaster, which has also been recommended by WHO (WHO, 2008).

Immediate Physical Health Effects Weather-related disasters can do both immediate and long-term physical harm. Nearly one-fourth of post-disaster health complaints are acute injuries (e.g., cuts, abrasion, sprains and strains; Freedy & Simpson, 2007). In a review of the Kobe and Northridge earthquakes, Lowder (1995) found that two of the most common conditions requiring treatment in the first day following the earthquake were lacerations (45%) and fractures/dislocations (11%). These immediate impacts can create additional stress and hinder response and recovery efforts, as those affected seek treatment or find themselves incapacitated. There are conflicted data as to whether immediate medical attention significantly affects survival rates (the socalled “golden hour”) following injury (Lerner & Moscati, 2008). Regardless of the fatality rates, however, injuries require attention and can reduce mobility and functionality of those injured and render them less able to tend to those not able to care for themselves, such as the very young and elderly.

Mental Health Effects of Disaster Psychological symptoms that emerge during the days or weeks following disaster can take months or years to dissipate. Some disaster victims develop chronic mental health problems such as posttraumatic stress disorder, depression, or anxiety (Vernberg et al., 1996). It is noteworthy that chronic PTSD has also been associated with increased risk for suicide, substance abuse, aggressive and violent behaviors, interpersonal problems, vocational difficulties, and health concerns (Brown, 2005). PTSD rates after the 2005 tsunami in Thailand were elevated among victims who

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experienced a delayed evacuation, felt that that their own or a family member’s life was in danger, or who felt extreme fear or panic (Warunee et al., 2006). It has been noted that psychological functioning following disaster should be globally assessed rather than limited simply to PTSD assessment. Other psychological stress reactions, however, are not always considered (Silverman & La Greca, 2002). Persistent anxiety and fear may be linked with the nature of disaster, especially among children (Vogel & Vernberg, 1993; Silverman & La Greca, 2002). Among children and adolescents assessed 2 months following the 2005 tsunami in Thailand, levels of depression were positively correlated with displacement after the tsunami. Depressive symptoms were also associated with feelings that one’s own or family members’ lives were in danger during the disaster (Warunee et al., 2006). In children, short-term responses to disaster may include developmental regression, clinging behavior, aggressiveness, inattentiveness, bed-wetting (in young children), somatic complaints, irritability, social withdrawal, and frequent crying (Madrid, Grant, Reilly, & Redlener, 2006). A survey conducted within a year after Hurricane Katrina determined that more than half of the children in affected areas in New Orleans needed mental health referrals for evaluation and almost 40% reported feeling depressed, angry, or sad (Osofsky & Osofsky, 2006).

Long-Term Effects of Psychological Distress on Physical Health Disaster-related psychological distress (e.g., PTSD, anxiety, depression) predisposes victims for subsequent physical health problems and somatic symptoms (Friedman & McEwen, 2004). PTSD is predictive of higher rates of subsequent medical illness including reproductive, metabolic, and immunological problems (Friedman & McEwen, 2004). Furthermore, up to one-half of all visits to primary care physicians are attributable to conditions that are caused or exacerbated by mental or emotional problems. Disaster exposure can impact long-term physical health in a way that is not explained by the event itself. Mental states such as anxiety and depression can manifest biologically as alterations of activity in brain circuits related to threatening situations. Repeated stress response activation may damage these neural structures (Sapolsky, 1996) and the physiological stress responses they activate (McEwen, 2008). In particular, the sympathetic branch of the autonomic nervous system or sympathetic nervous system (SNS) and the hypothalamic–pituitary–adrenal (HPA) axis comprise the two major stress response pathways. These systems respond to a novel acute stressor, such as a disaster often presents, to coordinate the “fight or flight” response that mobilizes energy and acuity to meet the demands of a physical stressor. The body does not discriminate physical from psychological stressors, however. Initial physiological responses tend to help a person respond to the physical demands of an earthquake, flood, or severe weather. In contrast, frequent and repeated traumatic memories of an event activate the same stress responses even when no physical demand is present.

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Both the HPA and sympathetic nervous systems regulate immune function. Glucocorticoids such as cortisol have multiple modulatory effects on immune function (Webster, Elenkov, & Chrousos, 1997). Chronic stress-related HPA activation may favor inflammatory processes (Elenkov & Chrousos, 1999). Thus, endocrine stress hormones can increase systemic low-grade, or “background,” inflammation, which has recently been shown to predispose for a number of diseases including cardiovascular illnesses in adults (Elhajj, Haydar, Hujairi, & Goldsmith, 2004; Feigin, Anderson, & Mhurchu, 2002). Suppression of certain other aspects of immune functioning is common after a disaster. For example, a review of 177 articles on disaster research that included over 60,000 respondents reported that over 25% of disaster victims experience a decline in immune system functioning, in particular cellular immunity, after a disaster (Norris et al., 2002). This decline in immune functioning may result in a higher number of self-reported somatic complaints and an increase in the number of days taken in sick leave.

Differential Physical and Psychosocial effects on Vulnerable Populations It is clear that when determining who are most vulnerable to psychosocial impacts of climate change, research on disaster intervention has identified groups to be at greater risk including children, the elderly, rural and urban poor, racial and ethnic minorities, those with a previous history of emotional disability, and, in general, those with a marginalized pre-disaster existence (Gheytanchi et al., 2007; Bourque et al., 2006)

Health Effects (Mental/Physical) Among Low-Income Disaster Victims One of the critical issues in the understanding of the effects of extreme events is the manner in which low-income or poverty-level populations are affected. Disasters disproportionately affect those who are most vulnerable due to poor health, low socioeconomic status, and advanced age. Such disaster victims are often the most vulnerable to injury because they are typically dependent on others to care for them in day-to-day environments, and then especially so during a disaster (Freedy and Simpson, 2007). In their analysis of Hurricane Katrina, Gheytanchi et al. (2007, p. 124) found disproportionate impacts on the poor, largely black communities of New Orleans’s Ninth Ward. As a group, these residents lacked access to quality education, housing, and employment opportunities available in surrounding communities. There were also issues of basic resource availability in terms of housing, transportation, and evacuation information prior to, and during, the storm. The lack of essential

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resources, shelter, transportation, and information led to higher rates of fatality, injury, and damage to property among poor black communities. In short, evacuation plans relied on resources not available to these residents. Race and socioeconomic factors must be considered in disaster response plans and, importantly, must also be considered in psychological response and prevention efforts.

Health Effects on Disaster Victims by Ethnicity A review of the literature on cultural aspects of mental health during national and international disaster responses (for an overview of issues, see Marsella and Christopher, 2004) reveals not only some commonality in mental health problems including the expected problems of anxiety, depression, acute stress reactions, and PTSD but also some variations in the definitions and meanings of disasters and variations in symptomatology and culture-specific expressions of distress. Although the need for cultural sensitivities among those providing mental health services following disasters has been recognized and encouraged, it remains largely an ideal rather than a reality. Disaster events point toward the need for additional research as well as practice guides and clinical recommendations to increase future cultural competency in disasters. This is especially the case in international setting and humanitarian crises (described in more detail in Chapter 6).

Health Effects on Children and Elderly Disaster Victims The most vulnerable among the population are those that already receive some level of routine care but, in an extreme event, require complete care such as the elderly and children. Bourque et al. (2006) examined the physical and mental health effects of Hurricane Katrina and found that elderly people were substantially overrepresented among the dead. They also reported that the preexisting circumstances of the evacuees made them particularly vulnerable to a high level of psychological distress that was exacerbated by severe disaster exposure and lack of economic and social resources. The elderly as a vulnerable population will continue to increase in the future. Hobbs and Stoops (2002) note that the proportion of older residents (above 65) and very old residents (above 85) is expected to rise in the coming decades. The proportion of the senior population in the very old category is growing quickly. Between 1960 and 2000, the number of those above 85 grew 274%, compared to the entire U.S. population, which grew only 45% (Hobbs & Stoops, 2002). Advancing age can be expected to be accompanied by multiple chronic illnesses that may result in increased vulnerability to infectious disease or external/environmental stresses, such as extreme heat. These issues, combined with poverty, may add to this vulnerability (Miller, 2007).

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At the other end of the age spectrum we find that the young are also at risk. Disasters can have profound and long-lasting negative psychological sequels for children. Mental health problems can emerge during the days or weeks following disaster and can take months or years to dissipate. Some studies have reported that 60% of children and 39% of adults were still suffering from some form of PTSD symptoms 2.5 years after a natural disaster (Norris et al., 2002). It is noteworthy that chronic PTSD has been associated with increased risk for suicide, substance abuse, aggressive and violent behaviors, interpersonal problems, vocational difficulties, long-term changes in brain structure and function, and health problems later in life (Brown, 2005). A growing body of research suggests that children are also at greater risk than adults to develop serious health impairments after experiencing a major disaster (Norris et al., 2002), possibly due to lasting effects of disaster-related stressors on stress responses systems.

Health Effects in Developing Nations It is usually the case that extreme events and disasters in developing countries will result in higher death rates and more destruction than similar events in developed nations. Among the approximate 600,000 worldwide deaths from weather-related natural disasters in the 1990s, 95% occurred in developing countries (World Health Organization, 2003). Factors contributing to increased risk in such countries include structural vulnerabilities, inadequate resources for disaster response, unfavorable socioeconomic and political conditions, inadequate perception of disaster risk and preparedness, and population density in urban areas (Inter-Agency Standing Committee, 2007; Hoyois, Scheuren, Below, & Sapir, 2007; Palakudiyil & Todd, 2003). Individuals who experience a disaster in a developing country are at high risk for developing psychological pathology such as anxiety, depression, and PTSD. For example, a study following the 1998 Armenian earthquake reported that 72% of children who experienced the earthquake were suffering from PTSD symptoms several months after the event (Grigorian, 1992). A lower prevalence was reported studies conducted in rural India, where 23% of children who experienced the disaster met criteria for PTSD months after the event (Sharan, Chaudhary, Kavathekar, & Saxena, 1996), and in Poland where 18% of adolescents met PTSD criteria 2.5 years after a flood (Bokszczanin, 2007). However, it should be noted that those figures should be interpreted with caution. Research conducted by scientists from developed nations, who apply their methods of measurement with unknown psychometric properties in different cultural settings, is frequently invalid and can lead to misleading conclusions. These studies point to the need for additional research and appropriately tailored intervention to reduce the incidence of postdisaster pathologies and better understand culture-specific expression of distress after disaster.

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Recommendations for Research Models, Procedures, and Measurement Disaster victims display both psychological and physiological stress responses after disaster, which can impact development and health. Therefore, the use of multimodal (qualitative, interview, self-report, and physiological) assessments should be encouraged in research and practice. Studies of the biological pathways by which disaster may affect health are especially lacking. Longitudinal studies that track disaster victims would provide additional insight into the benefit of intervention and treatment strategies. Studies need to address the complexity of these effects, with multidisciplinary teams that can examine and explore the impact of an event, as well as evaluate what interventions are appropriate and more or less effective. Culture-specific expressions of distress and common presenting symptoms such as unexplained somatic complaints are often not captured with traditional psychometric instruments. Strategies, tools, and techniques need to be evaluated for their cultural context, and a critical examination of proposed solutions should be undertaken to ensure an overall framework and specific set of interventions are culturally sensitive and ethical.

Research on Policy and Practice As described in the prior sections, extreme events and disasters cause damage and disruption from the individual to the collective community level. As climate change continues to influence the rate of extreme events, it will be critical to understand the policy and practice needs as we seek to plan for, respond to, and hopefully mitigate against the effects of disasters. To better prepare for events globally will require additional research on how we understand the differential effects on populations that are more vulnerable, less resourced, and disadvantaged before the event occurs. More robust measurement methodologies and metrics are needed to understand where in the physical and social infrastructure systems changes in practice are necessary and appropriate. To know where resources can have the most beneficial effect for preventing harm, either at the individual, family or community level, requires a better understanding of how the event disruptions affect social networks and individual and family dynamics. This kind of research is more interdisciplinary and holistic than what has traditionally taken place and will require new collaborations and nontraditional funding sources. At the core of this research is the desire to create communities, families, and individuals that are more “resilient.” While resilient is a term that is now more and more common, there is still little consensus regarding how one defines this concept, or, more importantly, how one moves a community system from a lower level of resiliency to a measurably higher level. The United Nations’ working definition of

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resilience incorporates a capability for learning from experience: “The capacity of a system, community or society potentially exposed to hazards to adapt, by resisting or changing in order to reach and maintain an acceptable level of functioning and structure. This is determined by the degree to which the social system is capable of organizing itself to increase this capacity for learning from past disasters for better future protection and to improve risk reduction measures” (UN/International Strategy for Disaster Reduction (ISDR), Geneva, 2004). Research on social systems needs to address the most vulnerable segments of communities worldwide: the very old, the very young, the poor and the disenfranchised. More focused research is needed to understand the investment potential for improving social capital resources in a community versus the paradigm of structural solutions, or trying to “build” one’s way out of a disaster. The goal is to create more adaptive communities, creating inherent resilience among community residents rather than an expectation that recovery will come from outside the community.

Recommendations for Practice Definitive attribution of natural disasters to human effects on climate change versus natural causes is difficult. Despite the actual cause of a disaster, the most consequential issue with regard to mental health effects among victims is the public perception of human cause. Because man-made disasters do not elicit the same level of community response, insufficient tangible support for victims of man-made disaster may predispose for worse mental and physical health outcomes. On a personal level, the grieving of disaster-related loss is likely to be complicated by feelings of anger, frustration, or resentment directed at the human causes of the event. While Hurricane Katrina was difficult to clearly attribute to human causes/climate change, the failure of levys to hold back the subsequent floodwaters elicited anger and complicated grief for victims. Because perception of human contribution to the cause of climate change–induced disasters is likely to affect mental health outcomes, victim’s perceptions regarding cause should be considered as a possible indicator of long-term well-being in both research and practice settings.

Community-Based Models of Preparedness The key to resilient communities will come from the strengths and capabilities of the local residents themselves. In the Japan and the U.S., a model has evolved that is based on the expectation that the local residents will be prepared to deal with the impact of an extreme event, without external aid coming for days or weeks. The framework is called Community Emergency Response Teams or CERT. These organizations have been proven to be effective in preparing communities and individuals and assisting with response and recovery efforts once a disaster has taken place (Simpson, 2000, 2001; Flint & Brennan, 2006). The basic principles recognize that

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there are latent capabilities of the local population, and that if given the opportunity to receive basic training and information, it would make them more effective first responders.

Needs in Developing Countries As noted by the ISDR (2009), not only will there be an increase in climate hazards but also “it will likely lead to other changes such as ecosystem degradation, reduced availability of water and food, and changes to livelihoods, that will increase the vulnerability of communities to natural hazards. Developing countries will be hardest hit by the increasing disaster risk. . .” (ISDR, 2009, p. 1). It will be vitally important to produce some “exemplary practice” guides, and the production of assistance that will not only mitigate future hazards as part of development but also reduce the exposure of vulnerable populations. An example of this kind of effort is seen in the ISDR publication “Applying Disaster Risk Reduction for Climate Change Adaptation: Country Practices and Lessons” where brief descriptions of projects, partnerships and processes are provide in the countries of India, Peru, Samoa, Vietnam, South Africa, and the U.K. (ISDR, 2009). The six examples underscore the need to build collaborative efforts and target the risks and specific needs of the local communities.

Individual and Family Support Needs The existing empirical literature strongly suggests that stressful events such as disasters may have both short- and long-term biological consequences, with possible wide-ranging effects. After weather-related disasters, victims are often confronted with additional and cumulative stressors that lead to feelings of loss of control and thereby continue to activate psychological and physiological stress responses. Recent data collected after Hurricane Katrina show that parents suffer greater distress if the family needs for help continue to be unmet years after the event (Kilmer & Gil-Rivas, 2010). Thus, simply improving tangible support could facilitate better adjustment among families by reducing parent’s distress. Disasters have different phases, including pre-impact, impact, recoil, postimpact, and recovery and reconstruction (La Greca, Vernberg, & Roberts, 2002). Evidence suggests that events during the impact phase account for much of post-disaster symptomatology, and interventions to limit psychological harm in this period are critical (Silverman & La Greca, 2002). It is important to note, however, that it is difficult to distinguish who will develop more chronic psychological problems during the impact phase, as most individuals will experience significant distress. This is considered a normal reaction to an abnormal event and should not be pathologized. It has been recommended that first responders and health care staff should be trained in basic principles of psychological first aid (PFA), which is a basic way

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of providing compassionate support with the goal of meeting the most immediate needs (IASC, 2007). Yet, the initial focus is often on search and rescue, medical treatment, and food and shelter. It would be important to consider issues of mental health and psychosocial support as part of disaster preparedness (e.g., by training response workers in PFA). Given the effects described in this review, it is apparent that more resources and attention need to be focused on alleviating psychological and biological stress reactions. Organizing support groups for caregivers can help parents engage in problem solving, share their concerns, and receive social support from others. The data on effects of chaotic homes and nonresponsive parenting are relevant and suggest that tangible support for parents during disaster response, in particular, support that stabilizes routines in the home and frees parental time and attention to be focused on children’s needs, may help protect children from impacts on social development.

Conclusion This chapter has identified a sample of the effects that increased extreme weather effects can have on all sectors of our communities, with effects ranging from direct infrastructure losses, to physical harm, to mental health effects, both short and long term. We have also identified places where additional research is clearly needed, as are revisions in our approach to practice and intervention at individual and all community levels. Beyond these identified issues, it is important to point out three additional points in closing. First, extreme weather events exist in a gray area when it comes to the attribution of blame for the event. On the one hand, it is a natural event. On the other hand, if attributed to global warming, the increase and severity of the events are attributable to human-induced climate change. For victims of natural disaster, subjective appraisal of human cause of the event may have much to do with the degree of resulting mental distress. Second, while these extreme weather events have differential onset and impacts as described in prior sections, their mental health effects may all be chronic and last far beyond the even the recovery phase of the event. Whether a drought or hurricane, the mental health effects can last months to years as the events themselves tend to initiate a series of emotional stressors, relocation, loss of loved ones, or educational and vocational opportunities. Third, there is increasing understanding that efforts across the spectrum of community, family, and individuals and across physical and social networks and infrastructure systems must be approached in a more interdisciplinary and holistic manner. More importantly, we must look for ways in which we can draw on existing and latent social capital and resources of the local community and find ways to leverage those strengths with interventions that can have exponentially positive effects on the individual and the community. For example, there is promising research on the positive mental and physical health benefits of supportive social networks (Kawachi & Berkman, 2001; Uchino, Cacioppo, Kiecolt-Glaser, 1996;

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Cohen, 2004). These findings suggest high promise for disaster interventions aimed at the family and community level, especially with regard to beneficial effects on broader and long-term mental and physical health outcomes.

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gastrointestinal and other illness and mental health in flooded and non-flooded households. Communicable Disease and Public Health, 7(1), 39–46. Sapolsky, R. (1996). Why stress is bad for your brain. Science, 273(5276), 749–750. Sharan, P., Chaudhary, G., Kavathekar, S. A., & Saxena S. (1996). Preliminary report of psychiatric disorders in survivors of a severe earthquake. American Journal of Psychiatry, 153(4), 556–558. Shaw, R., & IEDM Team. (n.d). Climate disaster resilience: Focus on coastal urban cities in Asia. Retrieved February 8, 2010, from Kyoto University: http://www.unescap.org/idd/events/2009_ EGM-DRR/Japan-Rajib-Shaw-CLIMATE-DISASTER-RESILIENCE.pdf Silverman, W. K., & La Greca, A. (2002). Children experiencing disasters: Definitions, reactions and predictors of outcomes. In A. La Greca, W. K. Silverman, E. M. Vernberg, & M. C. Roberts (Eds.), Helping children cope with disasters and terrorism. American Psychological Association. Helping children cope with disasters and terrorism (pp. 11–33). Washington, DC, US: American Psychological Association, xvii, 446 pp. Simpson, D. M. (2000). Non-institutional sources of assistance following a disaster: Potential triage and treatment capabilities of neighborhood-based organizations. Journal of Pre-Hospital and Disaster Medicine, 15(4), 73–80. Simpson, D. M. (2001). Community emergency response training (CERTs): A recent history and review. Natural Hazards Review, 2(2), 54–63. Simpson, D. M. (2008). Disaster preparedness measures: A test case development and application. Disaster Prevention & Management, 17(5), 645–661. Simpson, D. M., & Katirai, M. (2006). Measurement and indicators for disasters: Topical bibliography. Working Paper # 06-01. University of Louisville: Center for Hazards Research. Spratt, D., & Sutton, P. (2008). Climate code red: The case for emergency action. Carlton North, VIC: Scribe Publications. Uchino, B. N., Cacioppo, J. T., & Kiecolt-Glaser, J. K. (1996). The relationship between social support and physiological processes: A review with emphasis on underlying mechanisms and implications for health. Psychological Bulletin, 119(3), 488–531. UNDP. (2007). Building disaster resilient communities: Good practices and lessons learned (67 pp). Geneva: Publication of the Global Network of NGOs for Disaster Risk Reduction. Vernberg, E., & Varela, R. (2001). Posttraumatic stress disorder: A developmental perspective. In M. W. Vasey and M. R. Dadds (Eds.), The developmental psychopathology of anxiety (pp. 386– 406). New York: Oxford University Press. Vernberg, E. M., Silverman, W. K., La Greca, A. M., & Prinstein, M. J. (1996, May). Prediction of posttraumatic stress symptoms in children after hurricane Andrew. Journal of Abnormal Psychology, 105(2), 237–248. Vogel, J., & Vernberg, E. (1993). Children’s psychological response to disasters. Journal of Clinical Child Psychology, 22, 464–484. Warunee, T., Lopes Cardozo, B., Somchai Chakkraband, M. L., Guadamuz, T., Pengjuntr, W., Tantipiwatanaskul, P., et al. (2006). Symptoms of posttraumatic stress disorder and depression among children in Tsunami-affected areas in Southern Thailand. Journal of the American Medical Association, 296, 5549–5559. Webster, E., Elenkov, I., & Chrousos, G. (1997). The role of corticotrophin-releasing hormone in neuroendocrine-immune interactions. Molecular Psychiatry, 2(5), 368–372. Weinstein, N. D., Lyon, J. E., Rothman, A. J., & Cuite, C. L. (2000). Preoccupation and affect as predictors of protection action following natural disaster. British Journal of Health Psychology, 5, 351–363. Weissbecker, I., Sephton, S. E., Martin, M., & Simpson D. M. (2008). Psychological and physiological correlates of stress in children with exposure to disaster: A review of the current research. Children, Youth and Environments, 18(2), 33–70. World Health Organization. (2003). Climate change and human health: Risks and responses. Summary. Geneva, Switzerland: World Health Organization. World Health Organization. (2008). Scaling up care for mental, neurological and substance use disorders. Geneva, Switzerland: Mental Health Gap Action Program.

Chapter 5

Humanitarian Crises: The Need for Cultural Competence and Local Capacity Building Inka Weissbecker and Jennifer Czincz

Climate Change and Humanitarian Crises Humanitarian Crises Humanitarian crises are already causing significant suffering in many regions throughout the world, and climate change is likely to worsen the problem. With rising temperatures, climate scientists predict an increase in droughts and floods, as well as more severe tropical storms and other adverse weather events such as heat waves (IPCC, 2007). Such extreme weather events can manifest as natural disasters, which are defined as causing a “serious disruption of the functioning of a community or a society causing widespread human, material, economic or environmental losses which exceed the ability of the affected community or society to cope using its own resources” (International Strategy for Disaster Risk Reduction, 2004). Humanitarian emergencies, on the other hand, are characterized by additional factors such as the need for external assistance, risks of ongoing excess deaths, diseases, and malnutrition (Office for the Coordination of Humanitarian Affairs (OCHA), 1999). Complex humanitarian emergencies can result from additional factors such as ongoing armed conflict, leading to extensive violence and loss of life, massive displacement of people, widespread damage to societies and economies, the need for large-scale, multifaceted humanitarian assistance, as well as hindrance to such assistance by political and military constraints and security risks to relief workers (Office for the Coordination of Humanitarian Affairs (OCHA), 1999). The extent of humanitarian emergencies can be measured using rates of mortality, malnutrition, and diseases (e.g. measles, cholera, diarrhea), as well as by the breakdown of governmental structures and human rights abuses (Toole & Waldman, 1990). An increase in humanitarian crises has been recognized as yet another likely result of climate change, with the international and humanitarian communities working on

J. Czincz (B) Yale University School of Medicine, New Haven, CT 06511, USA e-mail: [email protected]

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identifying areas of high risk, adaptation mechanisms, and responses. Issues of mental health and psychosocial well-being have received increasing consideration in the area of humanitarian crises, which also has implications in the context of climate change. The goal of this chapter is threefold: to provide a framework for conceptualizing vulnerability at the individual, community, and country levels; to shed light on important challenges and cross-cultural considerations in the humanitarian field; and to explore ways in which psychologists and mental health professionals can contribute to responding to humanitarian crises, promoting adaptation, and building the evidence base for effective intervention.

The Interaction Between Hazards and Vulnerabilities Climate change has been conceptualized to result in humanitarian crises through the interaction of two factors: the direct effects of weather-related phenomenon called “hazards” and the underlying vulnerability of the affected population (Schneider et al., 2007; Thow & de Blois, 2008). Direct effects of climate change relevant to humanitarian crises include the climate hazards of floods, droughts, and tropical cyclones (Thow & de Blois, 2008). Underlying vulnerabilities can be divided into five groups, which include natural (e.g. availability of water, agriculture), human (e.g. poverty and health), social (e.g. governance, conflict risk, displacement), financial (GDP), and physical (e.g. road and communication infrastructure) vulnerabilities (Thow & de Blois, 2008). The combination of hazards and vulnerabilities increases the risk of harmful consequences such as deaths, injuries, losses of property and livelihoods, disrupted economic activities, and damaged environments (Thow & de Blois, 2008). Vulnerabilities can be present at the individual, community, and country levels. At the country level, underlying vulnerabilities encompass the lack of financial resources, weak or undemocratic governance, and widespread poverty and health problems, which already co-occur in many regions of the world, including several areas in Africa and Central and South Asia. It is notable that many of the countries that are less developed and more vulnerable both economically and politically are the very same areas that are being more profoundly affected by climate change. Indeed, a report commissioned by the Office for the Coordination of Humanitarian Affairs and other organizations has identified several countries and regions as “risk hot spots,” which have the combination of high climate hazard risk and high underlying vulnerability (as defined by the five factors named previously). These areas include Africa (e.g. sub-Saharan Africa, Central Africa and Southeast Africa, the Great Lakes region, and Madagascar); Central, South, and Southeast Asia (e.g. Afghanistan, Pakistan, parts of India, Bangladesh, Myanmar, Vietnam, and Indonesia); Central America; and the western part of South America (see Fig. 5.1). Many of these regions are at risk for more than one climate hazard and rank low on human development indices. The risk for humanitarian emergencies is also compounded by increasing population density in South and Southeast Asia, as well as by risks for armed conflict in South Asia and parts of Central and East Africa

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Map 13:

Fig. 5.1 Humanitarian risk hotspots. Source: Thow and de Blois (2008)

(Thow & de Blois, 2008). As discussed in more detail in Chapter 8, climate change may increase the risk of conflict and further destabilize vulnerable regions, driven by factors such as resource scarcity, mass migration, and increased dissatisfaction with weak or nondemocratic governance (Smith & Vivekananda, 2007). The risk of armed conflict can be exacerbated by environmental events such as droughts, for example, which could result in complex and protracted emergencies (Thow & de Blois, 2008). It has been noted by several authors that those living in developing countries will likely bear the brunt of disasters and humanitarian crises related to climate change. Indeed, between 1990 and 1998, 97% of all deaths resulting from natural disasters occurred in developing countries (Strachan, 2006). Vulnerabilities also apply at the community and individual levels. Communities with fewer resources situated in disaster-prone areas (e.g. low-lying areas, slums) are at increased risk for being affected by climate hazards and adverse consequences such as displacement, further poverty, and disease (Thow & de Blois, 2008). Specific subgroups such as women, children, the elderly, those with preexisting disabilities, marginalized groups, and those living in poverty are similarly at a higher risk during disasters and often constitute disproportionate numbers of victims (Douglas et al., 2008; Thow & de Blois, 2008). Differences in vulnerabilities therefore occur both between and within countries, which has consequences for disadvantaged groups even in wealthier nations. Hurricane Katrina in the United States, for example, had a disproportionate effect on the poor and on African Americans (Atkins &

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Moy, 2005). When considering the risk for developing mental health problems following disasters and crises, vulnerable groups similarly include children, women, the elderly, the poor, racial and ethnic minorities, marginalized groups, and those with a previous history of severe stressors or mental disorders (Norris et al., 2002). It seems likely that the complex interaction between extreme weather events and underlying vulnerabilities can further exacerbate preexisting inequalities between countries, communities, and individuals. Mental health problems are relevant in this context since they can contribute to underlying vulnerabilities or result from humanitarian crises.

The Role of Mental Health and Psychosocial Well-Being Mental Health Problems as an Underlying Vulnerability Health has been recognized by humanitarian organizations as one of the five key underlying vulnerabilities contributing to the risk for adverse consequences due to humanitarian crises related to climate change. However, health in this context refers to physical (e.g. prevalence of HIV, malaria, tuberculosis, and undernutrition) but not mental health conditions (Thow & de Blois, 2008). The World Health Organization has only recently released a report recognizing people with mental health problems as a vulnerable population (World Health Organization, 2010). Those suffering from preexisting mental health problems are especially vulnerable to the harmful consequences of humanitarian crises (Jones et al., 2009). Individuals with severe mental disorders may be abandoned or mistreated by their families when leaving their residences as a result of climate hazards or conflict (i.e., tied to trees, chained, kept in cages; Jones et al., 2009). Even the mentally ill who are taken to refugee camps typically do not have access to the facilities and staff needed to provide adequate care and medication (Jones et al., 2009). This vulnerability is compounded by the fact that mental health and psychosocial programs that are set up during humanitarian crises are often narrowly focused on “trauma” and PTSD, leaving other mental health problems untreated (Jones et al., 2009). Furthermore, mental health problems are correlated with many of the same underlying vulnerabilities that increase the adverse impact of climate change and humanitarian crises. Specifically, factors such as poverty, low education, political insecurity, and social exclusion have also been associated with higher rates of mental health problems (Patel, Araya, de Lima, Ludermir, & Todd, 1999; World Health Organization, 2008). On the one hand, mental illness can contribute to further vulnerability such as poor physical health and lower economic productivity. Depression, for example, has been associated with decreased adherence to HIV and tuberculosis regimens, while maternal depression has been linked with child undernutrition and poor child growth (Patel, DeSouza, & Rodrigues, 2003; Rahman, Patel, Maselko, & Kirkwood, 2008). On the other hand, diseases such as HIV have been linked with subsequent psychosocial difficulties (Collins, Holman, Freeman, & Patel, 2006). Mental health problems can therefore result from underlying

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vulnerabilities as well as contribute to and create new vulnerabilities to the effects of climate change in humanitarian settings. Yet, much of the projected humanitarian impact of climate change will occur in developing countries that already have a weak health infrastructure and even fewer mental health services. Low-income countries have 0.05 psychiatrists and 0.16 psychiatric nurses per 100,000 people, compared to 200 times more in high-income countries (World Health Organization, 2005a) (see Fig. 5.2). The World Health Organization estimates that 76–85% of serious mental health cases in less-developed countries have received no treatment in the previous 12 months (World Health Organization, 2008). Mental health remains one of the most underfunded areas of health care, especially in low-resource settings, and there is a large gap between what is needed and what is available (Inter-Agency Standing Committee, 2007; World Health Organization, 2008). The World Health Organization has identified countries that currently have a high burden of mental, neurological, and substance use disorders, few mental health professionals, and a low GDP (World Health Organization, 2008). Several of those countries have also been designated humanitarian climate change “hotspots,” including countries in Africa (e.g. Burundi, DRC, Ethiopia, Nigeria, Djibouti), Asia (e.g. Afghanistan, Bangladesh, India, Indonesia), the Americas (e.g. Haiti), and Eastern Europe (e.g. Azerbaijan).

Mental Health Problems as Consequence of Humanitarian Crises Individuals affected by humanitarian crises frequently suffer various severe and interrelated stressors such as losing their home, livelihoods, material belongings, and community or social support systems. They may also witness horrific events and atrocities and lose loved ones, become separated from family members, and suffer physical assault, gender-based violence, or severe malnutrition (Inter-Agency Standing Committee, 2007). Children and youth may become orphaned or separated, which puts them at increased risk for living on the streets, human trafficking,

Fig. 5.2 Number of psychiatrists per 100,000 population. Source: World Health Organization, 2005a

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exploitation, dangerous or forced labor, undernutrition, or being abducted into armed groups (Inter-Agency Standing Committee, 2007). Such severe events and chronic stressors can cause significant suffering among the affected population. The majority of individuals experience acute symptoms of distress that resolve without intervention, while others may develop more long-standing mental health difficulties (Inter-Agency Standing Committee, 2007). As will be discussed later in this chapter, it is difficult to estimate the impact of humanitarian crises on mental health, as many existing studies in this area suffer from methodological limitations that do not give due consideration to culturally shaped local expressions of distress. The World Health Organization estimates that in humanitarian emergencies, the percentage of people with a severe mental disorder increases by 1% over the baseline of 2–3%, while mild or moderate mental disorders such as PTSD or depression may increase by 5–10% above estimated baseline of 10% (World Health Organization, 2005b). The link between mental health problems and acute weather disasters (i.e., floods, cyclones) has been established to a much greater extent than more chronic climate-related problems such as droughts, which can also turn into humanitarian crises (Berry et al., 2008). Some research suggests that acute disasters tend to be related to more rapid-onset difficulties such as traumatic stress and anxiety reactions, while slow-onset hazards such as droughts tend to result in more helplessness, depression, ongoing emotional distress, and generalized anxiety (Coelho, Adair, & Morcellin, 2004). The experience of humanitarian crises and large-scale disasters such as flooding and tropical storms has been associated with an increased incidence of depression, PTSD and other anxiety disorders, substance abuse, suicide, and somatic complaints (Ahern, Kovats, Wilkinson, Few, & Matthies, 2005; Inter-Agency Standing Committee, 2007; Norris et al., 2002). Children may display behavioral problems, aggression, bed-wetting, or increased anxiety (Durkin, Khan, Davidson, Zaman, & Stein, 1993; Inter-Agency Standing Committee, 2007; Norris et al., 2002). Severe droughts have the potential of leading to famine and malnutrition, which can have especially severe impacts on children. Prenatal, postnatal, and childhood malnutrition have been associated with lower cognitive functioning and behavioral problems such as ADHD among children (Galler & Barrett, 2001). Prenatal exposure to famine and malnutrition may also increase the risk for the development of conduct disorder, antisocial personality disorder (Neugebauer, Hoek, & Susser, 1999), and schizophrenia (Song, Wang, & Hu, 2009; St Clair et al., 2005). Such mental and behavioral problems can persist into adulthood and can have implications for long-term development and educational and occupational achievement. It has been estimated that a large drought in Zimbabwe, for example, contributed to a loss of 7–12% of lifetime earnings for the children who suffered from malnutrition (Alderman, Hoddinott, & Kinsey, 2003). Mental health and behavioral problems not only cause significant human suffering but further increase indicators of human vulnerability such as lower economic productivity, poverty, and poor health. It has been recognized that mental health problems can negatively impact recovery efforts as well as social and economic development of communities after humanitarian crises (Baingana, Bannonb, & Thomas, 2005). Health problems associated with psychological stress and mental illness include cardiovascular, metabolic, central nervous system, gastrointestinal,

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reproductive, and immunological problems that may lead to increased disease susceptibility (McEwen, 1997; Reacher et al., 2004). Depression and substance use disorders also adversely affect adherence to treatment for other diseases such as HIV/AIDS and tuberculosis (World Health Organization, 2008). Those suffering from mental health and behavioral problems are also at a higher risk for violence and injuries (World Health Organization, 2008). In sum, mental health, psychosocial and behavioral problems are relevant in understanding and projecting the impact of climate change on humanitarian crises. First, individuals with preexisting mental health problems are more vulnerable to the adverse effects of humanitarian crises such as death, injury, and human rights abuses. Second, mental health and behavioral problems are both causes and effects of other underlying human vulnerabilities such as poverty and poor health. Third, humanitarian crises can have profound impacts on mental health and psychosocial well-being, which can further increase vulnerability and reduce prospects for social and economic recovery and development. Lastly, it should be noted that many of the countries identified as “hotspots” that are at risk for humanitarian crises due to climate change are the same countries that already suffer from higher rates of mental health problems and weak mental health infrastructure. Together, these points confer a strong imperative for action among the mental health community to join the dialogue on climate change and to advocate for the inclusion of mental health and psychosocial factors in relevant projections, research, and allocation of resources. However, in order to do this effectively, several important challenges in this field should be considered.

Challenges and Cross-Cultural Considerations Providing Humanitarian Assistance The term “humanitarian assistance” defines interventions aimed at meeting immediate and basic needs of populations affected by crises and conflict. Such needs fall into categories such as water and sanitation, food and nutrition, shelter, settlement, and nonfood items as well as health services. It has been projected that climate change could increase humanitarian costs anywhere between 32% (57 million USD) and 1600% (2.7. billion USD, when criteria such as climate hazard intensity are taken into account) by 2030 (Webster, Ginnetti, Walker, Coppard, & Kent, 2008). However, humanitarian spending typically falls short of covering the true cost of humanitarian emergencies, which include all direct losses (i.e. economic, physical, human) as well as indirect effects (i.e. lost income or productivity, greater national debt or inflation, and a decreased focus on prevention efforts in favor of emergency relief) (Schipper & Pelling, 2006). Providing humanitarian assistance has become more dangerous over the years, as humanitarian emergencies tend to occur in areas of political instability or armed conflict. Furthermore, the nature of humanitarian relief has changed over the past decades, as most conflicts do not occur between but within weakened or collapsed states (Burkle, 1999), and climate change may further reinforce this trend.

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Humanitarian aid workers are increasingly targeted by armed groups and face significant security threats and problems of accessing affected populations and providing services in insecure, disrupted, and remote settings (Sheik et al., 2000). Acute humanitarian crises often turn into prolonged emergencies in large geographical areas with ongoing difficulties arising from instability, mass migration, lack of accountability, and human rights abuses. It has been shown that disasters and crises that are acute and receive significant attention from the media also tend to receive the most humanitarian assistance (Brownscombe, 2005). However, two of the three types of climate hazards that may lead to humanitarian crises, droughts and floods (as opposed to tropical storms) are likely to have a slower onset and a more chronic course, which may make them invisible to the general public. Humanitarian needs arising from the effects of climate change are likely to be complex. Addressing mental health and psychosocial issues in this context should take such complexities into account and occur in coordination with the affected population, governments, and the humanitarian and development communities.

Assessment and Intervention The assessment of mental health and psychosocial issues as well as the design and implementation of programs in humanitarian contexts is ripe with controversy and criticisms, which have explored the assessment, validity, and treatment of mental health problems as well as their historical, cultural, and sociopolitical contexts (Pupavac, 2004; Summerfield, 1999). Short-lived interventions that are implemented in response to humanitarian crises by mainly Western mental health professionals, and that solely focus on problems of stress and trauma resulting from the current crisis, have been criticized as inappropriate for several reasons, and they often do not take the perceived needs of affected populations into account. Humanitarian crises do not occur in a vacuum but within a framework of previous stressors and vulnerabilities as well as subsequent difficulties and events. As mentioned previously, mental health problems are often closely tied to underlying economic difficulties, political instability, social marginalization, and poor overall health (Nordanger, 2007; Summerfield, 1999). Communities may perceive other problems and daily stressors such as poverty and domestic or community violence as more pressing than specific events considered “traumatic” by Western aid workers (Miller, Kulkarni, & Kushner, 2006; Summerfield, 1999). Focusing solely on mental health effects of one “traumatic event” (e.g. a flood or a storm) may also not capture complexities of prior stressful experiences and future stressors of protracted humanitarian crises. Research suggests that current difficulties such as poor social support or stigmatization can be stronger predictors of mental health problems such as depression than past traumatic experiences of atrocities (Gorst-Unsworth & Goldenberg, 1998). Humanitarian crises do not only occur within the context of various prior and future stressors, but are also experienced and perceived by individuals and communities within specific cultural frameworks. Western assumptions about the extent and

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type of suffering and mental illness or about the etiology, assessment, and treatment of mental health problems therefore require critical examination. Historically, clinicians, researchers, and humanitarian workers have often worked under the premise that everyone exposed to a “traumatic event” or a “critical incident” was in need of intervention, and whole groups and populations were assumed to be “traumatized” (Pupavac, 2001). This assumption may have stemmed from a medical model, in which an impact occurs on a static object (the body) that subsequently may show signs of such impact that seem relatively universal. As noted earlier, however, various research studies suggest that most individuals who have been subjected to crises and even to horrific events do not subsequently suffer from mental disorders (Inter-Agency Standing Committee, 2007). An important distinction should be made between the actual events and the subjective reaction to those events, which vary from person to person. Furthermore, it has been found that large-scale single-session mass interventions, such as debriefing, can be harmful (Rose, Bisson, Churchill, & Wessely, 2002; Summerfield, 1995) and are no longer recommended (Inter-Agency Standing Committee, 2007). It should also be considered that mental health problems among affected diverse cultural communities may not fit with Western DSM or ICD criteria (Summerfield, 2002). Local expressions or “idioms of distress” (Breslau, 2004; Kleinman, 1995) may show similarities and differences compared to standardized diagnostic criteria, depending on the cultural context. In many regions such as Southeast Asia, for example, psychological distress can manifest as somatic complaints including headaches, stomachaches, or chronic pain, while other symptoms such as sleep paralysis have been observed in Cambodian refugees (Miller et al., 2006). Admitting to experiencing mental health difficulties is also associated with shame and stigma in many cultures, which may also contribute to the presentation of symptoms in a somatic context or which may deter people from seeking help. Expressions of distress can also manifest in impaired social or occupational functioning or in socially deviant behaviors such as substance use and domestic and community violence (Marsella & Christopher, 2004). Aid organizations and researchers tend to focus programmatic efforts on particular subgroups such as children, women, or victims of violence while less attention has been paid to other important groups such as the elderly, men, and individuals suffering from learning disabilities, developmental disorders, or severe mental disorders (Allden et al., 2009; Breslau, 2004). Yet, those with severe mental disorders are among the most vulnerable during humanitarian crises. A recent study compiling data from community-based mental health services in five humanitarian settings found that complaints of reactions to extreme stress and adjustment disorders only constituted 0–19% of presenting problems, while other severe neuropsychiatric disorders (e.g. epilepsy and schizophrenia) made up 28–91% of complaints (Jones et al., 2009). Yet, broader mental health services are typically not available, leaving those with preexisting mental health problems at higher risk for death, injury, suffering, and human rights abuses. Another critique of mental health in humanitarian settings is that the medicalization of trauma separates it from its sociopolitical context, where it belongs (Miller et al., 2006; Summerfield, 1999; Zarowsky, 2004). Furthermore, the focus

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is placed on the individual problems rather than the surrounding social problems (Kleinman, 1995), and suffering is seen as individual and not collective (Zarowsky, 2004). Indeed, individuals and communities themselves may experience their suffering as social or political and not as medical and as relating to a larger framework of testimony and advocacy. This point also seems applicable to the context of climate change and its consequences, which occur within a larger framework of social and political causes and responsibilities. Mental health interventions during humanitarian crises can also undermine traditional, nonprofessional family and community support mechanisms, local coping strategies, and natural recovery processes (Pupavac, 2001; Summerfield, 1999). After the 2004 Indian Ocean tsunami, it was reported that the vast majority of individuals sought support from family members and turned to prayer and religious leader in times of stress, and that many children were upset by counselors from different organizations that would come for brief periods of time and ask them to retell their story multiple times (Good, Good, & Grayman, 2009). It is also critical to note that those affected by humanitarian crises engage in making meaning and sense of the events, individually and collectively. In the case of Aceh, the Tsunami was seen by some as sent by God to bring an end to the conflict (Good et al., 2009). Aid workers and clinicians can interfere with this, imposing their own views of what happened in a language of medical symptoms and causes and effects that may not be shared by the affected population (Almedom & Summerfield, 2004). Individuals may also view themselves as active survivors rather than as passive victims, which should be supported rather than undermined (Pupavac, 2004). One important determinant of the risk for mental health problems following adverse events is the perception of those events and the construction of meaning around them (Herman, 1992). The process of constructing meaning and forming different realities around the same events is deeply cultural (Marsella & Christopher, 2004). As discussed in more detail in Chapter 11, local ways of framing and coping with events can also help individuals and communities overcome adversity. Outside helpers may view climate-related hazards as caused by climate change, which is ties to natural forces and anthropogenic CO2 emissions, but affected communities may hold a different view. People also tend to fare better when they feel that they are in control of their own destiny, which can be undermined by humanitarian interventions that can foster a sense of dependency and helplessness (Pupavac, 2004). Lastly, mental health and psychosocial interventions in humanitarian settings are often short lived and not sustainable. Yet, many countries expected to be at the highest risk due to climate change already have a weak mental health infrastructure and are likely to benefit from capacity building rather than brief programmatic efforts by mental health specialists. Mental health and psychosocial programs are also not immune from general critiques of the humanitarian field including poor coordination among different agencies, reliance on reactive funding, lack of accountability, and poor continuity in transitioning short-term relief into long-term sustainable development activities. Considering the urgent humanitarian needs expected due to climate change as well as past critiques of mental health and psychosocial approaches provides an important imperative for increased efforts in better coordination with other

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programs and actors, professionalism, high ethical standards, and adherence to best practices and guidelines among psychologists and mental health professionals. The following section will discuss ways in which mental health professionals and psychologists can participate in responding to humanitarian crises, reducing underlying vulnerabilities, and extending the evidence base on best practices.

Potential Roles of Psychologists and Mental Health Professionals Responding to Humanitarian Crises In recent years, increased attention has been paid to mental health and psychosocial issues in humanitarian settings (Inter-Agency Standing Committee, 2007; Mollica et al., 2004). Yet, mental health and psychosocial support generally still receive a low priority by donors in humanitarian settings, and few organizations list mental health as one of their program areas, resulting in mental health needs often remaining unmet (Kim, Torbay, & Lawry, 2007). However, best practices and guidelines are emerging that can assist governments, humanitarian NGOs, and other organizations in addressing mental health and psychosocial issues. The recently released Inter-Agency Standing Committee Guidelines (IASC) on Mental Health and Psychosocial Support in Emergency Settings provide practical advice for protecting and promoting mental health and psychosocial well-being, considering a wide range of areas such as coordination, monitoring and evaluation, human rights, human resources, community mobilization, health services, and education (InterAgency Standing Committee, 2007). The Sphere Handbook, which sets minimum standards for humanitarian aid, now also has a section on mental health and social aspects of health, which covers topics such as providing psychological first aid, designing community-based psychological interventions, and considering the existing sociocultural context in all programmatic efforts (Young & Harvey, 2004). There have also been efforts to define cultural competencies for psychologists working with communities affected by disaster (Hansen, Pepitone-Arreola-Rockwell, & Greene, 2000; Marsella, Johnson, Watson, & Gryczynski, 2008). Several authors in the field have called for the adoption of a public health framework in working with populations affected by crises and conflict (Blanch, 2008; Brymer, Steinberg, Sornborger, Layne, & Pynoos, 2008). Such an approach would focus not only on the individual but also on the community and support preventive efforts, well-being, and resilience rather than only treating psychopathology. This approach is potentially cost-effective and can be more sensitive to social, economic, and political issues. IASC guidelines state that mental health and psychosocial interventions can be categorized as falling on a continuum of support ranging from psychological first aid and nonspecialized and community services designed to meet basic needs of an entire population to specialized services for select individuals needing more specialized mental health care (Inter-Agency Standing Committee, 2007). When designing interventions in humanitarian settings, it has been recommended to follow the steps of an initial needs assessment, subsequent program design, implementation, and

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continued monitoring evaluation, which should involve the affected community as much as possible (Inter-Agency Standing Committee, 2007). Methods have been developed for rapid mental health needs assessments that involve both qualitative and quantitative data collection and map local community resources such as natural healers, to assess local idioms of distress and culturally relevant indicators of functioning (Bolton, 2001; Bolton & Tang, 2002; De Jong & Van Ommeren, 2002). Such methods actively engage affected communities in discussing their priorities and in defining what constitutes well-being, distress, and functioning within their cultural and regional context. Participatory methods can also involve communities in designing and shaping an intervention that is acceptable and useful to them and in monitoring and evaluating outcomes (Eisenbruch, De Jong, & Van De Put, 2004; Schulz, Israel, & Lantz, 2003). It is crucial to not only involve the local population but also build on existing community capacities. Local psychologists, traditional healers, or community leaders can serve as culture brokers who tend to have a much deeper knowledge of expressions of distress and methods of coping. Furthermore, they can receive appropriate training, deliver interventions, and provide referrals. They often have established relationships of trust in the community and remain in the country after outside funding for mental health or psychosocial programs has ended. The expertise and knowledge of psychologists and mental health professionals can potentially also make the work of other humanitarian actors more effective and more responsive to psychosocial issues. Partnership with other programs could improve compliance with medical regimens, address maternal depression and distress that can impact child development and nutrition, or address substance use issues that can stunt benefits of microcredit or other economic recovery initiatives. Currently, innovative programs are emerging such as providing psychosocial support and improving mother–child relationships at local feeding centers (Rahman et al., 2008), which may also have relevance, given the link between climate change and food insecurity due to drought and other conditions.

Building Local Capacity It has been emphasized that adaptation to climate change to build resilience is essential, especially among developing countries that should receive appropriate support from developed countries (Stern, 2006). Reducing vulnerability and building capacity with the aim of promoting and protecting mental health and well-being can focus on underlying social and economic issues affecting mental health, as well as on building mental health infrastructure. Recently developed conceptualizations of social vulnerability (Brklacich, Chazan, & Dawe, 2007) or community resilience (Norris, Stevens, Pfefferbaum, Wyche, & Pfefferbaum, 2008), which take aspects such as economic development and social capital into account, are potentially applicable in this regard. Efforts are currently under way to promote global mental health, especially in developing countries (Patel, Saraceno, & Kleinman, 2006), which is also relevant in the context of climate change and humanitarian crises. The World Health Organization has recently launched the mental health Gap Action Programme

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(World Health Organization, 2008), which outlines ways in which mental health problems can be effectively addressed in low- and middle-income countries. Recommendations include cost-effective interventions at the community level and integration of mental health care into primary health care services. Priority conditions include depression, schizophrenia, substance use, epilepsy, and developmental disorders in children, but there is no guidance on anxiety or PTSD (World Health Organization, 2008). The Lancet dedicated a special issue to global mental health in 2008 (Patel et al., 2008; Patel & Sartorius, 2008), and the “Movement for Global Mental Health” (Eaton & Patel, 2009) was subsequently launched (Patel et al., 2008). Investing in local mental health infrastructure may be especially important in those countries that have been identified as climate change “hotspots” and have low local mental health capacity. The extent of existing mental health infrastructure could also factor into vulnerability indices for countries and communities, which could help to further understand and predict the potential impact of climate change and guide decisions for funding and support. Sources of funding such as the Kyoto Protocol Adaptation Fund and the National Adaptation Programs of Action (NAPA) are being made available to developing countries to adapt to and respond to climate change. Financial assistance is provided in areas such as agriculture, health, infrastructure development, improving disease control and prevention; and supporting capacity building related to prevention and response to natural disasters (Adaptation Fund Board, 2009). Mental health and psychosocial issues are rarely considered in climate change adaptation and capacity building plans but could be integrated in accordance with recent humanitarian and capacity building guidelines (Inter-Agency Standing Committee, 2007; World Health Organization, 2008).

Expanding Directions for Research There is broad agreement on the critical need to build the evidence base for mental health and psychosocial interventions in humanitarian and low-resource settings and to gain a better understanding of mental health within different cultural contexts (Inter-Agency Standing Committee, 2007; Saraceno, 2007; Summerfield, 2008). The majority of existing research has focused on describing mental health problems among populations affected by humanitarian crises rather than on effective interventions (Eisenbruch et al., 2004). Of the intervention research that does exist, very few studies have followed current guidelines or recommendations such as actively involving the affected population, conducting a prior needs assessment, or developing psychometric measures of local idioms of distress (Batniji, Van Ommeren, & Saraceno, 2006; Bolton et al., 2007). There is also very little research on individuals with severe mental disorders affected by humanitarian crises (Batniji et al., 2006, Jones, 2009 #5160). Although general guidelines exist, research is still needed to evaluate the effectiveness of feasible, accessible, low-cost interventions, which could be scaled up (Morris, van Ommeren, Belfer, Saxena, & Saraceno, 2007; Patel et al., 2007). It should be noted, however, that conducting research in humanitarian settings poses numerous difficulties, such as instability and insecurity in

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affected regions, questions of cultural validity and acceptability of psychometric instruments and interventions, and the challenges of conducting research that is ethical and can benefit existing communities (Allden et al., 2009). Nongovernmental organizations that are engaged in providing mental health and psychosocial services in crises settings often do not evaluate the outcomes of their work, and it is difficult to obtain funding for such evaluations (Allden et al., 2009). Future research is clearly needed that follows existing guidelines and recommendations, assesses local expressions of distress and well-being, builds on existing strengths and capacities, and has potential for sustainability and scaling up. This will require collaboration and partnerships between researchers, practitioners, and affected communities.

Summary and Conclusions Gaining a better understanding of mental health and psychosocial issues in the context of humanitarian crises due to climate change requires several considerations. Adverse effects of climate change are the result of both climate hazards (e.g. floods, droughts and tropical cyclones) and underlying natural, human, social, financial, and physical vulnerabilities (Thow & de Blois, 2008). Climate change “hotspots” are characterized by a high probability of climate hazards and significant preexisting vulnerabilities. Mental health and psychosocial issues are rarely considered in this context, but there are several links that can be highlighted. Individuals with preexisting mental disorders face a higher risk of death, injury, and human rights abuses during humanitarian crises. Mental health problems can also be causes and effects of underlying vulnerabilities such as poverty and poor health. The provision of mental health and psychosocial programming in humanitarian settings has not only experienced significant critique based on neglecting population needs and cultural contexts but has also been hampered by its absence from the global health agenda and from many relief and development activities. Yet, guidelines and methods are emerging that hold considerable promise in improving local participation and ownership, forging links with other humanitarian areas and programs, and building the evidence base on best practices. It is now up to psychologists and mental health professionals to connect the dots between climate change, humanitarian crises, and their own expertise and to work with other disciplines and local populations around common goals. This also requires expanding the borders of the field beyond traditional diagnostic and treatment approaches, toward gaining a deeper understanding and appreciation of different countries and cultures, and joining with other fields in addressing global problems.

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Chapter 6

Security and Conflict: The Impact of Climate Change Chad Michael Briggs and Inka Weissbecker

Introduction The connection between climate change and security is now increasingly recognized as a legitimate cause for concern whether the implications are for military security (CNA Corporation, 2007), energy security (Paskal, 2009), or ecological security (Pirages & De Geest, 2003). The United Nations Security Council held its first debate on climate change in April 2007, stating that “an unstable climate will exacerbate some of the core drivers of conflict, such as migratory pressures and competition for resources” (United Nations Security Council, 2007). Similarly, former UN Secretary-General Kofi Annan has referred to climate change as a ‘threat to peace and security’ (opening address on 15 November 2006 to the 12th session of the Conference of the Parties to the UNFCCC in Nairobi). In April 2007, high-ranking retired US generals published a report terming climate change a serious threat to the security of the USA that will promote extremism and terrorism, especially in unstable regions (CNA Corporation, 2007). This has been followed by official warnings from the US Department of Defense’s 2010 Quadrennial Defense Review (QDR) and 2010 US State Department’s Quadrennial Diplomacy and Development Review (QDDR), which both identified climate and other environmental changes as strategic security risks. However, others have been more cautious in drawing conclusions, pointing out that the links between climate change and security are complex and that various other factors that can make regions more vulnerable should be taken into account (Salahyan, 2008). This chapter will lay out the new concepts of security being developed in the USA and other countries and examine some potential security impacts and possible solutions, drawing on literature on environmental science, political science, sociology, and social psychology.

C.M. Briggs (B) Air University, USAF, Maxwell Air Force Base, AL, USA e-mail: [email protected]

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Definitions of Security The definition of the term “security” as the absence of armed conflict and violence has broadened since the end of the Cold War, and varying definitions exist. The term ‘human security’ tends to be a far broader concept than traditional security definitions and is meant as a way to emphasize that security issues have consequences far below the state-level analyses common in political science (Buzan, 1991). The term “human security” was introduced in 1994 in the United Nations Development Programme (UNDP), which encompasses security threats in seven areas: economic security, food security, health security, environmental security, personal security, community security, and political security (United Nations Development Programme, 1994). This human security concept stands in sharp contrast with traditional versions of ‘national security.’ National security emerged as a field of study following the First World War in an attempt to explain the tragic violence between European states and was reinforced by the Second World War and subsequent focus on nuclear politics during the Cold War. The overriding concern was the outbreak of war, defined as legitimized violence between states (countries), which were assumed for simplicity’s sake to be rational, unitary actors on the international stage (Hartmann, 1998; Kaplan, 1991). Despite some work in the field of international relations that emphasized substate and transnational processes (Buzan, 1991; Dalby, 2006), much of political science methodology continues to focus on the state. Security studies was therefore often at a loss for explaining security that was not controlled by state governments, or (as with some terrorism studies) assumed that countries did ultimately control everything.

Climate Change, Security, and Conflict The emerging discourse on links between climate change and violent conflict has largely focused on increased resource scarcity and migration as the main drivers of conflict. Yet, considerable debate exists regarding those linkages, and it has been argued that various other risk factors need to be taken into account. Climate issues also necessitate the use of new methodologies and nontraditional security concepts in order to encapsulate the complexity of environmental, energy, and social dynamics that influence both process and impact.

Resource Scarcity The potential role of resource scarcity and overpopulation in driving conflict is not a novel argument. The 1990s witnessed the first significant debates over the role of the environment in security, which quickly coalesced around questions of how environmental scarcity led to the outbreak of violence between states (Deudney, 1991; Homer-Dixon, 1991; Kaplan, 1994). Earlier conceptions have focused on population

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growth and consumption forcing changes on the environment and resource scarcity. Such analyses tended to see the environment as a static quality, and those suffering from shortages of food or water were often blamed for their own ‘overpopulation’ as being root causes of their own misery. In 1994, Robert Kaplan wrote an influential article in The Atlantic Monthly, warning of coming resource wars in Africa and the dark, violent future that we faced. The logic of Kaplan’s article followed that of much political discourse and research in the 1990s, arguing that population pressures lead to competition for resources, and that this competition would increase conflicts across the globe. President Clinton required his cabinet to read the piece, which described racial hatred and overpopulated countries and made direct reference to the research of Homer-Dixon. Outside the stretch limo would be a rundown, crowded planet of skinhead Cossacks and juju warriors, influenced by the worst refuse of Western pop culture and ancient tribal hatreds, and battling over scraps of overused earth in guerrilla conflicts that ripple across continents and intersect in no discernible pattern – meaning there’s no easy-to-define threat. Kennan’s world of one adversary seems as distant as the world of Herodotus. (Kaplan, 1994)

The limousine reference was a metaphor for the richer West, who would remain behind protective walls that incorrectly implied a strict territorial boundary between resource deprivation in Africa and high levels of consumption in the West. In lamenting the loss of the Cold War version of security (“Kennan’s world,” a reference to George Kennan and the Cold War policy of communist containment), Kaplan was reflecting an unease that political science was unable to explain many conflicts, particularly complex emergencies that could not be attributed vis-à-vis Soviet-US tensions. Many security specialists lacked methodologies that could explain security in a broader framework and incorporate the complex pathways of environmental interaction with livelihoods, infrastructure, health, and related risks. Some writers have also warned about resource wars between the rich and the poor. In a US Department of Defense report, Schwartz and Randall (2003) write that “nations with the resources to do so may build virtual fortresses around their countries, preserving resources for themselves. Less fortunate nations (. . .) may initiate struggles for access to food, clean water or energy (. . .) defense priorities shift and the goal is resources for survival rather than religion, ideology, or national honor” (Schwartz & Randall, 2003; cited in: Saleyhan et al. 2008). Those scenarios also highlight what Dalby (2002) has noted: “the problem with environmental security is that it begs the question ‘security for whom’?” (Dalby, 2002; cited in Winter, 2006). While many authors have highlighted the security concerns of wealthy nations, others have countered the argument by painting wealthy nations themselves as a threat to security by contributing to systematic industrialization, exploitation, and inequity. Indeed, one of the members of the Namibia delegation (member of the G77) stated in the 2007 Security Council debate about climate change that “humanity, and the developing countries in particular, have

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been subjected to what could be described as low-intensity biological or chemical warfare. Greenhouse gases are slowly destroying plants, animals and human beings.” Despite the visibility of the potential connection between natural resource scarcity and the outbreak of violent conflict, it has been very difficult to substantiate causal links. In both cases, whether the claims of overpopulation or the concerns over environmental conflict (some authors more explicitly linked these ideas), the focus tended to remain on less developed areas, and the inclusion of security concerns often seemed ill-fitting (Dalby, 2006). Practically, making strong connections between climate and violence may get the attention of the public, and this argument has been used to underline the urgency of acting on the threat of climate change. However, such oversimplification is likely not useful either for policy makers or those concerned with climate adaptation. Several authors have argued that there is no evidence that environmental scarcity actually led to the outbreak of violent conflict and that other factors tend to be involved as well (Barnett, 2000; Gleditsch, 1998; Hauge & Ellingson, 1998). Realistic group conflict theory suggests that conflict can result if groups are in competition over scarce resources but that this often co-occurs with distortions in perception of the other group as being aggressive as well as with scapegoating and blaming (Christie et al., 2008; Winter & Cava, 2006). Peace psychologists and political scientists have noted that such conflict does not inevitably lead to violence and may (if not more often) even lead to cooperation and relationship building rather than conflict (Deutsch, Coleman, & Marcus, 2006; Christie et al., 2008). When conflict does exist, it can be argued that environment tends to be one of many factors that may have helped lead to the outbreak of violence, but it was rarely if ever the determining factor. Claiming, for example, that water scarcity between Israel and Jordan led to the 1967 conflict between the countries removes rather significant context of history and instead attempts to reduce such a complex question down to correlation between simplified factors (Lowi, 1995). This example is itself simplified, for it relates to one environmental factor (water) in a localized context. To pose the question in terms of global climate change, where cause/effect and local geography are themselves complex, risks simplify the issue even more. Although it makes sense that resource competition should raise the risks of violence, without examination of cooperation and coping strategies of those most affected by environmental changes, we risk seeing only what we wish to see. Climate-induced environmental change is a global process that erases most political boundaries, is only indirectly related to resources or population, has local impacts that vary widely according to place and society, and requires study by a large range of disciplines and experts. Most notably, climate security involves assessment of risks that are potentially very high in impact and yet have probabilities that can rarely be assessed with any accuracy (Barnett, 2003). Whether resource scarcity leads to violent conflict or cooperation and which factors predict one outcome or the other are fruitful research areas for political scientists, sociologists, and psychologists in the context of climate change (as discussed later in this chapter).

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Migration Migration has been cited as another possible pathway in linking climate change and violent conflict. Climate change is projected to contribute to significant displacement of populations due to adverse environmental conditions (e.g. droughts) and water-level rise in coastal areas. For example, with some predictions of sea level rise in the 21st century approaching upward limits of four to six meters, large areas of coastal regions will be inundated. Absent large-scale and long-term reclamation efforts, as in the Netherlands, sea water flooding is generally an overwhelming force to which one cannot simply adapt as a local community. Migration of the entire affected area will likely be necessary, with a larger community needing to intervene in order to accommodate those displaced. Small Pacific island nations like Tuvalu will likely disappear first, forcing relocation of entire populations to other countries. In regions like Bangladesh, even modest sea level rise will force displacement of tens of millions of people, with obvious destinations including eastern India (Renaud et al., 2007; Warner et al., 2008). Even land that is not completely submerged may be uninhabitable, as rising nearby seas may bring dangerous storm surges, especially when combined with storm intensity issues as described above. Continued settlement of coastal regions and flood plains will greatly increase future risks of forced displacement, especially in regions with low social cohesion combined with high-risk exposure. Those areas already suffering from instability are much more likely to exhibit displaced populations than those with resilient capacities (Briggs, 2009). Customary practices of many cultures used migration to adapt to seasonal changes in food and water availability, especially the opening of arable land for agriculture or pasture. This historical process has been severely curtailed over the years with the rise of the nation-state and strict immigration regulations, so that now migration is sometimes considered ipso facto, a security concern when people cross state boundaries. Even when not based on concerns over terrorism, it is often argued that climate-induced migration from one country to another will cause instability and conflict. Integration of large, displaced populations can take many years, with emigrants forced to confront hostility from previous residents. This may especially be the case if residents compete with host populations over scarce resources such as food, water, land, and employment opportunities. Migration can also exacerbate preexisting ethnic tensions, if it threatens the dominance of one group over another. Ethic identities can be exploited for political purposes, which can lead to social exclusion and contribute to conflict (Lohrmann, 2000). However, it has been noted that migration alone does not lead to conflict and that policies of social integration and citizenship are particularly important factors (Gleditsch, Nordås, & Salehyan, 2007). Furthermore, it has been argued that migration is more often a symptom of instability than the cause of it. If large numbers of people are suddenly moving from one place to another due to environmental conditions, either the conditions themselves are so extreme so as to overwhelm the community structure or the structure itself was so weak that the environmental

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conditions were merely a catalyst for underlying problems in the community (Afifi & Warner, 2008; IOM, 2005; Warner et al., 2008). The experience of Irish immigrants to the USA in the 1800s may be instructive. Difficulties of migration and integration are not necessary outcomes, and problems may be mitigated by concerted efforts to accommodate and integrate those forced to leave their homes. In smaller communities such accommodation may be expected, but in the international community identity politics play a much larger role in how well and effectively a country is able to absorb environmental migrants. In this sense, identification of climate migration as a security issue may be counterproductive, should security be defined as state centered or identity specific.

Limitations of Previous Approaches and Analyses Security analyses of climate change to date have tended to simplify both climate processes and security impacts, often combining summaries of the Fourth IPCC Assessment with Cold War models of interstate warfare (CNA, 2007; European Commission, 2008; GBN, 2007; German Federal Ministry for Economic Cooperation & Development, 2002; NIC, 2008; Schwartz & Randall, 2003; WBGU, 2008) or by assuming that climate impacts were fait accompli (International Alert, 2008). The prevalent conceptualizations of climate security are overly narrow for several reasons, both analytical and practical. First, it defines only one outcome of climate security scenarios and does not examine counter-cases where environmental changes do not lead to conflict. One tends to look where there is already conflict or extreme political tension and then asks what effect climate changes will have. It is impossible with such an approach to isolate environmental issues from the preexisting conflict, in which other factors may be much more crucial but unexamined because the environment is highlighted. This is closely related to the second concern with narrow approaches to conflict and climate, which is that in any politically charged situation, environmental factors may be of more symbolic importance than a substantive concern. In other words, people may fight over environmental issues or natural resources, but as a proxy for other issues that cannot be addressed for one reason or another. The environmental movements in Eastern Europe in the late 1980s, which helped to topple a number of communist governments, were short lived precisely because the environment was a substitute for other, deeper political divides. The idea of proxy issues also leads to the third consideration, that of identity and action. Many environmental security writings risked ‘naturalizing’ the debate or using the environment as a physical factor in explaining complex political conflicts. To describe environmental factors as a ‘root cause’ of conflict or migration (as with Homer-Dixon, 1991, Kaplan, 1994; Myers, 2005) is to imply that environmental change is a necessary and sufficient cause for security outcomes. Such arguments strongly imply that identities are fixed and that social dynamics in the face of changing conditions necessarily result in the breakdown of social order.

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Empirically this is not necessarily the case, as communities faced with disaster risks or other environmental challenges often react positively against a perceived collective risk, even when previous divisions may have indicated otherwise. The reactions of people in such cases depend partly upon past experiences with similar risks, as, for example, small communities faced with food insecurity and drought may have coping mechanisms that involve charity and cooperation that may not exist under normal circumstances. If risks are perceived as collective, and coping with environmental conditions are super-ordinate goals, then disasters may bring members of a community closer together. Such analyses also tend to downplay social and psychological impacts, particularly when they are second- or thirdorder effects of broader geophysical changes. Also missing are the psychological aspects of resilience, or the ability to withstand or adapt to severe environmental changes. Fourth, discussions focused on traditional security definitions and conceptualizing interstate violence arising from rational actions of unitary political states are not the concern with climate change risks. A study that utilized the database of the World Health Organization’s (WHO) Collaborating Centre for Research on the Epidemiology of Disasters (CRED, 2010), which has recorded all the storm and flood disasters since 1950, found a connection between storm and flood disasters and an intensification of conflict, violent unrest, and/or political crisis in 12 of 171 cases. In many cases those disasters resulted in domestic political crises. The review of 73 empirically well-recorded ‘environmental conflicts’ that occurred between 1980 and 2005, however, also showed that these were limited to a regional scope and did not present any serious threat to international security (German Advisory Council on Global Change (WBGU); 2008). A fundamental problem with environmental and climate security discussions lies in the very nature of violent conflict and the inability of social scientists to predict conflict. Even if social scientists can describe conditions that might give rise to outbreaks of violence or terrorism, these are never sufficient factors for determining the outcome of a given situation, nor are the pathways to violence consistent. When applied to potential future situations, the ability to predict outbreaks become even more contentious. Security experts were unable to predict the North Korean invasion of South Korea in 1950, the Tet Offensive in Vietnam in 1968, the fall of the Berlin Wall in 1989 and subsequent attempted Soviet coup in 1991, the genocide in Rwanda, and other major events where either information was available, or where intense monitoring was in place. Lastly, discussions of climate security have tended to remain focused on traditional security definitions, describing such environmental changes as ‘threat multipliers’ that serve to exacerbate existing international security concerns. Although there is some truth to this, it tends to imply that the world of the future will be very much like the world we have now, only more so. However, tracing the connections from climate changes to conflict and violence is a difficult task. Put simply, there is no direct connection between environmental changes and violence, and focusing on such linear pathways tends to create ‘tunnel thinking’ in which alternate pathways to humanitarian crises and systemic instability are missed because they

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are not watched. In fact, it is the reliance upon notions of linear causality that so often leads to confusion and oversimplification. Even authors who discuss nonlinear relationships and complex systems very often proceed with analyses that are substantively little different from any other (Homer-Dixon, 1995). With environmental issues, this generally involves seeing the environment as an external variable that impacts society, while failing to consider complex interactions and feedback loops in and between systems (Busby, 2007; Price-Smith, 2002). Admittedly, carrying out such assessments of complex systems and cascading effects is extremely difficult, and the requisite research on network failures and resilience has only emerged in the past decade (Albert, Jeong, & Barabási, 1999).

Vulnerability and Risk Factors The complexity of environmental issues and lack of strong causality have led some researchers to conclude that climate change is not a security issue (Walt, 2009), because it either does not fit into predetermined categories of measurement or is too difficult to determine cause and effect. However, there is substance to concerns that climate change can lead to security situations (Halden, 2007; Litfin, 1999). However, this requires greater redefinition of security, and the role that environmental systems play in maintaining underlying stability of complex social systems. Determining where systems are vulnerable likewise requires abandonment of assumptions of linear cause–effect and demands greater attention to cross-disciplinary research. Analytically, the concept of human security may be considered so broad that it is difficult to understand how it is defined or measured. But the shift to vulnerability studies draws upon the experience of research in risk assessment, ecology, sociology, and epidemiology/public health in order to help identify ‘weak spots’ in relationships and systems (Wisner et al., 2005). The focus shifts from adverse outcomes (i.e. violence) to conditions that underlie stability of social, political, ecological, and geophysical systems, in an attempt to provide foresight and warning in advance of instability. Vulnerability assessments therefore maintain the normative orientation of human security and incorporate environmental factors while integrating established methodologies. More important for practitioners, the focus on vulnerability aims to allow prevention of worst outcomes, often by identifying possible future scenarios, and the means by which they can be avoided and/or adapted to. Psychology and other disciplines also have an important role in identifying such vulnerabilities. Indeed, it has been argued that future social impacts of climate change are unlikely to trigger “classic” interstate wars, but they may lead to destabilization processes and conflict between groups if other factors are present. Peace psychologists have defined conflict as arising from “perceived or real incompatibilities in goals between individuals or groups” (Christie et al., 2008). The causes of violent conflict are complex and multifaceted and include risk factors such as a low level of economic development, realistic group conflict, relative and absolute deprivation and disparities, social identities, nationalism, an instrumentalization of

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environmental degradation for group-specific interests, a lack of societal mechanisms for regulating conflict, weak state structures, the organization and arming of parties to a conflict, a large population and/or a high population density, rough terrain, border on a neighboring country in which a violent conflict is being waged, and the influence of past conflict (e.g. Christie et al., 2008; Smith & Vivekananda, 2007). It has been suggested that there are 46 countries in which the effects of climate change create a higher risk of conflict due to various economic, social, and political problems such as current or recent wars, poverty and inequality, and bad governance (Smith & Vivekananda, 2007).

Poverty – Absolute and Relative Deprivation Absolute Deprivation Estimations of the overall economic costs of climate change come to the conclusion that an increase of just a few degrees Celsius could result in a global loss of welfare in the order of up to 5% of global GDP (Solomon et al., 2007; Stern, 2006), disproportionately affecting developing countries. Research suggests that limited economic and livelihood opportunities can increase people’s propensity to join armed groups or resort to violence. Deprivation can also lead to the adoption of destructive ideologies in which others are viewed as barriers to need satisfaction (Christie et al., 2008).

Relative Deprivation Another consequence of climate change may be an increase in the disparity between the “haves” and the “have-nots,” both within and between nations. Some authors suggest that one group’s perception of a discrepancy between its current standard of living and that of another group can result in conflict and intergroup hostility (Christie et al., 2008). Indeed, countries in which the gap between the most affluent and the poorest sections of the population is especially large are considered to be fundamentally more prone to conflict (German Advisory Council on Global Change (WBGU), 2008). As Sen (1999) has pointed out in the past, many instances of starvation in the world are not the result of simply too little food for too many people but have important social and political dimensions that prevent food from reaching those who need it or prevent affected populations from adapting to the situation productively. This is especially relevant in the context of projected climate-related food insecurity in many developing nations. While conflict often occurs along lines of ethnic and cultural identities and societal polarization, it has been suggested that it is not polarization itself that increases vulnerability to conflict, but rather that the dominance of one ethnic group over another, whereas the existence of multiple ethnic and religious fractions can actually

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lower the risk of conflict (Collier quoted in Smith, 2004). However, when perceived and actual group differences in access to resources coincide with ethnic divisions, the risk of conflict increases. Several authors have noted the dangers of “horizontal inequality”, which refers to social, economic, political, or other inequality between different subcultures living in the same society, which may fall along the lines of ethnic, linguistic, cultural, or religious group identities (Steward, 2004). The risk for conflict is seen as especially high if a majority exists against an almost equally large minority and when low incomes coincide with social exclusion (Steward, 2004). Intergroup relations suffered in the aftermath of Hurricane Katrina, for example, where the loss of key resources highlighted racial group differences in financial and geographic security. African Americans were also more likely than whites to interpret the government’s response as indicating racism (Adams, O’Brien, & Nelson, 2006). Unequal distribution of resources and resulting food insecurity for some nations can also lead to government instability if the government is seen as responsible. Reports have emerged that states already worried about food security have taken preemptive measures, but often ones that bolster national security in one state at the expense of another. In the first 6 months of 2009, some 20 million hectares of land in Africa and Southeast Asia were leased or sold, very often to secure arable land for foreign countries. Not all of the land will be used for food, as biofuel production may be more profitable and fits with parallel concerns over energy insecurity. Such measures, however, reduce locally available crops for consumption in countries that often already experience food scarcity and lack the resources to import food from elsewhere. The government of Madagascar fell in early 2009, after revelations that 1.3 million hectares of land (roughly the size of Belgium, and half the arable land in the country) were to be leased to the South Korean firm Daewoo Logistics for corn and palm oil exports to South Korea (FAO/WFP, 2009; Gower, 2009). Reportedly, Daewoo would have paid nothing for use of the land (Jung-a, Oliver, & Burgis, 2008). In other regions, land deals by wealthier countries plan to deforest large areas of land in order to produce biofuels, thereby feeding back into worsening climate change conditions. Such practices are likely to lead to worsening inequity of food distribution with consequently negative health and economic effects on vulnerable populations, exacerbating existing tensions.

Social Division and Fragmentation Abrupt and unexpected changes can overwhelm otherwise resilient communities, creating the cascading failures demonstrated in complex network research. Those networks that already exhibit either vulnerable network topologies (e.g. those that are hierarchical and not scale free) or weak network connections (e.g. lack of trust) are more likely to break apart or suffer complete failure as a result of environmental stresses (Briggs et al., 2009; DeFur et al., 2007; Füssel, 2007; Gallopín, 2006; Wisner et al., 2005). Communities under severe social stress and economic division prior to disaster conditions may fragment even more under shifting environmental conditions. In this case, environmental changes do not create the divisions; the

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disaster only uncovers preexisting vulnerabilities in society that had been caused by nonenvironmental factors. Those divisions can be exacerbated by relative deprivation of one group, as noted above, or by other factors. In industrialized countries, income inequality is often an indicator of a weak and vulnerable community, as, many argue, the aftermath of Hurricane Katrina demonstrated (Wisner et al., 2005). Divisions may also be created artificially, in order to serve political ends. The division in Darfur between “Africans” and “Arabs” was encouraged by outside actors and those attempting to maintain political power; they were not given categories of identity, nor were disputes over resources a predetermined outcome. In many ways, conflicts over natural resources in Darfur are examples of where the environment is used as a weapon against others (i.e. resilience targeting), and it would be highly misleading to say that environmental conditions caused the conflict.

Dissatisfaction with the Government States functions are important in relation to moderating risk of climate change as well as conflict, and states play a key role in containing or aggravating violence. The interaction between environmental and political factors is therefore critical for understanding violence and conflict (Salahyan, 2008). It has even been argued that the extent to which climate change triggers “a succession of new wars” in Africa ultimately “depends more on governance and governments than on the strength of the climate ‘signal’ itself” (United Nations Environment Programme, 2007; cited in Brown, 2007). Indeed, disasters frequently shed light on government failures such as poor housing development in vulnerable areas, lack of implemented building codes, and insufficient or poorly coordinated disaster preparedness and response (Drury und Olson, 1998). Such failures, which are seen as responsible for added damage and casualties, often enter the public discourse in the aftermath of disasters (Drury und Olson, 1998). Such failures can contribute to eroding the social contract between state and citizens, which can contribute to political instability or even violent conflict (Smith & Vivekananda, 2007). Three examples may be illustrative. (1) The 1970 typhoon in East Pakistan killed approximately 300,000 people (today’s Bangladesh) and led to a strengthening of the separatist opposition over the government’s insufficient aid measures. The government responded with repression and violence, which was followed by a civil war that claimed about 3 million lives. Bangladesh gained independence in 1971. (2) Climate changes are also affecting availability of water in several Asian states such as Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan, exacerbating already scarce freshwater resources. Combined with colder winters and rising energy prices for fossil fuels, the electricity shortages in Kyrgyzstan’s capital Bishkek have resulted in dissatisfaction with the government as schools and businesses have closed (Normatov & Petrov, 2006; Osmonaliyeva, 2010). (3) The breakdown in conditions and response to Hurricane Katrina in the USA in 2005 highlight not only racial and economic inequalities but also governmental shortcomings such as past practices of land use and diversion of disaster-response resources to Iraq and Afghanistan.

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Risk Mitigation and Peace Building Investing in Foresight and Warning Ultimately, one of the most effective and necessary ways in which the international community can ensure the well-being and security of people affected by climate change is to develop effectively focused foresight and warning capabilities. Ability to plan for possible scenarios is a necessary component of adaptive capacity building and effective response. This does not mean that accurate predictions will be possible or that effective probabilities will be calculable. Rather, precautionary action can be taken against future conditions, even when their likelihood is unknown, so long as the impact of such events is significant enough. Identification of such scenarios requires knowledge of up-to-date climate science and possible future conditions, understanding of how such geophysical changes created cascading impacts onto ecosystems and infrastructure, and how social, political, and economic systems are then likewise affected. Expertise is also therefore needed at the ecological and geographical levels, plus regional expertise on the unique impacts that would be experienced by various scenarios and where key vulnerabilities lay in infrastructure, ecosystems, economies, and sociopolitical networks. Without this resolution, the ability to scale assessments from the global processes to local levels and back, our understanding of security implications will be overly simplified and truncated. International efforts like GlobalEESE (the Global Energy and Environmental Strategic Ecosystem1 ) have attempted to bring together the requisite expertise to provide advance warning of such issues, but risk communication to the public of security and health risks will still be a crucial component of addressing climate security. Promoting Community Adaptation and Access to Resources Dire predictions about coming environmental wars imply that climate change requires military solutions, to secure by force one’s own resources or erect solid barriers to large-scale distress migration. But focusing on military responses both raises the stakes and diverts attention from the more cost-effective alternative of adaptation. Community adaptation practices rely upon trust and administration. Adaptation measures are rarely as effective when carried out by individuals as compared to communities, at least in part because the community networks allow for failure in one section while the rest of the community survives. Should a few, random households suffer disaster in a healthy community network, the others in the community can provide support and access to resources that the affected families would otherwise lack. The network bonds rely upon trust between individuals and groups and regulative frameworks (either formal or informal) that allow for common practices 1 http://www.globaleese.org/

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of charity, assistance, or temporary loans. Violent incidents and crime such as “looting” after disaster are less frequent than commonly believed, and there tend to be more reports of a wave of mutual goodwill within affected societies and a fall in the crime rate (WGBU, 2008). Such social network practices can be as simple as neighbors agreeing to help one another, or can involve insurance policies, disaster relief practices, or resource reallocation (DeFur et al., 2007; Füssel, 2007; Gallopín, 2006; Wisner et al., 2005). It is important that such practices should be developed in advance of potential environmental changes or disasters, either as an emergent property of the system or deliberate policy of a government. Another key measure of adaptive capacity which reduces climate change risks is access to resources, which itself has several components: financial and resource access, trust, and administration. Financial and resource access may be the most obvious component of this type of resilience and refers to availability of money and capital (financial, human, natural, or otherwise) in changing or adapting to environmental conditions (Wisner et al., 2005). Whether draining wetlands to control malaria or installing air conditioning to lessen the effects of extreme heat, such actions require capital and are investments in reducing vulnerability. There are also cultural forms of capital that are equally valuable as resources (Lantze & RavenRoberts, 2006). Traditional societies often have ways of coping with changing environmental conditions, in large part because they have lacked the technology to change the environment itself. Farmers could (at least at times) withstand droughts, households could survive without electricity, and infrastructure was not as sensitive to natural disasters. Often these forms of cultural capital were lost over the years, although it is possible to adopt them anew or once again (Füssel, 2007). Consistent with peace-building approaches, it has been suggested to engage communities in a social process, communicate implications and risks of climate change, and generate adaptation measures that build on local knowledge and existing resources and that strengthen social networks and mutual support (Smith & Vivekananda, 2007).

Reducing Inequalities Standard development economics assume that more wealth equals more resilience and therefore focuses on economic growth as a path to decreased vulnerability. This may be a highly misleading assumption in this context, given that not poverty itself but relative deprivation and resource inequalities appear to play a major role in contributing to conflict. Peace researchers have argued that the risk of conflict can be reduced by promoting positive peace, which refers to rectifying structural inequities and promoting input and participation of marginalized groups (Galtung, 1996). Positive peace is promoted by engaging in “structural peace building,” which has the aim of restructuring political and economic systems in ways that promote social justice and the equitable and sustainable access to resources for the satisfaction of human needs (Christie et al., 2008). Those concepts gain new relevance in the context of climate change and violent conflict, with structural peace building as one potential mitigation strategy.

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Improving Governance Promoting political transparency, accountability, and the rule of law is crucial for preventing violent conflict. Corruption and cronyism often prevent resources from reaching the most vulnerable populations, leading to gross income inequalities and severe poverty (Salahyan, 2008). Governments can play an important role in reducing the risk of conflict by facilitating access to public services and social activities without discrimination, aiding the integration of immigrants (including climate refugees), safeguarding minority rights, and promoting tolerance among the local population. Conflict resolution mechanisms and techniques at the local and international levels such as negotiation, mediation, arbitration, diplomacy, interactive problem solving, and cooperation on superordinate goals can also help prevent conflicts from arising (Salahyan, 2008; Hare, 2007).

Promoting Cooperation and Collaboration Warfare can be considered an inefficient and costly way to resolve conflicts over resources, while cooperation may be more advantageous for both parties than competition (Salahyan, 2008). Researching the conditions under which competing political actors either cooperate with one another or engage in conflict has always been one of the core tasks of political science as well as some areas of psychology. Competitive relations are fraught with impaired communication, suspicion, criticism, disagreement, power plays, coercion, and the belief that solutions benefit one party but not all parties. In contrast, cooperation is characterized by effective communication, friendliness, helpfulness, coordination of effort, shared values and beliefs, willingness to enhance the other’s power, and the viewpoint that conflict is a mutual problem to be solved (Christie et al., 2008). Whether opposing parties manage a conflict by competition or cooperation appears to depend on several factors. It has been noted that conflicts can be especially difficult to manage constructively when they are structured in a zero-sum fashion, in which parties believe that one side’s win is the other side’s loss (Deutsch, 1973). On the other hand, the development of superordinate shared goals that would benefit both groups (e.g. building a bridge, a school, and a hospital) can be an excellent way to develop cooperation and reduce conflict (Deutsch, 2008). It has also been suggested that agreements worked out over shared resources such as water have even helped diffuse tensions on other matters and can lead to changes in social identities and perceived interdependencies (Winter & Cava, 2006). Such a cooperation agreement is more likely when certain benefit-sharing factors, such as economic advantages, are foreseeable (Klaphake and Voils, 2006). Conca (2001) has listed three dimensions for enhancing environmental cooperation and identity shifts: transparency, reciprocity, and extended future time frame. In some cases a natural disaster can help bring a community closer together, as a form of superordinate goal where everyone helps as a whole (Wisner et al., 2005). Similarly, parties engaged in resource-based conflict have benefitted from working on integrative agreements, or win-win solutions. Historically, the examples of

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cooperation between states over renewable resources such as water have far outnumbered those of violent conflict (Wolf et al., 2003; Homer-Dixon, 1999), perhaps because renewables are less available for immediate exploitation than are nonrenewables such as oil (Winter & Cava, 2006). Coordinating and optimizing the use of water over state borders brings benefits to all involved participants, such as an improved water management system, the conservation of freshwater ecosystems, dam building for shared power generation, and improved efficiency in the agricultural and energy sectors (Sadoff & Grey, 2002; Philips et al., 2006), which provides strong incentives in favor of cooperation. Disasters and Climate Change as Peace-building Opportunities? Some authors have suggested that climate change and resulting challenges such as disasters and challenging environmental conditions can be treated as a peacebuilding opportunity (Worldwatch Institute, 2005; Smith & Vivekananda, 2007). In the wake of the tsunami of 2004, for example, a peace agreement was reached between the Free Aceh Movement (GAM) and the Indonesian central government. The movement and the Indonesian army had been fighting since 1976 over the status of the province of Aceh. After a severe earthquake in the Pakistani area of Kashmir in October 2005, the Indian and Pakistani governments agreed on relief efforts for the disaster area. Addressing climate change could facilitate the development of practical, problem solving dialogue through which cooperative relationships could be established and promoted and otherwise divided communities could be reconciled by posing a threat against which to unite and tasks on which to cooperate (Smith & Vivekananda, 2007). Furthermore, adaptation efforts can include elements of peace building, promoting social engagement, equal access to resources, government transparency and accountability, and dialogue and social engagement around subordinate shared goals. However, it should also be considered that in many of the countries most at risk, the government is likely to be unwilling or unable to take on the tasks of adaptation and peace building and governance may even be part of the problem. Promoting adaptation and peace-building measures is likely to continue to be challenging and may require international cooperation and the support of local and community initiatives (Smith & Vivekananda, 2007). The Global Environment Facility now funds development projects that have the potential to prevent resourcebased conflict, and the Environment and Security Initiative (ENVSEC) set up in 2002 by the United Nations and European countries identifies global examples for environmental peacemaking (Winter & Cava, 2006).

Conclusions Certain shifts in climate are already being observed, such as melting of the Greenland ice sheet or loss of Arctic sea ice. Potential implications include higher risks for storms, droughts, and floods, to which low-resource regions and groups are

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particularly vulnerable. The net aggregate effects of climate change are expected to be overwhelmingly negative, whether measured in terms of ecosystem health, excess morbidity and mortality of human populations, mental health impacts, economic damages, or political and social measures of stability. Availability of vital resources such as land, food, and water may threaten the sustainability of communities unable to adapt, and vulnerable nodes in key systems may fail, spreading impacts far beyond the local and visible. Several authors have warned of impeding re