mental-health-climate.pdf

MENTAL HEALTH AND OUR CHANGING CLIMA\ TE: IMPACTS, IMPLICATIONS, AND GUIDANCE Marc\f 201\b

2 Mental Health and Our Changing Climate: \fmpacts\b \fmplications\b and Guidance American Psychological Association | ecoAmerica 3 THIS GUIDE IS BROU\PGHT TO YOU BY EDITORS AND CONTRIBUTORS Ashlee Cunsolo\b PhD\b Director\b Labrador \fnstitute of Memorial University Victoria Derr\b PhD\b Assistant Professor\b Environmental Studies\b California State University\b Monterey Bay Thomas Doherty\b PsyD\b Licensed Clinical Psychologist Paige Fery\b Research Coordinator\b ecoAmerica Elizabeth Haase\b MD\b Chair\b Climate Psychiatry Committee\b Group for the Advancement of Psychiatry Associate Professor\b University of Nevada\b Reno\b School of Medicine\: John Kotcher\b PhD\b Post-doctoral Research Fellow\b Center for Climate Change Communication\b George Mason University Linda Silka\b PhD\b Psychologist\b Senior Fellow\b Senator George J. Mitchell Center for Sustainability Soluti\:ons Lise Van Susteren\b MD\b Psychiatrist\b Private Practice Jennifer Tabola\b Senior Director\b Climate for Health\b ecoAmerica REVIEWERS ecoAmerica and the Am\:erican Psychological Association thank the following reviewers who provided valuable feedback on drafts of this report: Daniel Dodgen\: (Department of Hea\:lth and Human Services)\b Chandrakala Ganesh (California State University\b East Bay)\b Caroline Hodge (University of Michigan \: MBA/MS Candidate 2018)\b Howard Kurtzman (American \: Psychological Association)\b Joshua Morganstein (Department of Psychiatry\b Uniformed Services University of the Healt\:h Sciences & Center for the Study of Traumatic Stress)\b Susan Schneider (University of the Pacific)\b Robert Ursano (Center Department of Psychiatry\b Uniformed Services University of the Health Sciences & Center for the Study of Traumatic Stress)\b Michael Wright (Licensed Social Worker\b Author )\b and Michael Yogman (Committee on Psychosocial Aspects of \:Child and Family Health\b Ameri\:can Academy of Pediatrics). ACKNOWLEDGEMENTS CONTENTS AUTHORS Susan Clayton Whitmore-Williams Professor of Psychology College of Wooster Christie Manning Visiting Assistant Professor\b Environmental Studies Macalester College Kirra Krygsman Research Manager ecoAmerica Meighen Speiser Chief Engagement O\:fficer ecoAmerica SPECIA\f THANKS ecoAmerica is grateful to the John D. and Catherine T. MacArthur Foundation for its generous support. Suggested citation Clayton\b S.\b Manning\b C. \:M.\b Krygsman\b K.\b & Speiser\b M. (2017). Mental Health and Our Changing C\:limate: \fmpacts\b \fmplications\b and Guidance . Washington\b D.C.: American Psychological Association\b and ecoAmerica. WHY WE OFFE\f THIS \fEP\FO\fT \b EXECUTIVE SUMMA\fY 6 I. CONTEXT 9 Our Changing \:Climate: A Primer 10 The Climate and Health \fmpact\:s on Humans 11 Linking Physical \fmpacts\b Mental\: Health\b and Community Well-Being 14 Comprehending Climate Change 16 Climate Solutions Benefit \:Mental Health 18 II. MENTAL HEALTH AND CLIMATE CHANGE 20 Mental Health\: \fmpacts 21 \fmpacts on \fndi\:viduals 22 \fmpacts on Community and Societ\:y 29 The Problem of \fnequity 31 III. ADD\fESSING THE MENTAL HEALTH IMPACTS 39 Building Resilience 40 Tips to Support \fndividua\:ls 42 Tips to Support Communities 45 What \fndividuals Can Do\: 53 What Mental Health Pr\:ofessionals Can Do 55 \fEFE\fENCES 58 GLOSSA\fY 68

2 Mental Health and Our Changing Climate: \fmpacts\b \fmplications\b and Guidance American Psychological Association | ecoAmerica 3 THIS GUIDE IS BROU\PGHT TO YOU BY EDITORS AND CONTRIBUTORS Ashlee Cunsolo\b PhD\b Director\b Labrador \fnstitute of Memorial University Victoria Derr\b PhD\b Assistant Professor\b Environmental Studies\b California State University\b Monterey Bay Thomas Doherty\b PsyD\b Licensed Clinical Psychologist Paige Fery\b Research Coordinator\b ecoAmerica Elizabeth Haase\b MD\b Chair\b Climate Psychiatry Committee\b Group for the Advancement of Psychiatry Associate Professor\b University of Nevada\b Reno\b School of Medicine\: John Kotcher\b PhD\b Post-doctoral Research Fellow\b Center for Climate Change Communication\b George Mason University Linda Silka\b PhD\b Psychologist\b Senior Fellow\b Senator George J. Mitchell Center for Sustainability Soluti\:ons Lise Van Susteren\b MD\b Psychiatrist\b Private Practice Jennifer Tabola\b Senior Director\b Climate for Health\b ecoAmerica REVIEWERS ecoAmerica and the Am\:erican Psychological Association thank the following reviewers who provided valuable feedback on drafts of this report: Daniel Dodgen\: (Department of Hea\:lth and Human Services)\b Chandrakala Ganesh (California State University\b East Bay)\b Caroline Hodge (University of Michigan \: MBA/MS Candidate 2018)\b Howard Kurtzman (American \: Psychological Association)\b Joshua Morganstein (Department of Psychiatry\b Uniformed Services University of the Healt\:h Sciences & Center for the Study of Traumatic Stress)\b Susan Schneider (University of the Pacific)\b Robert Ursano (Center Department of Psychiatry\b Uniformed Services University of the Health Sciences & Center for the Study of Traumatic Stress)\b Michael Wright (Licensed Social Worker\b Author )\b and Michael Yogman (Committee on Psychosocial Aspects of \:Child and Family Health\b Ameri\:can Academy of Pediatrics). ACKNOWLEDGEMENTS Ho8083 AUTHORS Susan Clayton Whitmore-Williams Professor of Psychology College of Wooster Christie Manning Visiting Assistant Professor\b Environmental Studies Macalester College Kirra Krygsman Research Manager ecoAmerica Meighen Speiser Chief Engagement O\:fficer ecoAmerica SPECIA\f THANKS ecoAmerica is grateful to the John D. and Catherine T. MacArthur Foundation for its generous support. Suggested citation Clayton\b S.\b Manning\b C. \:M.\b Krygsman\b K.\b & Speiser\b M. (2017). Mental Health and Our Changing C\:limate: \fmpacts\b \fmplications\b and Guidance . Washington\b D.C.: American Psychological Association\b and ecoAmerica. WHY WE OFFE\f THIS \fEP\FO\fT \b EXECUTIVE SUMMA\fY 6 I. CONTEXT 9 Our Changing \:Climate: A Primer 10 The Climate and Health \fmpact\:s on Humans 11 Linking Physical \fmpacts\b Mental\: Health\b and Community Well-Being 14 Comprehending Climate Change 16 Climate Solutions Benefit \:Mental Health 18 II. MENTAL HEALTH AND CLIMATE CHANGE 20 Mental Health\: \fmpacts 21 \fmpacts on \fndi\:viduals 22 \fmpacts on Community and Societ\:y 29 The Problem of \fnequity 31 III. ADD\fESSING THE MENTAL HEALTH IMPACTS 39 Building Resilience 40 Tips to Support \fndividua\:ls 42 Tips to Support Communities 45 What \fndividuals Can Do\: 53 What Mental Health Pr\:ofessionals Can Do 55 \fEFE\fENCES 58 GLOSSA\fY 68

4 Mental Health and Our Changing Climate: \fmpacts\b \fmplications\b and Guidance American Psychological Association | ecoAmerica 5 When you think about clim\:ate change\b mental health mig\:ht not be the first thing that comes to mind. Americans a\:re beginning to grow familiar with climate change and its he\:alth impacts: worsening asthma and allergies; heat-related stress; foodborne\b waterborne\b and vector-borne diseases; i\:llness and injury related to storms; and floods and\: droughts. However\b the connections with men\:tal health are not often part of the disc\:ussion. \ft is time to expand information and action on \:climate and health\b inclu\:ding mental health\:. The health\b economic\b political\b a\:nd environmental implications of climate change affect all of us. The tolls on our mental \:health are far reaching. They induce stress\b depression\b and anxiety; strain social and community relationships; and have been linked to increases in aggression\b violence\b and crime. Children and communities with few resources to deal with the impacts of\: climate change are those most impacted. To compound the issue\b the psychological responses to climate change\b such as conflict avoidance\b fatalism\b fear\b helplessness\b and resignation are growing. These responses are keeping us\b and our \:nation\b from properly addressing the core causes of and solu\:tions for our changing climate\b and from building and sup\:porting psychological resiliency. To help increase awareness of these challenge\:s and to address them\b the American\: Psychological Association and ecoAmerica sponsored this report\b Mental Health and \:Our Changing Climate: \fmpacts\b \fmplications\b and Guidance . This is an updated and expanded version of our 2014 report\b Beyond Storms & Droughts: The Psychological \fmpacts of\: Climate Change \b which explored how climate change can impact \:mental health and \:provided guidance to engage the publi\:c. This updated report is intended to further inform and empower health and medi\:cal professionals\b community and elected leaders\b and the\: public. Our websites offer webinars and other r\:esources to supplement this r\:eport. On behalf of the a\:uthors\b the many professionals who contributed directly and indirectly to this work\b and all those \:involved in expanding awareness of and action on \:climate and mental health\b than\:k you for taking the time\: to review and share this important resource. We invite your feedback\b and as the \:field continues to grow\b we’ll continue to update this work. Howard S. Kurtzman\b Ph.D. Acting Executive Director for Science American Psychological Association Bob Perkowitz Founder & President ecoAmerica WHY WE OFFER TH\fS RE\:PORT A CLOSER LOOK: A Clinical Psych\fl\fgist’s \bake \fn Climate Change Thomas Doherty\b PsyD pag\:e 28 Climate change is a human\:-caused problem\b which is more difficult to cope with than disas\:ters that are beyond human control. Mental health \:professionals can help give people a sense of power over how they respond. Inuit Mental Health \hand Climate Change Ashlee Cunsolo\b PhD \: page 33 The \fnuit are a prime example of communities that have experienced the mental distress and loss of cultural identity brought on by a changing landsca\:pe and environmental conditions. Childr en’s Em\fti\fnal Resp\fnses t\f Climate Change Elizabeth Haase\b MD \: page 36 Direct experience with and future unknown effects of climate change can cause chi\:ldren to exhibit symptoms of PTSD\b such as phobic beha\:vior\b panic\b nightmares\b and anxiety. R esilience in the Face \ff Climate Change Victoria Derr\b PhD \: page 41 Research with a diverse sample of youth students\b age 11–15\b in Boulder\b Colorado\b showed that youth views of resilience stem from complex social and environmental supports. Finding a Place f\fr Psych\fl\fgy in Climate Change Deliberati\fns Linda Silka\b PhD \: page 47 New England is an example of vital inf\:rastructure that is at risk from rising sea levels and of opportun\:ities for psychologists to work with professionals in various fields to prepare for the effects. Our M\fr al Obligati\fn: \bhe Duty t\f Warn and Act Lise Van Susteren\b MD \: page 57 Growing numbers of cli\:mate Cassandras are being debilitated by anxiety about fut\:ure harm to the planet. Where is the collective health effort to address this issue? T he time is now for mental health p\:rofessionals to act. Throughout the report are six essays from mental health professionals that \five into particular topics of expertise on mental health an\f climate change.

4 Mental Health and Our Changing Climate: \fmpacts\b \fmplications\b and Guidance American Psychological Association | ecoAmerica 5 When you think about clim\:ate change\b mental health mig\:ht not be the first thing that comes to mind. Americans a\:re beginning to grow familiar with climate change and its he\:alth impacts: worsening asthma and allergies; heat-related stress; foodborne\b waterborne\b and vector-borne diseases; i\:llness and injury related to storms; and floods and\: droughts. However\b the connections with men\:tal health are not often part of the disc\:ussion. \ft is time to expand information and action on \:climate and health\b inclu\:ding mental health\:. The health\b economic\b political\b a\:nd environmental implications of climate change affect all of us. The tolls on our mental \:health are far reaching. They induce stress\b depression\b and anxiety; strain social and community relationships; and have been linked to increases in aggression\b violence\b and crime. Children and communities with few resources to deal with the impacts of\: climate change are those most impacted. To compound the issue\b the psychological responses to climate change\b such as conflict avoidance\b fatalism\b fear\b helplessness\b and resignation are growing. These responses are keeping us\b and our \:nation\b from properly addressing the core causes of and solu\:tions for our changing climate\b and from building and sup\:porting psychological resiliency. To help increase awareness of these challenge\:s and to address them\b the American\: Psychological Association and ecoAmerica sponsored this report\b Mental Health and \:Our Changing Climate: \fmpacts\b \fmplications\b and Guidance . This is an updated and expanded version of our 2014 report\b Beyond Storms & Droughts: The Psychological \fmpacts of\: Climate Change \b which explored how climate change can impact \:mental health and \:provided guidance to engage the publi\:c. This updated report is intended to further inform and empower health and medi\:cal professionals\b community and elected leaders\b and the\: public. Our websites offer webinars and other r\:esources to supplement this r\:eport. On behalf of the a\:uthors\b the many professionals who contributed directly and indirectly to this work\b and all those \:involved in expanding awareness of and action on \:climate and mental health\b than\:k you for taking the time\: to review and share this important resource. We invite your feedback\b and as the \:field continues to grow\b we’ll continue to update this work. Howard S. Kurtzman\b Ph.D. Acting Executive Director for Science American Psychological Association Bob Perkowitz Founder & President ecoAmerica WHY WE OFFER TH\fS RE\:PORT A CLOSER LOOK: A Clinical Psych\fl\fgist’s \bake \fn Climate Change Thomas Doherty\b PsyD pag\:e 28 Climate change is a human\:-caused problem\b which is more difficult to cope with than disas\:ters that are beyond human control. Mental health \:professionals can help give people a sense of power over how they respond. Inuit Mental Health \hand Climate Change Ashlee Cunsolo\b PhD \: page 33 The \fnuit are a prime example of communities that have experienced the mental distress and loss of cultural identity brought on by a changing landsca\:pe and environmental conditions. Childr en’s Em\fti\fnal Resp\fnses t\f Climate Change Elizabeth Haase\b MD \: page 36 Direct experience with and future unknown effects of climate change can cause chi\:ldren to exhibit symptoms of PTSD\b such as phobic beha\:vior\b panic\b nightmares\b and anxiety. R esilience in the Face \ff Climate Change Victoria Derr\b PhD \: page 41 Research with a diverse sample of youth students\b age 11–15\b in Boulder\b Colorado\b showed that youth views of resilience stem from complex social and environmental supports. Finding a Place f\fr Psych\fl\fgy in Climate Change Deliberati\fns Linda Silka\b PhD \: page 47 New England is an example of vital inf\:rastructure that is at risk from rising sea levels and of opportun\:ities for psychologists to work with professionals in various fields to prepare for the effects. Our M\fr al Obligati\fn: \bhe Duty t\f Warn and Act Lise Van Susteren\b MD \: page 57 Growing numbers of cli\:mate Cassandras are being debilitated by anxiety about fut\:ure harm to the planet. Where is the collective health effort to address this issue? T he time is now for mental health p\:rofessionals to act. Throughout the report are six essays from mental health professionals that \five into particular topics of expertise on mental health an\f climate change.

6 Mental Health and Our Changing Climate: \fmpacts\b \fmplications\b and Guidance American Psychological Association | ecoAmerica 7 Thus far, most research and communications on the impacts of climate chan\fe have emphasized the physical health e\bects, while mental \lhealth has been sec\londary. Building upon Beyond Storms and Droughts: The Psychological \fmpacts of Climate Change \b the goal of this \:updated report is to increase awareness of the psychological impacts of climate change on human mental health and well-being. The report provides climate communicators\b planners\b policymakers\b public health professionals\b and other l\:eaders the tools and tips needed to respond to these impacts and \:bolster public engagement on clima\:te solutions. The impacts of clima\lte chan\fe on people’\ls physical, mental, and community health ari\lse directly and indirectly. Some human health \:eff ects stem directly from natural disasters exacerbated by climate change\b like floods\b storms\b wildfir es\b and heatwaves. Other effects surface more gradually from changing temperatures and rising sea le\:vels tha t cause forced migration. Weakened infrastructure and less secure food systems are examples of indirect climate impacts on society’s physical and mental he\:alth. Some communities and pop\lulations are more vulnerable to the health-related impacts of clima\lte chan\fe. Factors that may increase sensitivity to the mental health impacts include geographic location\b presence of pre-existing disabilities or chronic illnesses\b and socioeconomic and demographic inequalities\b such a\:s education level\b income\b and age. \fn particular\b stress from climate impacts can cause c\:hildren t o experience changes in behavior\b development\b memory\b executive function\b decision-making\b and\: scholastic achievement. T he connection between chan\fes in the \lclimate and impacts on a perso\ln can be difficult to \frasp. Although people’ s understanding and knowledge of climate change can increase by experiencing the effects directly\b perception\b politics\b and uncertainty can complicate this link. Psychological factors (like psychological distance)\b a political divide\b uncertainty\b helplessness\b and denial influe\:nce the way people comprehend information and form their beliefs o\:n climate change. Research on the impacts of\: climate change on human well-being is partic\:ularly important g\:iven the relationship among understanding\b experiencing\b and comprehending climate change. People’s willingness to support and engag\:e in climate solutions is likely to increase if they can relate them to local experiences or if they see the relevance to their own health and well-being. Additionally\b individuals who have higher perceived environmental self-efficacy\b or the sense of being able to positively contribute\b are more motivated to act on climate solutions (Sawitri\b Hadiyanto\b & Hadi\b 2015). Climate solutions are available now, are widespread, and support p\lsycholo\fical health. \fncreasing adoption of \:active commuting\b public tr\:ansportation\b green spac es\b and clean energy are all solutions that people can choose \:to support and integrate into their daily lives. These climate solutions\b among oth\:ers\b can help to curb the stress\b anxiety\b and other mental \: illnesses incurred from the decline of \: economies\b infrastructure\b and social identit\:y tha t comes from damage to the climate. Major acute mental health imp\lacts include increases in trauma and shock, po\lst- traumatic stress disorder (PTSD), compounded stress, anxiety, substance abuse , and depression. Climate change– induced extreme weather\b changing weather pa tterns\b damaged food and water resources\b and polluted air impact human\: mental health. \fncr eased levels of stress and distress from these factors can also put strains on social relationships and even have impacts on physical health\b such as\: memory loss\b sleep disorders\b immune suppression\b and changes in digestion. Major chronic mental health \limpacts include hi\fher rates of a\f\fression and violence, more mental health eme\lr\fencies, an increased sense of help\llessness, hopelessness, or fatalism, and intense feelin\fs of loss. These feelings of loss may be due t o profound changes in a p\:ersonally important place (such as one’s home) and/ or a sense that one has lost control over events in one’s life due to disturbances from climate change. Additionally\b a sense of loss regarding one’s personal or occupational identity can arise \:when treasured objects are destroyed by a disaster or place-based occupations are disrupted by climate change. Personal relationships and the \lways in which people interact in communities and with each other ar\le a\bected by a chan\fin\f climate. C ompounded stress from a changing environment\b ecomigration\b and/or ecoanxiety can affect community mental well-being t hrough the loss of social identity and\: cohesion\b hostility\b violence\b and interpersonal and intergroup aggression. Psycholo\fical well-bein\f includes p\lositive emotions, a sense \lof meanin\f and purpose, and stron\f social connections. Although the psychological impacts o\:f c limate change may not be obvious\b they are no less serious because they can lead to disorders\b such as depression\b antisocial behavior\b and suicide. Therefore\b these disorders must be considered impacts of clima te change as are disease\b hunger\b and other physical health consequences. Buildin\f r esilience is essential to address the physical and mental he\lalth impacts of climate chan\fe. Many local governments within the United States and in other countries have created plans to protect and enhanc e infrastructure\b but these plans tend to overlook the support \:needed to ensure thriving psychological well-being. There is an opportunity t\:o include the resilience capacity of individ\:uals and c ommunities in the development of preparedness plans. RECOMMENDATIONS This report concludes with four sets of recommendations designed to help readers put these research findings into action. Tips to support individu\lals. This section provides strategies for practitioners\b policymakers\b and communicators to build personal attributes and social suppor\:t that will help to prepare for and recover from climate change–related mental trauma. The following are a few of the top recommendations: 1. Build belief in one\:’s own resilience. 2. Foster optimism. 3. Cultivate active coping and self-regulation skills. 4. Maintain practices that help to provide a sense of mea\:ning. 5. Promote connectedness to family\b place\b culture\b and community. EXECUT\fVE SUMMARY

6 Mental Health and Our Changing Climate: \fmpacts\b \fmplications\b and Guidance American Psychological Association | ecoAmerica 7 Thus far, most research and communications on the impacts of climate chan\fe have emphasized the physical health e\bects, while mental \lhealth has been sec\londary. Building upon Beyond Storms and Droughts: The Psychological \fmpacts of Climate Change \b the goal of this \:updated report is to increase awareness of the psychological impacts of climate change on human mental health and well-being. The report provides climate communicators\b planners\b policymakers\b public health professionals\b and other l\:eaders the tools and tips needed to respond to these impacts and \:bolster public engagement on clima\:te solutions. The impacts of clima\lte chan\fe on people’\ls physical, mental, and community health ari\lse directly and indirectly. Some human health \:eff ects stem directly from natural disasters exacerbated by climate change\b like floods\b storms\b wildfir es\b and heatwaves. Other effects surface more gradually from changing temperatures and rising sea le\:vels tha t cause forced migration. Weakened infrastructure and less secure food systems are examples of indirect climate impacts on society’s physical and mental he\:alth. Some communities and pop\lulations are more vulnerable to the health-related impacts of clima\lte chan\fe. Factors that may increase sensitivity to the mental health impacts include geographic location\b presence of pre-existing disabilities or chronic illnesses\b and socioeconomic and demographic inequalities\b such a\:s education level\b income\b and age. \fn particular\b stress from climate impacts can cause c\:hildren t o experience changes in behavior\b development\b memory\b executive function\b decision-making\b and\: scholastic achievement. T he connection between chan\fes in the \lclimate and impacts on a perso\ln can be difficult to \frasp. Although people’ s understanding and knowledge of climate change can increase by experiencing the effects directly\b perception\b politics\b and uncertainty can complicate this link. Psychological factors (like psychological distance)\b a political divide\b uncertainty\b helplessness\b and denial influe\:nce the way people comprehend information and form their beliefs o\:n climate change. Research on the impacts of\: climate change on human well-being is partic\:ularly important g\:iven the relationship among understanding\b experiencing\b and comprehending climate change. People’s willingness to support and engag\:e in climate solutions is likely to increase if they can relate them to local experiences or if they see the relevance to their own health and well-being. Additionally\b individuals who have higher perceived environmental self-efficacy\b or the sense of being able to positively contribute\b are more motivated to act on climate solutions (Sawitri\b Hadiyanto\b & Hadi\b 2015). Climate solutions are available now, are widespread, and support p\lsycholo\fical health. \fncreasing adoption of \:active commuting\b public tr\:ansportation\b green spac es\b and clean energy are all solutions that people can choose \:to support and integrate into their daily lives. These climate solutions\b among oth\:ers\b can help to curb the stress\b anxiety\b and other mental \: illnesses incurred from the decline of \: economies\b infrastructure\b and social identit\:y tha t comes from damage to the climate. Major acute mental health imp\lacts include increases in trauma and shock, po\lst- traumatic stress disorder (PTSD), compounded stress, anxiety, substance abuse , and depression. Climate change– induced extreme weather\b changing weather pa tterns\b damaged food and water resources\b and polluted air impact human\: mental health. \fncr eased levels of stress and distress from these factors can also put strains on social relationships and even have impacts on physical health\b such as\: memory loss\b sleep disorders\b immune suppression\b and changes in digestion. Major chronic mental health \limpacts include hi\fher rates of a\f\fression and violence, more mental health eme\lr\fencies, an increased sense of help\llessness, hopelessness, or fatalism, and intense feelin\fs of loss. These feelings of loss may be due t o profound changes in a p\:ersonally important place (such as one’s home) and/ or a sense that one has lost control over events in one’s life due to disturbances from climate change. Additionally\b a sense of loss regarding one’s personal or occupational identity can arise \:when treasured objects are destroyed by a disaster or place-based occupations are disrupted by climate change. Personal relationships and the \lways in which people interact in communities and with each other ar\le a\bected by a chan\fin\f climate. C ompounded stress from a changing environment\b ecomigration\b and/or ecoanxiety can affect community mental well-being t hrough the loss of social identity and\: cohesion\b hostility\b violence\b and interpersonal and intergroup aggression. Psycholo\fical well-bein\f includes p\lositive emotions, a sense \lof meanin\f and purpose, and stron\f social connections. Although the psychological impacts o\:f c limate change may not be obvious\b they are no less serious because they can lead to disorders\b such as depression\b antisocial behavior\b and suicide. Therefore\b these disorders must be considered impacts of clima te change as are disease\b hunger\b and other physical health consequences. Buildin\f r esilience is essential to address the physical and mental he\lalth impacts of climate chan\fe. Many local governments within the United States and in other countries have created plans to protect and enhanc e infrastructure\b but these plans tend to overlook the support \:needed to ensure thriving psychological well-being. There is an opportunity t\:o include the resilience capacity of individ\:uals and c ommunities in the development of preparedness plans. RECOMMENDATIONS This report concludes with four sets of recommendations designed to help readers put these research findings into action. Tips to support individu\lals. This section provides strategies for practitioners\b policymakers\b and communicators to build personal attributes and social suppor\:t that will help to prepare for and recover from climate change–related mental trauma. The following are a few of the top recommendations: 1. Build belief in one\:’s own resilience. 2. Foster optimism. 3. Cultivate active coping and self-regulation skills. 4. Maintain practices that help to provide a sense of mea\:ning. 5. Promote connectedness to family\b place\b culture\b and community. EXECUT\fVE SUMMARY

8 Mental Health and Our Changing Climate: \fmpacts\b \fmplications\b and Guidance Tips to support communities. This section is for people\b organizations\b and mental a\:nd public health pr\:ofessionals who are at the forefront of and/or are interested in strengthening communities’ responses to acute events and confronting gradual changes in th\:e climate\b in order to alleviate adverse mental health outcomes. The following are several of the topline recommended strategies for protecting well-being and alleviating adverse mental health \:outcomes: 1. Assess and expand community mental health infrastructure. 2. Reduce disparities and p\:ay attention to populations of concern. 3. Engage and train community members on how to respond. 4. Ensure distribution of resources and augment with external supplies. 5. Have clear and frequent climate–mental health communication. \f hat indi\biduals can do. At home and in the \:community\b people can take actions in their \:everyday lives to buffer agains t some of the projected impacts\b and thes\:e actions can also provide a greater sense of individ\:ual security and control. The following are several of the topline actions indi\:viduals can take: 1. Make and practice household emergency plans. 2. Participate in mindset training to prepare for adversity and adaptation through increased awareness of our emotions. 3. Care for oneself through healthy habits. 4. Connect with family\b friends\b neighbors\b and other groups to build strong social networks. \f hat mental health and \5other professional leaders can do\5. Health professionals and fellow leaders are uniquely position\:ed t o foster new levels of support for climate solutions. Considered the nation’s most highly trusted and accessible messengers\b health professionals reach a breadth and diversity of Americans. The following are several of the topline opportunities for health leaders: 1. Become a mental healt\:h–related climate-literate professional. 2. Engage fellow public and mental\: health professionals. 3. Be vocal\b model leaders \:within your communities. 4. Support national and international climate–mental health solutions. I. CONTEXT

8 Mental Health and Our Changing Climate: \fmpacts\b \fmplications\b and Guidance Tips to support communities. This section is for people\b organizations\b and mental a\:nd public health pr\:ofessionals who are at the forefront of and/or are interested in strengthening communities’ responses to acute events and confronting gradual changes in th\:e climate\b in order to alleviate adverse mental health outcomes. The following are several of the topline recommended strategies for protecting well-being and alleviating adverse mental health \:outcomes: 1. Assess and expand community mental health infrastructure. 2. Reduce disparities and p\:ay attention to populations of concern. 3. Engage and train community members on how to respond. 4. Ensure distribution of resources and augment with external supplies. 5. Have clear and frequent climate–mental health communication. \f hat indi\biduals can do. At home and in the \:community\b people can take actions in their \:everyday lives to buffer agains t some of the projected impacts\b and thes\:e actions can also provide a greater sense of individ\:ual security and control. The following are several of the topline actions indi\:viduals can take: 1. Make and practice household emergency plans. 2. Participate in mindset training to prepare for adversity and adaptation through increased awareness of our emotions. 3. Care for oneself through healthy habits. 4. Connect with family\b friends\b neighbors\b and other groups to build strong social networks. \f hat mental health and \5other professional leaders can do\5. Health professionals and fellow leaders are uniquely position\:ed t o foster new levels of support for climate solutions. Considered the nation’s most highly trusted and accessible messengers\b health professionals reach a breadth and diversity of Americans. The following are several of the topline opportunities for health leaders: 1. Become a mental healt\:h–related climate-literate professional. 2. Engage fellow public and mental\: health professionals. 3. Be vocal\b model leaders \:within your communities. 4. Support national and international climate–mental health solutions. I. CONTEXT

10 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 11 OUR CHANGING CLIMATE\f A PRIMER ACCELERATION From wildfire\b and drought in California to \bevere flooding in Maryland to Ala\bkan communitie\b threatened by ri\bing \bea\b, we are clearly living th\mrough \bome of the mo\b\mt \bevere weather event\b in U.S. hi\btory a\b a re\bult of damage to our climate. The\be impact\b on our environment will, in tur\mn, affect human health and community well-being (Melillo\m, Richmond, & Yohe, 2014). CHANGES WORLDWIDE Climate change i\b creating vi\bible impact\b \mworldwide, including many here in America. A\b \bee\mn in the tripling o\mf heat wave\b between 2011 and 2012, weather pattern\b introduce la\bting impact\b, \buch a\b food insecurity (Duffy & Tebaldi, 2012; Hatfield et al., 2014). Similarly, ri\bing \bea-\burface temperature\b have been connected to increa\bing rate\b of di\bea\be for marine life and human\b (Doney et al., 2014). Sea level\b are e\btimated to increa\be anywhere from 8 inche\b to 6.6 feet due to warmer temperature\b by 2100, putting 8 million\m American\b living in\m coa\btal area\b at ri\bk for flooding (Parri\b et al., 2012). In term\b of our economy, Hurricane Sandy c\mo\bt the United State\b around $68 billion i\mn total (National Oceanic and Atmo\bpheric Admini\btration, 2016). Drought\b cau\bed by increa\be\b in temperature and changing weather pattern\b co\bt California $2.7 billion in 2015 and Texa\b $7.62 billion in 2011 (Howitt, MacEwan, Medellín-Azuara, Lund, & Sumner, 2015; Guerrero, 2011). A\b the\be climate di\bturbance\b become more dramatic and per\bi\btent, we mu\bt prepare for the\be climate condition\b. COMMUNITIES ARE IMP\:ACTED Our communitie\b’ health, \minfra\btructure, and economy are directly connected to our climate (Kryg\bman, Spei\ber, Wood, & Barry, 2016). A\b temperature\b increa\be, we experience higher level\b of pollution, allergen\b, and di\bea\be\b (\mKryg\bman, Spei\ber, Mer\be, Marx, & Tabola, 2016). Severe weather event\b threaten our bu\bine\b\be\b and vulnerable communitie\b. Pollution and drought undermine our\m food and water \bupplie\b, and the latter increa\be\b the prevalence of wildfire\b that can de\btroy home\b and communitie\b (Zi\bka et al., 2016). Although all \mAmerican\b are affected, certain population\b of concern will feel the impact\b more \beverely (U.S. Global Change Re\bearch Program [US - GCRP], 2016). Together, communitie\b can build\m resilience to a changing climate. HEALTH IS IMPACTED A\b \bevere weather event\b, poorer air quality, degraded food and water \by\btem\b, and phy\bical illne\b\be\b increa\be, the direct and indirect impact\b on health mu\bt be under\btood (USGCRP, 2016). The next \bection highligh\mt\b the phy\bical health impact\b of climate change, and the following \bection\b delve deeper into the mental health\m impact\b, and what can be done to protect human well-being. THE CLIMATE AND HEALTH IMPACTS ON HUMANS Health i\b more than the ab\bence of di\bea\be. Health include\b ment\mal health, a\b well a\b phy\bical well-being, and communitie\b that fail to provide ba\bic \bervice\b and \bocial \bupport challenge bo\mth. A\b we think about the impact\b of climate change on our communitie\b, we need to recognize not only the direct effect\b but al\bo the in\mdirect con\bequence\b for human health ba\b\med on damage to the phy\bical and \bocial community infra\btructure. Regardle\b\b of how the\be impact\b \burface, whether they occur within a matter of hour\b or over \beveral decade\b, the outcome\b of climate change are interconnected to all facet\b of our health. \m Thi\b \bection review\b the primary way\b in which geophy\bical change\b affect human health, in the \bhor\mt and long term. ACUTE IMPACTS: DISASTER\fRELATED EFFECTS Recent increa\be\b in natural di\ba\bter\b illu\btrate the relation\bhip between the acceleration of climate change and \bevere weather. Area\b that endure a natural di\ba\bter face a number of ri\bk\b and difficult\mie\b. Direct phy\bical impact\b range from brute phy\bical trauma to more perniciou\b effect\b, like increa\bed incidence of infectiou\b di\bea\be, a\bthma, heart di\bea\be, and lung problem\b. The\be phy\bical health impact\b \minteract with mental health impact\m\b, which i\b why they are detailed in thi\b report on page 39. In thi\b \bection, we u\be flood\b, the mo\b\mt common form of natural di\ba\bter\b (EM-DAT, 2011, a\b reported in Alderman, Turner, & Tong, 2012), a\b an example to illu\btrate the way\b in which direct health impact\b of\m di\ba\bter\b come about. Maj\br and min\br acute physical injury Natural di\ba\bter\b lead to increa\bed rate\b of death and injury. The mo\bt common cau\be\b of mortality during\m flood\b are drowning and acute phy\bical trauma (e.g., being \btruck by debri\b; Alderman et\m al., 2012). Thi\b pa\bt year alone, death\b from fla\bh flood\b have more than doubled the 1\m0-year average (National Weather Service, 2016). During and after a flood, many people \bu\btain non-fatal injurie\b, \buch a\b cut\b and broken bone\b. Among other impact\b, more frequent rainfall can lead to an increa\be in traffic accident\b (Leard & Roth, 2016). Figure 1. Depict\b the many different way\b climate change impact\b human health \m (Center\b for Di\bea\be Control and Prevention [CDC], 2014). a. For more information on climate change, the cau\be\b, and th\me role of human activi\mty, view the National Climate A\b\be\b\bment report Our climate is changing at an accelerated rate and c\bntinues t\b have pr\bf\bund impacts \bn human heal\:th. This change je\bpardizes n\bt \bnly physical health but als\b mental health.\: This secti\bn pr\bvides a primer \bn the ge\bphysical impacts \bf climate change. a

10 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 11 OUR CHANGING CLIMATE\f A PRIMER ACCELERATION From wildfire\b and drought in California to \bevere flooding in Maryland to Ala\bkan communitie\b threatened by ri\bing \bea\b, we are clearly living th\mrough \bome of the mo\b\mt \bevere weather event\b in U.S. hi\btory a\b a re\bult of damage to our climate. The\be impact\b on our environment will, in tur\mn, affect human health and community well-being (Melillo\m, Richmond, & Yohe, 2014). CHANGES WORLDWIDE Climate change i\b creating vi\bible impact\b \mworldwide, including many here in America. A\b \bee\mn in the tripling o\mf heat wave\b between 2011 and 2012, weather pattern\b introduce la\bting impact\b, \buch a\b food insecurity (Duffy & Tebaldi, 2012; Hatfield et al., 2014). Similarly, ri\bing \bea-\burface temperature\b have been connected to increa\bing rate\b of di\bea\be for marine life and human\b (Doney et al., 2014). Sea level\b are e\btimated to increa\be anywhere from 8 inche\b to 6.6 feet due to warmer temperature\b by 2100, putting 8 million\m American\b living in\m coa\btal area\b at ri\bk for flooding (Parri\b et al., 2012). In term\b of our economy, Hurricane Sandy c\mo\bt the United State\b around $68 billion i\mn total (National Oceanic and Atmo\bpheric Admini\btration, 2016). Drought\b cau\bed by increa\be\b in temperature and changing weather pattern\b co\bt California $2.7 billion in 2015 and Texa\b $7.62 billion in 2011 (Howitt, MacEwan, Medellín-Azuara, Lund, & Sumner, 2015; Guerrero, 2011). A\b the\be climate di\bturbance\b become more dramatic and per\bi\btent, we mu\bt prepare for the\be climate condition\b. COMMUNITIES ARE IMP\:ACTED Our communitie\b’ health, \minfra\btructure, and economy are directly connected to our climate (Kryg\bman, Spei\ber, Wood, & Barry, 2016). A\b temperature\b increa\be, we experience higher level\b of pollution, allergen\b, and di\bea\be\b (\mKryg\bman, Spei\ber, Mer\be, Marx, & Tabola, 2016). Severe weather event\b threaten our bu\bine\b\be\b and vulnerable communitie\b. Pollution and drought undermine our\m food and water \bupplie\b, and the latter increa\be\b the prevalence of wildfire\b that can de\btroy home\b and communitie\b (Zi\bka et al., 2016). Although all \mAmerican\b are affected, certain population\b of concern will feel the impact\b more \beverely (U.S. Global Change Re\bearch Program [US - GCRP], 2016). Together, communitie\b can build\m resilience to a changing climate. HEALTH IS IMPACTED A\b \bevere weather event\b, poorer air quality, degraded food and water \by\btem\b, and phy\bical illne\b\be\b increa\be, the direct and indirect impact\b on health mu\bt be under\btood (USGCRP, 2016). The next \bection highligh\mt\b the phy\bical health impact\b of climate change, and the following \bection\b delve deeper into the mental health\m impact\b, and what can be done to protect human well-being. THE CLIMATE AND HEALTH IMPACTS ON HUMANS Health i\b more than the ab\bence of di\bea\be. Health include\b ment\mal health, a\b well a\b phy\bical well-being, and communitie\b that fail to provide ba\bic \bervice\b and \bocial \bupport challenge bo\mth. A\b we think about the impact\b of climate change on our communitie\b, we need to recognize not only the direct effect\b but al\bo the in\mdirect con\bequence\b for human health ba\b\med on damage to the phy\bical and \bocial community infra\btructure. Regardle\b\b of how the\be impact\b \burface, whether they occur within a matter of hour\b or over \beveral decade\b, the outcome\b of climate change are interconnected to all facet\b of our health. \m Thi\b \bection review\b the primary way\b in which geophy\bical change\b affect human health, in the \bhor\mt and long term. ACUTE IMPACTS: DISASTER\fRELATED EFFECTS Recent increa\be\b in natural di\ba\bter\b illu\btrate the relation\bhip between the acceleration of climate change and \bevere weather. Area\b that endure a natural di\ba\bter face a number of ri\bk\b and difficult\mie\b. Direct phy\bical impact\b range from brute phy\bical trauma to more perniciou\b effect\b, like increa\bed incidence of infectiou\b di\bea\be, a\bthma, heart di\bea\be, and lung problem\b. The\be phy\bical health impact\b \minteract with mental health impact\m\b, which i\b why they are detailed in thi\b report on page 39. In thi\b \bection, we u\be flood\b, the mo\b\mt common form of natural di\ba\bter\b (EM-DAT, 2011, a\b reported in Alderman, Turner, & Tong, 2012), a\b an example to illu\btrate the way\b in which direct health impact\b of\m di\ba\bter\b come about. Maj\br and min\br acute physical injury Natural di\ba\bter\b lead to increa\bed rate\b of death and injury. The mo\bt common cau\be\b of mortality during\m flood\b are drowning and acute phy\bical trauma (e.g., being \btruck by debri\b; Alderman et\m al., 2012). Thi\b pa\bt year alone, death\b from fla\bh flood\b have more than doubled the 1\m0-year average (National Weather Service, 2016). During and after a flood, many people \bu\btain non-fatal injurie\b, \buch a\b cut\b and broken bone\b. Among other impact\b, more frequent rainfall can lead to an increa\be in traffic accident\b (Leard & Roth, 2016). Figure 1. Depict\b the many different way\b climate change impact\b human health \m (Center\b for Di\bea\be Control and Prevention [CDC], 2014). a. For more information on climate change, the cau\be\b, and th\me role of human activi\mty, view the National Climate A\b\be\b\bment report Our climate is changing at an accelerated rate and c\bntinues t\b have pr\bf\bund impacts \bn human heal\:th. This change je\bpardizes n\bt \bnly physical health but als\b mental health.\: This secti\bn pr\bvides a primer \bn the ge\bphysical impacts \bf climate change. a

12 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 13 Infrastructure, food, and water The direct effect of a natural di\ba\bter i\b often exacerbated by a ca\bcade of indirect con\bequence\b that follow. Natural di\ba\bter\b can lead to technological di\ba\bter\b (\buch a\b power outage\b ), breakdown\b in the water, \bewer, and other infra\btructure, or urban fire\b. For in\btance, the ri\bk of carbo\mn mono xide poi\boning related to power outage\b increa\be\b a\b a re\bult of climate change–induced di\ba\bter\b (Bell et al., 2\m016). Di\bruption\b to medical infra\btructure, including the provi\bion of medical \bupplie\b, can \mtran\bform minor i\b\bue\b into major and even fatal problem\b. In addition\m, di\bruption\b in other type\b of \bervice\b (e.g., cell phone communication, tran\bportation, or wa\bte management) add \btre\b\b and difficulty during the aftermath of a di\ba\bter. The\be di\bruption\b may impact people’\b phy\bical health by making it more difficult to acce\b\b health car e or by potentially increa\bing expo\bure to pe\bt\b or hazardou\b \bub\btance\b (e.g., when there i\b no garbage pick\m-up; B ell et al., 2016). Lo\b\b of income while bu\bine\b\be\b are clo\bed due to natural di\ba\bter\b can be a major t\mhreat to food \becurity, e\bpecially for non-profe\b\bional\b or \bmall bu\bi\mne\b\b owner\b. After effects Additional health t\mhreat\b follow in the wake of a di\ba\bter. Floodwater ha\b been \bhown to introduce toxic material\b, water-borne di\bea\be\b (e.g., re\bpiratory illne\b\be\b, \bkin infection\b, and neur ologic and ga\btrointe\btinal illne\b\b where there are poor hygiene re\bource\b), and vector-borne illne\b\be\b (e.g., We\bt Nile; Trtanj et al., 2016). Other after effect\b of flooding include heart attack, heat \btroke, dehydration, and \btroke, particularly when t\mhe affected area\b lack the nece\b\bary medical \bupplie\b (Jonkman, Maa\bkant, Boyd, & Levitan, 2009, p. 687 a\b reported in Alderman et a\ml., 2012). In addition, po\bt-flood mold due to fungal growth in\bide hou\be\b ca\mn wor\ben allergy or a\bthma \bymptom\b. MORE GRADUAL HEALTH EFFECTS Ongoing effect\b of climate change include ri\m\bing \bea level\b, increa\be\b in temperature, and change\b in precipitation that will affect agricultural condition\b. The impact\b on human health are le\b\b dramatic in the \bhort term but in the long\m run can affect more people and have a fundamental impact on \bociety. Severe and c\fanging weat\fer Period\b of higher-th\man-normal heat re\bult in higher rate\b of heat exhau\btion, heat cramp\b, heat \btroke, ho\bpital admi\b\bion for heart-related illne\b\be\b, and death (Sarofim et al., 2016). It’\b e\btimated that the average American citizen will experience between 4 and 8 time\b a\m\b many day\b above 95 degree\b Fahrenheit each year a\b he or \bhe do\me\b no w by the end of the century (Hou\ber, H\biang, Kopp, & Lar\ben, 2015). Thi\b increa\be will likely pu\bh Arizona’\b above-95-degree day\b from 116 today to a\b many a\b 205 by 2099 (Gordon, 2014). In contra\bt, extreme winter \btorm\b can expo\be people t o hypothermia and fro\btbite (Bell et al., 2016). Altered growing \bea\bon\b and ocean temperature\b change the timing\m and occurrence of diarrhea, fever, and abdominal cramp\b from pathogen tran\bmi\b\bion\b in r aw food (like Salmonella; Zi\bka et al., 2016). Additionally, changing weather pattern\b influence the expan\bion of the migration pattern\b of animal\b and \min\bect\b. Thi\b expan\bion ha\b already begun to re\bult in the \bpread of vector-borne illne\b\b, \buch a\b Lyme di\bea\be, malaria, dengue f\mever, plague, and Zika viru\b to new U.S. geographic area\b (Beard et al., 2016; Shuman, 2010). For example, vector-borne illne\b\be\b carried by mo\bquitoe\b can capitalize on receding floodwater for mo\bquito breeding. Res\biratory issues and allergens People expo\bed to ozone air pollution, \m which i\b emitted mo\btly by car\b and indu\btrial facilitie\b and i\b int\men\bified by w armer temperature\b, are more likely to vi\bit the ho\bpital f\mor re\bpiratory i\b\bue\b, \buffer from a\bthma, and die prematurely of \btroke\b or heart attack\b (Fann et al., 2016). Hotter and drier \bummer\b\m increa\be the frequency and inten\bity of large wildfire\b that contribute to \bmoke inhalation (Bell et al., 20 16). Pollution contribute\b to higher level\b of pollen and t\mran\blate\b into longer and more prevalent allergy \bea\bon\b (Fann et al., 2016; Seeley, 2012). Fetal and c\fild develo\bment Climate-driven phy\bical \btre\b\b on mother\b can cau\be adver\be birth outcome\b, \buch a\b preterm birth and low birth weight (Bell et al., 2016). Scientific re\bearch \bhow\b that children and developing fetu\be\b are at particular ri\bk from air pollution, h\meat, malnutrition, infectiou\b di\bea\be\b, all\mergie\b, and mental illne\b \be\b, which have detrimental impact\b on development (Perera, 2016). Water and food su\b\bly Nutrition and food safety can be affected becau\be climate change can lower crop yield\b, reduce the nutritional \mquality of food, interrupt di\btribution chain\b, a\mnd reduce acce\b\b to food becau\be familie\b lo\be inc ome. For example, higher CO 2 concentration\b lower the level\b of protein and e\b\bential mineral\b of widely con\bumed crop\b \buch a\b wheat, rice, and potatoe\b (Zi\bka et al., 2016). Barrier\b to food tran\bport, \buch a\b dama\mge to infra\btructure and di\bplac ement of employee\b, affect food market\b by increa\bing food co\bt\b (Lal et al., 2012). Drought\b, flood\b, and \mchange\b in the availability of fertile land lead t\mo hunger and malnutrition, though the\be chan\mge\b are le\b\b likely in wealthy countrie\b, \buch a\b th\me United State\b (Friel, Butler, & McMichael, 2011; McMichael, 2013). Neverthele\b\b, there will be an increa\bed likelihood of a globa\ml food market cri\bi\b a\b climate change accelerate\b (Paloviita,Järvelä, Jokinen, Mononen, & Sairien\m, 20 16). A two-degree Cel\biu\b increa\be in temperature place\b 100–400 million peo\mple at ri\bk of hunger, according to the World Bank (Friel e\mt al., 2011; McMichael, 2013). General fitness Increa\bed average temperature\b and decrea\bed air quality a\ml\bo lead to change\b in the type of acti\mvitie\b that people engage in, p articularly outdoor activitie\b and\m recreation. The\be change\b, in tur\mn, may be a\b\bociated with increa\bed rate\b of obe\bity and cardiova\bcular di\bea\be. Although people may compen\bate by exerci\bing in indoor environment\b, reduced acce\b\b to the re\btorative potential of outdoor environment\b may indirectly increa\be \btre\b\b and bypa\b\b the long-term emotional benefit\b of taking p\mhy\bical activity outdoor\b (Hartig & Catalano, 2013; Pa\banen, Tyrvainen, & Korpela, 2014). THE CLIMATE AND HEALTH IMPACTS ON HUMANS

12 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 13 Infrastructure, food, and water The direct effect of a natural di\ba\bter i\b often exacerbated by a ca\bcade of indirect con\bequence\b that follow. Natural di\ba\bter\b can lead to technological di\ba\bter\b (\buch a\b power outage\b ), breakdown\b in the water, \bewer, and other infra\btructure, or urban fire\b. For in\btance, the ri\bk of carbo\mn mono xide poi\boning related to power outage\b increa\be\b a\b a re\bult of climate change–induced di\ba\bter\b (Bell et al., 2\m016). Di\bruption\b to medical infra\btructure, including the provi\bion of medical \bupplie\b, can \mtran\bform minor i\b\bue\b into major and even fatal problem\b. In addition\m, di\bruption\b in other type\b of \bervice\b (e.g., cell phone communication, tran\bportation, or wa\bte management) add \btre\b\b and difficulty during the aftermath of a di\ba\bter. The\be di\bruption\b may impact people’\b phy\bical health by making it more difficult to acce\b\b health car e or by potentially increa\bing expo\bure to pe\bt\b or hazardou\b \bub\btance\b (e.g., when there i\b no garbage pick\m-up; B ell et al., 2016). Lo\b\b of income while bu\bine\b\be\b are clo\bed due to natural di\ba\bter\b can be a major t\mhreat to food \becurity, e\bpecially for non-profe\b\bional\b or \bmall bu\bi\mne\b\b owner\b. After effects Additional health t\mhreat\b follow in the wake of a di\ba\bter. Floodwater ha\b been \bhown to introduce toxic material\b, water-borne di\bea\be\b (e.g., re\bpiratory illne\b\be\b, \bkin infection\b, and neur ologic and ga\btrointe\btinal illne\b\b where there are poor hygiene re\bource\b), and vector-borne illne\b\be\b (e.g., We\bt Nile; Trtanj et al., 2016). Other after effect\b of flooding include heart attack, heat \btroke, dehydration, and \btroke, particularly when t\mhe affected area\b lack the nece\b\bary medical \bupplie\b (Jonkman, Maa\bkant, Boyd, & Levitan, 2009, p. 687 a\b reported in Alderman et a\ml., 2012). In addition, po\bt-flood mold due to fungal growth in\bide hou\be\b ca\mn wor\ben allergy or a\bthma \bymptom\b. MORE GRADUAL HEALTH EFFECTS Ongoing effect\b of climate change include ri\m\bing \bea level\b, increa\be\b in temperature, and change\b in precipitation that will affect agricultural condition\b. The impact\b on human health are le\b\b dramatic in the \bhort term but in the long\m run can affect more people and have a fundamental impact on \bociety. Severe and c\fanging weat\fer Period\b of higher-th\man-normal heat re\bult in higher rate\b of heat exhau\btion, heat cramp\b, heat \btroke, ho\bpital admi\b\bion for heart-related illne\b\be\b, and death (Sarofim et al., 2016). It’\b e\btimated that the average American citizen will experience between 4 and 8 time\b a\m\b many day\b above 95 degree\b Fahrenheit each year a\b he or \bhe do\me\b no w by the end of the century (Hou\ber, H\biang, Kopp, & Lar\ben, 2015). Thi\b increa\be will likely pu\bh Arizona’\b above-95-degree day\b from 116 today to a\b many a\b 205 by 2099 (Gordon, 2014). In contra\bt, extreme winter \btorm\b can expo\be people t o hypothermia and fro\btbite (Bell et al., 2016). Altered growing \bea\bon\b and ocean temperature\b change the timing\m and occurrence of diarrhea, fever, and abdominal cramp\b from pathogen tran\bmi\b\bion\b in r aw food (like Salmonella; Zi\bka et al., 2016). Additionally, changing weather pattern\b influence the expan\bion of the migration pattern\b of animal\b and \min\bect\b. Thi\b expan\bion ha\b already begun to re\bult in the \bpread of vector-borne illne\b\b, \buch a\b Lyme di\bea\be, malaria, dengue f\mever, plague, and Zika viru\b to new U.S. geographic area\b (Beard et al., 2016; Shuman, 2010). For example, vector-borne illne\b\be\b carried by mo\bquitoe\b can capitalize on receding floodwater for mo\bquito breeding. Res\biratory issues and allergens People expo\bed to ozone air pollution, \m which i\b emitted mo\btly by car\b and indu\btrial facilitie\b and i\b int\men\bified by w armer temperature\b, are more likely to vi\bit the ho\bpital f\mor re\bpiratory i\b\bue\b, \buffer from a\bthma, and die prematurely of \btroke\b or heart attack\b (Fann et al., 2016). Hotter and drier \bummer\b\m increa\be the frequency and inten\bity of large wildfire\b that contribute to \bmoke inhalation (Bell et al., 20 16). Pollution contribute\b to higher level\b of pollen and t\mran\blate\b into longer and more prevalent allergy \bea\bon\b (Fann et al., 2016; Seeley, 2012). Fetal and c\fild develo\bment Climate-driven phy\bical \btre\b\b on mother\b can cau\be adver\be birth outcome\b, \buch a\b preterm birth and low birth weight (Bell et al., 2016). Scientific re\bearch \bhow\b that children and developing fetu\be\b are at particular ri\bk from air pollution, h\meat, malnutrition, infectiou\b di\bea\be\b, all\mergie\b, and mental illne\b \be\b, which have detrimental impact\b on development (Perera, 2016). Water and food su\b\bly Nutrition and food safety can be affected becau\be climate change can lower crop yield\b, reduce the nutritional \mquality of food, interrupt di\btribution chain\b, a\mnd reduce acce\b\b to food becau\be familie\b lo\be inc ome. For example, higher CO 2 concentration\b lower the level\b of protein and e\b\bential mineral\b of widely con\bumed crop\b \buch a\b wheat, rice, and potatoe\b (Zi\bka et al., 2016). Barrier\b to food tran\bport, \buch a\b dama\mge to infra\btructure and di\bplac ement of employee\b, affect food market\b by increa\bing food co\bt\b (Lal et al., 2012). Drought\b, flood\b, and \mchange\b in the availability of fertile land lead t\mo hunger and malnutrition, though the\be chan\mge\b are le\b\b likely in wealthy countrie\b, \buch a\b th\me United State\b (Friel, Butler, & McMichael, 2011; McMichael, 2013). Neverthele\b\b, there will be an increa\bed likelihood of a globa\ml food market cri\bi\b a\b climate change accelerate\b (Paloviita,Järvelä, Jokinen, Mononen, & Sairien\m, 20 16). A two-degree Cel\biu\b increa\be in temperature place\b 100–400 million peo\mple at ri\bk of hunger, according to the World Bank (Friel e\mt al., 2011; McMichael, 2013). General fitness Increa\bed average temperature\b and decrea\bed air quality a\ml\bo lead to change\b in the type of acti\mvitie\b that people engage in, p articularly outdoor activitie\b and\m recreation. The\be change\b, in tur\mn, may be a\b\bociated with increa\bed rate\b of obe\bity and cardiova\bcular di\bea\be. Although people may compen\bate by exerci\bing in indoor environment\b, reduced acce\b\b to the re\btorative potential of outdoor environment\b may indirectly increa\be \btre\b\b and bypa\b\b the long-term emotional benefit\b of taking p\mhy\bical activity outdoor\b (Hartig & Catalano, 2013; Pa\banen, Tyrvainen, & Korpela, 2014). THE CLIMATE AND HEALTH IMPACTS ON HUMANS

14 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance ecoAmerica 15 LINKING PHYSICAL IMPACTS, MENTAL HEALTH, AND C OMMUNITY WELL-BEING Thi\b \bection i\b an overview of the interrelation among phy\bical health, mental\m health, and community well-being. We will expand on each topic later in thi\b report. MENTAL HEALTH The ability to proce\b\b information and make deci\bion\b without being di\bab\mled by extreme emotional re\bpon\be\b i\b threatened by climate change. Some emotional re\bpon\be i\b normal, and even negative emotion\b are a nece\b\bary part of a fulfilling life. In the extreme ca\be, however, they can interfere with our ability t\mo think rationally, plan our behavior, and con\bider alternative action\b. An extreme weather event can be a \bource of trauma, and the experience can cau\be di\babling emotion\b. \mMore \bubtle and indirect effect\b of climate change can add \btre\b\b to people’\b live\b in varying degree\b. Whether experienced indirectly or directly, \btre\b\bor\b to our climate tran\blate into impaired mental health th\mat can re\bult in depre\b\bion and anxiety (U\mSGCRP, 2016). Although everyone i\b able to cope with a certain amount of \btre\b\b, the accumulated effect\b of compound \btre\b\b can tip a per\bon from mentally healthy to mentally ill. Even uncertainty can be a \bource of \btre\b\b and a ri\bk factor for p\bychological di\btre\b\b (Greco & Roger, 2003). People can be negatively affected by hearing about th\me negative experience\b of other\b, and by fear\b—founded or unfounded—about their\m own potential vulnerability. PHYSICAL HEALTH AND MENTAL HEALTH Compromi\bed phy\bical health can be \ma \bource of \btre\b\b that threaten\b p\bychological well-being. Conver\bely, mental health problem\b can al\bo threaten phy\bical health, for example, by changing pattern\b of \bleep, eating, or exerci\be and by reducing immune \by\btem function. COMMUNITY HEALTH Although re\bident\b’ mental and\m phy\bical health affect communitie\b, the impac\mt\b of climate on community health can have a particularly \btrong effect on community fabric and interper\bonal relation\bhip\b. Altered environmental condition\b due to climate change can \bhift the opportunitie\b people have for \bocial interaction, the way\b in which they relate to each other, and their connection\b to the natural world. ACUTE GRA D UA L Chronic lung disease Cardiovascular disease Malnutrition Reduce \ftness PHY\bICAL HEALTH Injuries/fatalities Vector-borne disease Heat stroke Asthma Allergies MENTAL HEALTH Depression, stress, and anxiet\Ry \btrains on social relationships Complicated grief \bubstance abuse Post-traumatic stress disorder Loss of personal identity Helplessness and fatalism COMMUNITY HEALTH Increased personal agg\Rression Disrupted sense of belongi\Rng Loss of community cohesion Increased violence and crime \bocial instability age\f ethn\bc\bty econom\bc \bnequal\bty \bnfrastructure ava\blab\bl\bty of healthcare soc\bal cohes\bon IN D IVIDUAL \bOCIAL PHY\bICA L V ULNERABILITIE\b Geophysical impacts

14 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance ecoAmerica 15 LINKING PHYSICAL IMPACTS, MENTAL HEALTH, AND C OMMUNITY WELL-BEING Thi\b \bection i\b an overview of the interrelation among phy\bical health, mental\m health, and community well-being. We will expand on each topic later in thi\b report. MENTAL HEALTH The ability to proce\b\b information and make deci\bion\b without being di\bab\mled by extreme emotional re\bpon\be\b i\b threatened by climate change. Some emotional re\bpon\be i\b normal, and even negative emotion\b are a nece\b\bary part of a fulfilling life. In the extreme ca\be, however, they can interfere with our ability t\mo think rationally, plan our behavior, and con\bider alternative action\b. An extreme weather event can be a \bource of trauma, and the experience can cau\be di\babling emotion\b. \mMore \bubtle and indirect effect\b of climate change can add \btre\b\b to people’\b live\b in varying degree\b. Whether experienced indirectly or directly, \btre\b\bor\b to our climate tran\blate into impaired mental health th\mat can re\bult in depre\b\bion and anxiety (U\mSGCRP, 2016). Although everyone i\b able to cope with a certain amount of \btre\b\b, the accumulated effect\b of compound \btre\b\b can tip a per\bon from mentally healthy to mentally ill. Even uncertainty can be a \bource of \btre\b\b and a ri\bk factor for p\bychological di\btre\b\b (Greco & Roger, 2003). People can be negatively affected by hearing about th\me negative experience\b of other\b, and by fear\b—founded or unfounded—about their\m own potential vulnerability. PHYSICAL HEALTH AND MENTAL HEALTH Compromi\bed phy\bical health can be \ma \bource of \btre\b\b that threaten\b p\bychological well-being. Conver\bely, mental health problem\b can al\bo threaten phy\bical health, for example, by changing pattern\b of \bleep, eating, or exerci\be and by reducing immune \by\btem function. COMMUNITY HEALTH Although re\bident\b’ mental and\m phy\bical health affect communitie\b, the impac\mt\b of climate on community health can have a particularly \btrong effect on community fabric and interper\bonal relation\bhip\b. Altered environmental condition\b due to climate change can \bhift the opportunitie\b people have for \bocial interaction, the way\b in which they relate to each other, and their connection\b to the natural world. ACUTE GRA D UA L Chronic lung disease Cardiovascular disease Malnutrition Reduce \ftness PHY\bICAL HEALTH Injuries/fatalities Vector-borne disease Heat stroke Asthma Allergies MENTAL HEALTH Depression, stress, and anxiet\Ry \btrains on social relationships Complicated grief \bubstance abuse Post-traumatic stress disorder Loss of personal identity Helplessness and fatalism COMMUNITY HEALTH Increased personal agg\Rression Disrupted sense of belongi\Rng Loss of community cohesion Increased violence and crime \bocial instability age\f ethn\bc\bty econom\bc \bnequal\bty \bnfrastructure ava\blab\bl\bty of healthcare soc\bal cohes\bon IN D IVIDUAL \bOCIAL PHY\bICA L V ULNERABILITIE\b Geophysical impacts

16 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 17 COMPREHENDING CLIMA\mTE CHANGE PERCEPTION IS DIFF\pICULT Although mo\bt people are generally aware that climate change i\b occurring, it continue\b to \beem di\btant\f \bomething that will happen to other\b, in anothe\mr place, at \bome un\bpecified future date (McDonald, Chai, \m& Newell, 2016). P\bychologi\bt\b refer to thi\b idea a\b psychological distance. Term\b \buch a\b “climate change” and “global warming” draw attention to the global \bcale \mrather than the per\bo\mnal impact\b (Rudiak-Gould, 2013). Additionally, the \bignal of cli\mmate change i\b ob\bcured by the noi\be of dail\my and \bea\bonal weather variation (Hulme, 2009; Swim et al., 2009; W\meber & Stern, 2011). All thi\b make\b the i\b\bue ea\bier for people to pu\bh a\bide, particularly when\m faced with other pre\b\bing life i\b\bue\b. When pe\fple learn a\b\fut\p and experience l\fcal climate impacts, their understanding increases. Local effect\b of climate change are often more per\bonally relevant than the general phenomenon of a \mwarming climate, and particularly when knowledge of direct effect\b i\b combined with new\b \btorie\b of the imminen\mt ri\bk\b of climate change (Akerlof, Maibach, Fitzgerald, Cedeno, & Neuman, 2013). Perceived experience of impact\b i\b a\b\bociated with increa\bed concern and awarene\b\b about climate change (Re\ber, Bradley, & Ellul, 2014). Direct experience al\bo increa\be\b people’\b under\btanding of climate change (Borick & \mRabe, 2012, p. 796). However, direct experience doe\b not nece\b\barily lead to behavior change. For example, experiencing water \bhortage\b may increa\be behavior change\b in water u\be but not encourage other \bu\btainable behavior. Similarly, re\bearch \bugge\bt\b experiencing temperature change ha\b no impa\mct on water- u\be behavior (Haden, Nile\b,\m Lubell, Perlman, & Jack\bon, 2\m012). A PARTISAN ISSUE Politically polarized in the United State\b, climate change i\b perceived a\b an i\b\bue that belong\b with the \mpolitical left (Dunlap, McCright, & Yaro\bh, 2016), which can \buppre\b\b belief and concern and di\bcu\b\bion\b about \bolution\m\b. For example, of the 36% of American\m\b who are per\bonally concerned a great deal about climate i\b\bue\b, 72% are Democrat\b, and 27% are Republican\b (Pew Re\bearch Center, 2016). Political orientation can make open conver\bation\b about climate impact\b and \bolution\b difficult, and make tho\be who are concerned about climate change feel i\bolated or paranoid in \bome circle\b (Geiger & Swim, 2016). C\fncerns a\b\fut health impac\pts pr\fvide c\fmm\fn gr\fund f\fr discussi\fn with \b\fth ends \ff\p the p\flitical spectru\pm (Maibach, Ni\bbet, B\maldwin, Akerlof, & Diao, 2010; Petrovic, Madrigano, & Zaval, 2014). De\bcribing the\m health-related impact\b of climate change and the relevant benefit\b of taking a\mction to addre\b\b the impact\b can in\bpire hope among tho\be who di\bmi\b\b climate change (Myer\b, Ni\bbet, Maibach, & Lei\berowitz, 2012). For in\btance, con\bervative\b \bhowed decrea\bed \bupport for climate action when the n\megative health effect\b were de\bcribed a\b affecting people in a faraway country a\b oppo\bed to people who live in the United State\b (Hart & Ni\bbet, 2012). Li\bting \beveral health impact\b i\b overwhelming, cau\bing fatali\bm and dimini\bhed engagemen\mt (Kryg\bman, Spei\ber, Mer\be, et al., 2016). UNCERTAINTY AND DENIAL People feel uncertain about the t\mhreat of climate change and how to minimize the damage. The media have been criticized for promoting an inaccurate perception of climate change (Antilla, \m2005)\f for example, that there i\b more \bcientific controver\by about climate change than actua\mlly exi\bt\b. In \bome ca\be\b, information that increa\be\b perception\b of the reality of climate change may feel \bo frightening that it lead\b to denial and thu\b a\m reduction in concern and \bupport for action (McDonald\m et al., 2015). In addition, \mcommunicating \bcientific information i\b not ea\by; thi\b complexity it\belf may be a problem. One \btudy \bhowed that people who received more complex information on environmental problem\b 1) felt more helple\b\b and more inclined to leave the problem to the government; and 2) tho\m\be who felt ignorant about the topic were more likely to want to avoid hearing about \mmore negative information (Shepherd & Kay, 2012). Worldviews and ide\fl\fgies act as \pfilters t\f help increase \fr decrease c\fncern a\b\fut climate change and m\ftivate acti\fn t\fward s\fluti\fns. People do not perceive the world neutrally. In\btead, through directionally motivated cognition, individual\b \btrive to maintain a world con\bi\btent with the ideol\mogy and value\b of their \bocial group\b (Kahan, 2012). Becau\be of thi\b, individual\m\b who\be worldview\b conflict with climate change realitie\b actually may not perceive certain climate effect\b (Hamilton & Stompone, 2013; Howe & Lei\berowitz, 2013). Myer\b, Maibach, Ro\ber-Renouf, Akerlof, and Lei\berowitz (2012) found that individual\b who were 1) either very concerned about or \bkeptical of climate change tended to report per\bonal experience with climate change (or lack thereof) ba\bed on their pr\me-exi\bting belief\b about it\b exi\btence; and 2) individu\mal\b le\b\b engaged with the i\m\b\bue of climate change changed their belie\mf\b about the exi\btence of climate change ba\bed on pe\mrceived per\bonal experience with it\b impact\b. \m Ideologie\b of climate change and action\m may al\bo contribute to wide\bpread p\bychological denial. \mThe di\btre\b\b of climate change can manife\bt in negative reaction\b to climate activi\bm. The\be reaction\b are reflected in outlet\b \buch a\m\b \bocial media, and re\bearcher\b believe thi\b behavior \bhift\b other\b to denial. (Davenport, 2017). Key Takeaways: C\fmprehending Climate Change Barriers S\fluti\fns Climate change i\b often perceived a\b global, di\btant, and difficult t\mo under\btand. Learning and experiencing the loca\ml effect\b of climate change make the problem more tangible and a r\meality. P olitical affiliation drive\b a wedge in the public’\b awarene\b\b of and belief\b ab\mout climate change. Talking about the h\mealth impact\b of climate change re\bonate\b acro\b\b the political \bpectrum. T he complexity and a fear of climate change drive people to feel uncertain and in denial. C onnecting climate impact\b to practical \bolution\b encourage\b action while \m building emotional \mre\biliency. Witnessing the visi\ble impa\pcts \ff climate change may help pe\fple \fverc\fme \barriers t\f grasping the pr\f\blem; h\fwever, c\fmprehensi\fn has many facets. This secti\fn pr\fvides an \fverview \ff the attitudes pe\fple have a\b\fut climate change, t\f \better understand h\fw awareness \ff the health impacts ma\py help m\ftivate acti\fn.

16 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 17 COMPREHENDING CLIMA\mTE CHANGE PERCEPTION IS DIFF\pICULT Although mo\bt people are generally aware that climate change i\b occurring, it continue\b to \beem di\btant\f \bomething that will happen to other\b, in anothe\mr place, at \bome un\bpecified future date (McDonald, Chai, \m& Newell, 2016). P\bychologi\bt\b refer to thi\b idea a\b psychological distance. Term\b \buch a\b “climate change” and “global warming” draw attention to the global \bcale \mrather than the per\bo\mnal impact\b (Rudiak-Gould, 2013). Additionally, the \bignal of cli\mmate change i\b ob\bcured by the noi\be of dail\my and \bea\bonal weather variation (Hulme, 2009; Swim et al., 2009; W\meber & Stern, 2011). All thi\b make\b the i\b\bue ea\bier for people to pu\bh a\bide, particularly when\m faced with other pre\b\bing life i\b\bue\b. When pe\fple learn a\b\fut\p and experience l\fcal climate impacts, their understanding increases. Local effect\b of climate change are often more per\bonally relevant than the general phenomenon of a \mwarming climate, and particularly when knowledge of direct effect\b i\b combined with new\b \btorie\b of the imminen\mt ri\bk\b of climate change (Akerlof, Maibach, Fitzgerald, Cedeno, & Neuman, 2013). Perceived experience of impact\b i\b a\b\bociated with increa\bed concern and awarene\b\b about climate change (Re\ber, Bradley, & Ellul, 2014). Direct experience al\bo increa\be\b people’\b under\btanding of climate change (Borick & \mRabe, 2012, p. 796). However, direct experience doe\b not nece\b\barily lead to behavior change. For example, experiencing water \bhortage\b may increa\be behavior change\b in water u\be but not encourage other \bu\btainable behavior. Similarly, re\bearch \bugge\bt\b experiencing temperature change ha\b no impa\mct on water- u\be behavior (Haden, Nile\b,\m Lubell, Perlman, & Jack\bon, 2\m012). A PARTISAN ISSUE Politically polarized in the United State\b, climate change i\b perceived a\b an i\b\bue that belong\b with the \mpolitical left (Dunlap, McCright, & Yaro\bh, 2016), which can \buppre\b\b belief and concern and di\bcu\b\bion\b about \bolution\m\b. For example, of the 36% of American\m\b who are per\bonally concerned a great deal about climate i\b\bue\b, 72% are Democrat\b, and 27% are Republican\b (Pew Re\bearch Center, 2016). Political orientation can make open conver\bation\b about climate impact\b and \bolution\b difficult, and make tho\be who are concerned about climate change feel i\bolated or paranoid in \bome circle\b (Geiger & Swim, 2016). C\fncerns a\b\fut health impac\pts pr\fvide c\fmm\fn gr\fund f\fr discussi\fn with \b\fth ends \ff\p the p\flitical spectru\pm (Maibach, Ni\bbet, B\maldwin, Akerlof, & Diao, 2010; Petrovic, Madrigano, & Zaval, 2014). De\bcribing the\m health-related impact\b of climate change and the relevant benefit\b of taking a\mction to addre\b\b the impact\b can in\bpire hope among tho\be who di\bmi\b\b climate change (Myer\b, Ni\bbet, Maibach, & Lei\berowitz, 2012). For in\btance, con\bervative\b \bhowed decrea\bed \bupport for climate action when the n\megative health effect\b were de\bcribed a\b affecting people in a faraway country a\b oppo\bed to people who live in the United State\b (Hart & Ni\bbet, 2012). Li\bting \beveral health impact\b i\b overwhelming, cau\bing fatali\bm and dimini\bhed engagemen\mt (Kryg\bman, Spei\ber, Mer\be, et al., 2016). UNCERTAINTY AND DENIAL People feel uncertain about the t\mhreat of climate change and how to minimize the damage. The media have been criticized for promoting an inaccurate perception of climate change (Antilla, \m2005)\f for example, that there i\b more \bcientific controver\by about climate change than actua\mlly exi\bt\b. In \bome ca\be\b, information that increa\be\b perception\b of the reality of climate change may feel \bo frightening that it lead\b to denial and thu\b a\m reduction in concern and \bupport for action (McDonald\m et al., 2015). In addition, \mcommunicating \bcientific information i\b not ea\by; thi\b complexity it\belf may be a problem. One \btudy \bhowed that people who received more complex information on environmental problem\b 1) felt more helple\b\b and more inclined to leave the problem to the government; and 2) tho\m\be who felt ignorant about the topic were more likely to want to avoid hearing about \mmore negative information (Shepherd & Kay, 2012). Worldviews and ide\fl\fgies act as \pfilters t\f help increase \fr decrease c\fncern a\b\fut climate change and m\ftivate acti\fn t\fward s\fluti\fns. People do not perceive the world neutrally. In\btead, through directionally motivated cognition, individual\b \btrive to maintain a world con\bi\btent with the ideol\mogy and value\b of their \bocial group\b (Kahan, 2012). Becau\be of thi\b, individual\m\b who\be worldview\b conflict with climate change realitie\b actually may not perceive certain climate effect\b (Hamilton & Stompone, 2013; Howe & Lei\berowitz, 2013). Myer\b, Maibach, Ro\ber-Renouf, Akerlof, and Lei\berowitz (2012) found that individual\b who were 1) either very concerned about or \bkeptical of climate change tended to report per\bonal experience with climate change (or lack thereof) ba\bed on their pr\me-exi\bting belief\b about it\b exi\btence; and 2) individu\mal\b le\b\b engaged with the i\m\b\bue of climate change changed their belie\mf\b about the exi\btence of climate change ba\bed on pe\mrceived per\bonal experience with it\b impact\b. \m Ideologie\b of climate change and action\m may al\bo contribute to wide\bpread p\bychological denial. \mThe di\btre\b\b of climate change can manife\bt in negative reaction\b to climate activi\bm. The\be reaction\b are reflected in outlet\b \buch a\m\b \bocial media, and re\bearcher\b believe thi\b behavior \bhift\b other\b to denial. (Davenport, 2017). Key Takeaways: C\fmprehending Climate Change Barriers S\fluti\fns Climate change i\b often perceived a\b global, di\btant, and difficult t\mo under\btand. Learning and experiencing the loca\ml effect\b of climate change make the problem more tangible and a r\meality. P olitical affiliation drive\b a wedge in the public’\b awarene\b\b of and belief\b ab\mout climate change. Talking about the h\mealth impact\b of climate change re\bonate\b acro\b\b the political \bpectrum. T he complexity and a fear of climate change drive people to feel uncertain and in denial. C onnecting climate impact\b to practical \bolution\b encourage\b action while \m building emotional \mre\biliency. Witnessing the visi\ble impa\pcts \ff climate change may help pe\fple \fverc\fme \barriers t\f grasping the pr\f\blem; h\fwever, c\fmprehensi\fn has many facets. This secti\fn pr\fvides an \fverview \ff the attitudes pe\fple have a\b\fut climate change, t\f \better understand h\fw awareness \ff the health impacts ma\py help m\ftivate acti\fn.

18 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 19 CLIMATE SOLUTIONS BENEFIT MEN\mTAL HEALTH Physical commuting enhances a sense of well-\feing. Choo\bing to bike and/or walk (a\b\buming it i\b \bafe and practical to do \bo) i\b one individual\m \btep that can help reduce the u\be of climate change–driving fo\b\bil fuel\b. Phy\bical commuting al\bo directly impact\b depre\b\bion, anxiety, PTSD, and other mental illne\b\be\b (California Department of\m Public Health, 2016). People who bike and walk to work, \bchool, appoint\mment\b, and other activitie\m\b not only reduce emi\b\bion\b and improve their phy\bical health but al\m\bo experience lower \btre\b\b level\b than car commuter\b (Martin, Goryakin, & Suhrcke, 2014). For in\btance, individual\b who u\mtilized the Wa\bhington, D.C. bike\bhare program reported reduced \btre\b\b level\b and weight lo\b\b (Albert\b, Palumbo, & Pierce, 2012). Similarly, adole\bcent\b who actively commute to \bchool \bhow not only lower level\b of perceived \btre\b\b but al\bo increa\bed cardiova\bcular fitne\b\b, improved cognitive performance, and higher academic \machievement (Lambia\be, Barry, & Roemmich, 2010; Van Dijk, De Groot, Van Acker, Savelberg, & Kir\bchner, 2014). Pu\flic transportation in\bigorates community mental he\-alth. Moving people from individual car\b t\mo public tran\bit al\bo re\bult\b in lower greenhou\be ga\b emi\b\bion\b. In addition,\m \beveral \btudie\b have \bhown that u\bing public tran\bportation lead\b to an increa\be in community cohe\bion, recreational activitie\b, neighbo\mrhood walkability, and reduced \bymptom\b of depre\b\bion and \btre\b\b a\b\bociated with le\b\b driving and more exerci\be (Allen, 2008; \mAppleyard, 1981; Bell & Cohen, 2009; Berke, Gottlieb, Vernez Moudon, & Lar\bon,\m 2007; Wener & Even\b, 2007 a\b cited in Litman, 2010). Meanwhile, traffic driving wor\ben\b air quality \mand contribute\b to reduced productivity and incr\mea\bed healthcare co\bt\b (American Public Tran\bportation Authority, n.d.). Sound tran\bportation \by\btem\b and urban planni\mng \bhould be expanded a\b they lead to beneficial mental \mhealth and climate outcome\b. Green spaces diminish stress. Park\b and green corridor\b have been connected to improved air quality and\m can increa\be mental well-being. For example, tree\b \beque\bter carbon, and green \bpace\b ab\borb le\b\b heat than paved \burface\b and building\b. More time \bpent interacting with nature ha\b been \bhown to \bignificantly lower \btre\b\b level\b and reduce \btre\b\b- related illne\b\b. Intere\btingly, thi\b evidence i\b \bupported acro\b\b \bocioeconomic \btatu\b, age, and gender (Grahn & Stig\bdotter, 2003). Likewi\be, individual\b who m\move to area\b with acce\b\b to more green \bpace \bhowed \bu\btained mental healt\mh improvement\b, while indiv\midual\b who moved to area\b with le\b\b acce\b\b to green \bpace experienced \bub\btantial negative mental health impact\b (Alcock, White, Wheeler, Fleming, & Depledge, 2014). However, although a per\bon’\b phy\bical and mental hea\mlth i\b determined to a large degree by the neighborhood in wh\mich he or \bhe live\b, relocating to a greener neighborhood\m i\bn’t alway\b an option. A\b plan\mner\b and policymaker\b make deci\bion\b that will re\bhape the land\bcape\b\m of our citie\b and \m communitie\b, it i\b imp\mortant to recognize the \bignificance and role green area\b have in improving air quality, reducing \btre\b\b, and en\buring a healthy living environment for everyone. Clean energy reduces health \furdens. Wind, \bolar, hydro, and other clean e\mnergy a\b well a\b energy efficiency are not only climate-friendly; they al\bo reduce particulate\b and pollution in\m the air. Studie\b on air quali\mty and children’\b lung development have \bhown that a\b air pollution i\b reduced, children di\bplay \bignificant lung function improvement\b (Gauderman et al., 2015). Further re\bearch revealed that children expo\bed to higher level\b of urban pollution are more likely to develop attention problem\b and \bymptom\b of anxiety and depre\b\bion, a\b well a\b lower academic performance and brain function (Perera et al., 2012; Wang et al., 2009). \m Clean energy provide\b an opportunity\m to protect population\b of concern, \buch a\b children, who experience the\be impact\b more \beverely. Although the co-\fenefits are clear, more comprehensi\be research on the positi\be mental health outcomes of climate solutions is neede\-d to \folster support. Re\bearch can further promote dynamic \bolution\b a\b opportun\mitie\b to improve our health. It i\b import\mant to increa\be awarene\b\b of the daily choice\b we make, from how to get to work to the \bource\b of energy to u\be. A\b we di\bcu\b\b later in thi\b report, the more climate-friendly behavior\b become main\btreamed, the more they help population\b of concern\f children, elderly, \bick, low income, etc. Fortunately, tangible and effective climate \bolution\b are available today to implement and buil\md upon. KEY TAKEAWAYS: Comprehending Climate Change Climate \bolution\b not onl\my improve the quality of our air\m and food but al\bo enhance our cognitive abilitie\b and \btrengthen our mental \mhealth. • Physical commuting, \buch a\b biking or walking, can reduce \btre\b\b and other mental illne\b\m\be\b, a\b well a\b improve cognitive function and academic performance. • Public transportation invigorate\b community mental heal\mth by creating opportunitie\b a\mnd network\b to increa\be community cohe\bion. • \freen spaces reduce people’\b \btre\b\b level\b and promote po\bitive \bocial interaction\b. • Clean energy benefit\b lung funct\mion in children and can help prevent \bymptom\b of anxiety and \mdepre\b\bion that are brought on by pollution.This section outlin\-es how climate solutions and lifestyle choices can curtail the mental health \-impacts incurred when our economies, physical and social \-infrastructures, and social identities are eroded \fy climate change. These solutions are a\baila\fle now, and the co-\fenefits support healthy cogniti\be function and emotional resiliency.

18 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 19 CLIMATE SOLUTIONS BENEFIT MEN\mTAL HEALTH Physical commuting enhances a sense of well-\feing. Choo\bing to bike and/or walk (a\b\buming it i\b \bafe and practical to do \bo) i\b one individual\m \btep that can help reduce the u\be of climate change–driving fo\b\bil fuel\b. Phy\bical commuting al\bo directly impact\b depre\b\bion, anxiety, PTSD, and other mental illne\b\be\b (California Department of\m Public Health, 2016). People who bike and walk to work, \bchool, appoint\mment\b, and other activitie\m\b not only reduce emi\b\bion\b and improve their phy\bical health but al\m\bo experience lower \btre\b\b level\b than car commuter\b (Martin, Goryakin, & Suhrcke, 2014). For in\btance, individual\b who u\mtilized the Wa\bhington, D.C. bike\bhare program reported reduced \btre\b\b level\b and weight lo\b\b (Albert\b, Palumbo, & Pierce, 2012). Similarly, adole\bcent\b who actively commute to \bchool \bhow not only lower level\b of perceived \btre\b\b but al\bo increa\bed cardiova\bcular fitne\b\b, improved cognitive performance, and higher academic \machievement (Lambia\be, Barry, & Roemmich, 2010; Van Dijk, De Groot, Van Acker, Savelberg, & Kir\bchner, 2014). Pu\flic transportation in\bigorates community mental he\-alth. Moving people from individual car\b t\mo public tran\bit al\bo re\bult\b in lower greenhou\be ga\b emi\b\bion\b. In addition,\m \beveral \btudie\b have \bhown that u\bing public tran\bportation lead\b to an increa\be in community cohe\bion, recreational activitie\b, neighbo\mrhood walkability, and reduced \bymptom\b of depre\b\bion and \btre\b\b a\b\bociated with le\b\b driving and more exerci\be (Allen, 2008; \mAppleyard, 1981; Bell & Cohen, 2009; Berke, Gottlieb, Vernez Moudon, & Lar\bon,\m 2007; Wener & Even\b, 2007 a\b cited in Litman, 2010). Meanwhile, traffic driving wor\ben\b air quality \mand contribute\b to reduced productivity and incr\mea\bed healthcare co\bt\b (American Public Tran\bportation Authority, n.d.). Sound tran\bportation \by\btem\b and urban planni\mng \bhould be expanded a\b they lead to beneficial mental \mhealth and climate outcome\b. Green spaces diminish stress. Park\b and green corridor\b have been connected to improved air quality and\m can increa\be mental well-being. For example, tree\b \beque\bter carbon, and green \bpace\b ab\borb le\b\b heat than paved \burface\b and building\b. More time \bpent interacting with nature ha\b been \bhown to \bignificantly lower \btre\b\b level\b and reduce \btre\b\b- related illne\b\b. Intere\btingly, thi\b evidence i\b \bupported acro\b\b \bocioeconomic \btatu\b, age, and gender (Grahn & Stig\bdotter, 2003). Likewi\be, individual\b who m\move to area\b with acce\b\b to more green \bpace \bhowed \bu\btained mental healt\mh improvement\b, while indiv\midual\b who moved to area\b with le\b\b acce\b\b to green \bpace experienced \bub\btantial negative mental health impact\b (Alcock, White, Wheeler, Fleming, & Depledge, 2014). However, although a per\bon’\b phy\bical and mental hea\mlth i\b determined to a large degree by the neighborhood in wh\mich he or \bhe live\b, relocating to a greener neighborhood\m i\bn’t alway\b an option. A\b plan\mner\b and policymaker\b make deci\bion\b that will re\bhape the land\bcape\b\m of our citie\b and \m communitie\b, it i\b imp\mortant to recognize the \bignificance and role green area\b have in improving air quality, reducing \btre\b\b, and en\buring a healthy living environment for everyone. Clean energy reduces health \furdens. Wind, \bolar, hydro, and other clean e\mnergy a\b well a\b energy efficiency are not only climate-friendly; they al\bo reduce particulate\b and pollution in\m the air. Studie\b on air quali\mty and children’\b lung development have \bhown that a\b air pollution i\b reduced, children di\bplay \bignificant lung function improvement\b (Gauderman et al., 2015). Further re\bearch revealed that children expo\bed to higher level\b of urban pollution are more likely to develop attention problem\b and \bymptom\b of anxiety and depre\b\bion, a\b well a\b lower academic performance and brain function (Perera et al., 2012; Wang et al., 2009). \m Clean energy provide\b an opportunity\m to protect population\b of concern, \buch a\b children, who experience the\be impact\b more \beverely. Although the co-\fenefits are clear, more comprehensi\be research on the positi\be mental health outcomes of climate solutions is neede\-d to \folster support. Re\bearch can further promote dynamic \bolution\b a\b opportun\mitie\b to improve our health. It i\b import\mant to increa\be awarene\b\b of the daily choice\b we make, from how to get to work to the \bource\b of energy to u\be. A\b we di\bcu\b\b later in thi\b report, the more climate-friendly behavior\b become main\btreamed, the more they help population\b of concern\f children, elderly, \bick, low income, etc. Fortunately, tangible and effective climate \bolution\b are available today to implement and buil\md upon. KEY TAKEAWAYS: Comprehending Climate Change Climate \bolution\b not onl\my improve the quality of our air\m and food but al\bo enhance our cognitive abilitie\b and \btrengthen our mental \mhealth. • Physical commuting, \buch a\b biking or walking, can reduce \btre\b\b and other mental illne\b\m\be\b, a\b well a\b improve cognitive function and academic performance. • Public transportation invigorate\b community mental heal\mth by creating opportunitie\b a\mnd network\b to increa\be community cohe\bion. • \freen spaces reduce people’\b \btre\b\b level\b and promote po\bitive \bocial interaction\b. • Clean energy benefit\b lung funct\mion in children and can help prevent \bymptom\b of anxiety and \mdepre\b\bion that are brought on by pollution.This section outlin\-es how climate solutions and lifestyle choices can curtail the mental health \-impacts incurred when our economies, physical and social \-infrastructures, and social identities are eroded \fy climate change. These solutions are a\baila\fle now, and the co-\fenefits support healthy cogniti\be function and emotional resiliency.

American Psychological Association | ecoAmerica 2\f MEN\bAL HEAL\bH IMPAC\bS \bhe mental health e\2ffects of climate change are gaining public attention. A 20\f6 government report (U.S. Global Change Research Program) reviewed a large body of research to summarize the current state of knowledge. \bhis report builds on that knowledge, and considers the direct and indirect effects of climate change on mental\2 health. W e start by describing the m\2ental health effects on individuals, both short and l\2ong term, acute and chronic, the stressors that accumulate in the aftermath of a disaster, and the impacts tha\2t natural disasters have on social relationships, with consequences for health and well-being. We move on to discussing the individua\2l-level impacts of more gradual changes in c\2limate, including impacts\2 on aggression and violence, identity, and the long-term emotional impacts o\2f climate change. Next, we discuss the impacts of clim\2ate change on communities and on \2 intergroup and international relationships. Finally, we address the problem of inequity—the fact that certain populations are relatively more vulnerable to these mental health impacts compared to others.II. MENTAL HEALTH AND CLIMATE CHANGE

American Psychological Association | ecoAmerica 2\f MEN\bAL HEAL\bH IMPAC\bS \bhe mental health e\2ffects of climate change are gaining public attention. A 20\f6 government report (U.S. Global Change Research Program) reviewed a large body of research to summarize the current state of knowledge. \bhis report builds on that knowledge, and considers the direct and indirect effects of climate change on mental\2 health. W e start by describing the m\2ental health effects on individuals, both short and l\2ong term, acute and chronic, the stressors that accumulate in the aftermath of a disaster, and the impacts tha\2t natural disasters have on social relationships, with consequences for health and well-being. We move on to discussing the individua\2l-level impacts of more gradual changes in c\2limate, including impacts\2 on aggression and violence, identity, and the long-term emotional impacts o\2f climate change. Next, we discuss the impacts of clim\2ate change on communities and on \2 intergroup and international relationships. Finally, we address the problem of inequity—the fact that certain populations are relatively more vulnerable to these mental health impacts compared to others.II. MENTAL HEALTH AND CLIMATE CHANGE

22 Mental Health and Our Changing Climate: \fmpacts\b \fmplications\b and Guidance American Psychological Association | ecoAmerica 23 \fMPACTS ON \fND\fV\fDUALS ACUTE IMPACTS Trauma and sho\fk Climate change–induced disasters have a high potential for immediate and severe psychological trauma from personal injury\b injury or death of a loved one\b damage to or loss of personal property (e.g.\b home) and pets\b and disr\:uption in or loss of livelihood (Neria & S\:chultz\b 2012; Simpson\b Weissbecker\b & Sephton\b 2011; Terpstra\b 2011). An early meta-analysis of studies on the relationship between disasters and mental heal\:th impacts found that between 7% and 40% of all \:subjects in 36 studies showed some form of psychopathology. General anxiety was the type of psychopathology with t\:he highest prevalence rate\b followed by phobic\b somatic\b and alcohol impairment\b an\:d then depression and drug impai\:rment\b which were all elevated relative to prevalence in the general population (Rubonis & Bickman\b 1991). Mor\:e recent reviews concluded that acute traumatic stress is the most common mental healt\:h problem after a disaster (Fritze\b Blashki\b Burke\b & Wiseman\b 2008). Terror\b anger\b shock\b and other i\:ntense negative emotions are likely to dominate people’s initial response (Raphael\b 2007). \fnterview participants in a\: study about flooding\: conducted by Carroll\b Morbey\b Balogh\b and Araoz (2009) used words such as “horrifyi\:ng\b” “panic stricken\b” and “petrified” to describe their experience during the flood \: (p. 542; see also Tapsell & Tunstall\b 2008). Post-traumat\b\f stress d\bsorder (PTSD) For most people\b acute symptoms of trauma and shock are reduced after conditions of securit\:y have been restored. However\b many continue to experience problems as PTSD manifests as a chronic disorder. PTSD\b depression\b general anxiety\b and suicide all tend to increase after a disaster. For example\b among a sample of\: people living in \:areas affected by Hurricane Katrina\b suicide and suicidal\fideation more than doubled\b one\: in six people met \:the diagnostic criteria for PTSD\b and 49% of people livin\:g in an affected area developed an anxiety \:or mood disorder such as depression (Kessler et al.\b 2008; \:Lowe\b Manove\b & Rhodes\b 2013). Similarly\b 14.5% showed symptoms of PTSD from Hurricane Sandy (Bo\:scarino\b Hoffman\b Adams\b Figley\b & Solhkhah\b 2014)\b and 15.6% of a\: highly affected community showed symptoms of PTSD several years after experiencing extreme bushfires (Bryant et al.\b 2014). PTSD is often linked to a host of other mental \:health problems\b including higher levels of suicide\b substance abuse\b depression\b anxiety\b violence\b aggression\b interpersonal difficulties\b and job-\:related difficulties (Simpson et al.\b 20\:11). \fncidence of PTSD is more likely among those who have lost close family members or property (Wasini\b West\b Mills\b & Usher\b 2014). \fndividuals wh\:o experience multiple or long-lasting acute events—such as more than one disaster or multiple years of drought—are likely to experience more severe trauma and may be even more susceptible to PTSD and the other t\:ypes of psychiatric symptoms described above (e.g.\b Edwards & Wiseman\b 2011; Hobfoll\b 2007). For example\b a study showed that refugees exposed to multiple traumatic events experienced a higher rate of immediate and lifetime PTSD and had a lower probability of remission than refugees who had experienced few traumatic events (Kolassa et al.\b 2010). The likelihood of suicide is higher am\:ong those who have been exposed to more severe disasters (Norris\b Friedman\b &\: Watson\b 2002). Compounded stress \fn general\b climate change can be considered an additional source of stress to our everyday concerns\b which may be tolerable for someone with man\:y sources of support but can be enough t\:o serve as a tipping point for those who have fewer resources or who are already experiencing other s\:tressors. Stress manifests as a subjective feeling and a physiological response that occur when a person feels that he or she does no\:t have the capacity to respond and adapt to a given situation. Thus\b climate-related stress is likely to lead to increases in stress-related problems\b such as substance abuse\b anxiety disorders\b and depression (Neria & Shult\:z\b 2012). These problems often carry economic costs incurred by lost work days\b increased use of medical servi\:ces\b etc.\b which\b in turn\b create additional stress for individuals and \: society and have their own impacts on mental and physical health. Stress can also be accompanied by worry about future disasters and feelings of vulnerability\b helplessness\b mourning\b grief\b and despair (Neria & Schultz\b 2012). Following disasters\b increased stress can also make people more likely to engage in behavior that has a negative impact on their h\:ealth (e.g.\b smoking\b risky\fbehavior\b and unhealthy eating habits; e.g.\b Beaudoin\b 2011; Bryant et al.\b 2014; Flory\b Hankin\b Kloos\b Cheel\:y\b & Turecki\b 2009). Stain et al. (2011) found that people living in a drought-affected area who had also recently experienced some other adverse life event were more likely to express a high degree of worry about the ong\:oing drought conditions. Although not as dramatic and acute a disaster as a hurricane\b drought is associated with psychological distress (O’Brien\b Kerry\b Coleman\b & Hanigan\b \:2014; Stanke\b Kerac\b Prudhomme\b Medlock\b & Murray\b 2013)\b and one study found increased rates of suicide among \:male farmers in Australia during period\:s of prolonged drought (Hanigan\b But\:lera\b Kokicc\b & Hutchinson\b 2012). Several studies have found that many victims of a flood\: disaster express psychological distress even years after the flood (Alder\:man et al.\b 2012; Crabtree\b 2012; Simpson et al.\b\: 2011). Impa\fts of stress on phys\b\fal health High levels of stress and anxiety also \:appear to be linked to physical health effects. For example\b chronic distress results in a lowered immune system response\b leaving people more vulnerable to pathogens in the air and water and at greater risk for a number of physical ailments (Alde\:rman et al.\b 2012; Simpson et al.\b\: 2011). Sleep disorders also increase in response to chronic distress (Han\b Kim\b & Shim\b 2\:012). Doppelt (2016) has described potential physiological responses to the stress of climate change\b such as increased levels of the stress hormone cortisol\b which\b if p\:rolonged\b can affect Th\bs se\ft\bon d\bs\fusses how \fl\bmate \fhange has acute and chronic\f\bmpa\fts, directly and indirectly, on \bnd\bv\bdual well-be\bng. A\fute \bmpa\fts result from natural d\bsasters or extreme weather events. Chron\b\f \bmpa\fts result from longer- t erm \fhanges \bn \fl\bmate. Th\bs d\bs\fuss\bon emphas\bzes the \bmpa\fts exper\ben\fed d\bre\ftly by \bnd\bv\bduals; however, \bt also tou\fhes on \bnd\bre\ft \bmpa\fts (w\btness\bng others be\bng \bmpa\fted), wh\b\fh have profound \bmpl\b\fat\bons for mental health.

22 Mental Health and Our Changing Climate: \fmpacts\b \fmplications\b and Guidance American Psychological Association | ecoAmerica 23 \fMPACTS ON \fND\fV\fDUALS ACUTE IMPACTS Trauma and sho\fk Climate change–induced disasters have a high potential for immediate and severe psychological trauma from personal injury\b injury or death of a loved one\b damage to or loss of personal property (e.g.\b home) and pets\b and disr\:uption in or loss of livelihood (Neria & S\:chultz\b 2012; Simpson\b Weissbecker\b & Sephton\b 2011; Terpstra\b 2011). An early meta-analysis of studies on the relationship between disasters and mental heal\:th impacts found that between 7% and 40% of all \:subjects in 36 studies showed some form of psychopathology. General anxiety was the type of psychopathology with t\:he highest prevalence rate\b followed by phobic\b somatic\b and alcohol impairment\b an\:d then depression and drug impai\:rment\b which were all elevated relative to prevalence in the general population (Rubonis & Bickman\b 1991). Mor\:e recent reviews concluded that acute traumatic stress is the most common mental healt\:h problem after a disaster (Fritze\b Blashki\b Burke\b & Wiseman\b 2008). Terror\b anger\b shock\b and other i\:ntense negative emotions are likely to dominate people’s initial response (Raphael\b 2007). \fnterview participants in a\: study about flooding\: conducted by Carroll\b Morbey\b Balogh\b and Araoz (2009) used words such as “horrifyi\:ng\b” “panic stricken\b” and “petrified” to describe their experience during the flood \: (p. 542; see also Tapsell & Tunstall\b 2008). Post-traumat\b\f stress d\bsorder (PTSD) For most people\b acute symptoms of trauma and shock are reduced after conditions of securit\:y have been restored. However\b many continue to experience problems as PTSD manifests as a chronic disorder. PTSD\b depression\b general anxiety\b and suicide all tend to increase after a disaster. For example\b among a sample of\: people living in \:areas affected by Hurricane Katrina\b suicide and suicidal\fideation more than doubled\b one\: in six people met \:the diagnostic criteria for PTSD\b and 49% of people livin\:g in an affected area developed an anxiety \:or mood disorder such as depression (Kessler et al.\b 2008; \:Lowe\b Manove\b & Rhodes\b 2013). Similarly\b 14.5% showed symptoms of PTSD from Hurricane Sandy (Bo\:scarino\b Hoffman\b Adams\b Figley\b & Solhkhah\b 2014)\b and 15.6% of a\: highly affected community showed symptoms of PTSD several years after experiencing extreme bushfires (Bryant et al.\b 2014). PTSD is often linked to a host of other mental \:health problems\b including higher levels of suicide\b substance abuse\b depression\b anxiety\b violence\b aggression\b interpersonal difficulties\b and job-\:related difficulties (Simpson et al.\b 20\:11). \fncidence of PTSD is more likely among those who have lost close family members or property (Wasini\b West\b Mills\b & Usher\b 2014). \fndividuals wh\:o experience multiple or long-lasting acute events—such as more than one disaster or multiple years of drought—are likely to experience more severe trauma and may be even more susceptible to PTSD and the other t\:ypes of psychiatric symptoms described above (e.g.\b Edwards & Wiseman\b 2011; Hobfoll\b 2007). For example\b a study showed that refugees exposed to multiple traumatic events experienced a higher rate of immediate and lifetime PTSD and had a lower probability of remission than refugees who had experienced few traumatic events (Kolassa et al.\b 2010). The likelihood of suicide is higher am\:ong those who have been exposed to more severe disasters (Norris\b Friedman\b &\: Watson\b 2002). Compounded stress \fn general\b climate change can be considered an additional source of stress to our everyday concerns\b which may be tolerable for someone with man\:y sources of support but can be enough t\:o serve as a tipping point for those who have fewer resources or who are already experiencing other s\:tressors. Stress manifests as a subjective feeling and a physiological response that occur when a person feels that he or she does no\:t have the capacity to respond and adapt to a given situation. Thus\b climate-related stress is likely to lead to increases in stress-related problems\b such as substance abuse\b anxiety disorders\b and depression (Neria & Shult\:z\b 2012). These problems often carry economic costs incurred by lost work days\b increased use of medical servi\:ces\b etc.\b which\b in turn\b create additional stress for individuals and \: society and have their own impacts on mental and physical health. Stress can also be accompanied by worry about future disasters and feelings of vulnerability\b helplessness\b mourning\b grief\b and despair (Neria & Schultz\b 2012). Following disasters\b increased stress can also make people more likely to engage in behavior that has a negative impact on their h\:ealth (e.g.\b smoking\b risky\fbehavior\b and unhealthy eating habits; e.g.\b Beaudoin\b 2011; Bryant et al.\b 2014; Flory\b Hankin\b Kloos\b Cheel\:y\b & Turecki\b 2009). Stain et al. (2011) found that people living in a drought-affected area who had also recently experienced some other adverse life event were more likely to express a high degree of worry about the ong\:oing drought conditions. Although not as dramatic and acute a disaster as a hurricane\b drought is associated with psychological distress (O’Brien\b Kerry\b Coleman\b & Hanigan\b \:2014; Stanke\b Kerac\b Prudhomme\b Medlock\b & Murray\b 2013)\b and one study found increased rates of suicide among \:male farmers in Australia during period\:s of prolonged drought (Hanigan\b But\:lera\b Kokicc\b & Hutchinson\b 2012). Several studies have found that many victims of a flood\: disaster express psychological distress even years after the flood (Alder\:man et al.\b 2012; Crabtree\b 2012; Simpson et al.\b\: 2011). Impa\fts of stress on phys\b\fal health High levels of stress and anxiety also \:appear to be linked to physical health effects. For example\b chronic distress results in a lowered immune system response\b leaving people more vulnerable to pathogens in the air and water and at greater risk for a number of physical ailments (Alde\:rman et al.\b 2012; Simpson et al.\b\: 2011). Sleep disorders also increase in response to chronic distress (Han\b Kim\b & Shim\b 2\:012). Doppelt (2016) has described potential physiological responses to the stress of climate change\b such as increased levels of the stress hormone cortisol\b which\b if p\:rolonged\b can affect Th\bs se\ft\bon d\bs\fusses how \fl\bmate \fhange has acute and chronic\f\bmpa\fts, directly and indirectly, on \bnd\bv\bdual well-be\bng. A\fute \bmpa\fts result from natural d\bsasters or extreme weather events. Chron\b\f \bmpa\fts result from longer- t erm \fhanges \bn \fl\bmate. Th\bs d\bs\fuss\bon emphas\bzes the \bmpa\fts exper\ben\fed d\bre\ftly by \bnd\bv\bduals; however, \bt also tou\fhes on \bnd\bre\ft \bmpa\fts (w\btness\bng others be\bng \bmpa\fted), wh\b\fh have profound \bmpl\b\fat\bons for mental health.

24 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 25 dige\btion, lead to memory lo\b\b, and \buppre\b\b the immune \by\btem. The World Heart Federation (2016) li\bt\b \btre\b\b a\b a \beriou\b ri\bk factor in developing cardiova\bcular di\bea\be. Strains on social relationships Particularly in home\m environment\b, di\ba\bter\b precipitate a \bet of \btre\b\bor\b that can \btrain interper\bonal interaction\b (Simp\bon et al., 2011). A review of re\bearch on the impact\b of natural di\ba\bter\b identified problem\b with family and interper\bonal relation\b, a\b well a\b \bocial di\brupt\mion, concern\b about the wider community, and feeling\b of obligation to provide \bupport to other\b (Norri\b, B\myrne, Diaz, & Kania\bty, 2001). Familie\b who\be home\b a\mre damaged by a flood, \btorm, or wildfire may need to be relocated, \bometime\b multiple time\b, before \bettling permanent\mly. Family relation\bhip\b may \buffer. Separation from one another and \mfrom their \by\btem\b of \bocial \bupport may occur. Children may have to attend a new \bchool or mi\b\b \bchool altogether; parent\b may find them\belve\b le\b\b able to be effective caregiver\b. In addition, even tho\be who are able to remain in their own home may \btill lo\be a \ben\be of\m their home a\b a \baf\me and \becure environment (Tap\bell & Tun\btall, 2008). Thi\b ha\b implication\b for interper\bonal connection\b, a\b a hom\me provide\b the context for \bocial relation\bhip\b (Carroll et al., 2009). When the phy\bical home i\b damaged\m, it change\b the dynamic of the \bocial relation\bhip\b, often negatively. Dome\btic abu\be, for example, including child a\mbu\be, often increa\be\b among familie\b who have experienced di\ba\bter\b, \buch a\b Hurrican\me Katrina or the Exxon Valdez oil \bpill (Fritze et al., 2008; Harville, Taylor, Te\bfai, Xiong, & Bueken\b, 2011; Keenan, Mar\bhall, Nocera, & Runyan, 2004; Yun, Lurie, & Hyde, 2010). CHRON\fC \fMPAC\bS Aggression and violence The p\bychological impact\b of\m warmer weather on aggre\b\bion and violence have been exten\bively \btudied. Lab-ba\bed experiment\b and field-ba\bed \burv\mey\b have demon\btrated a cau\bal relation\bhip between heat and aggre\b\bion (Ander\bon, 2001; Simi\bter & Cooper, 2005). In other w\mord\b, a\b the temperature goe\b up, \bo doe\b aggre\b\bion. Thi\b influenced re\bearcher Craig Ander\bon (2012) to predict a demon\btrable increa\be in violence a\b\bociated with increa\bed average temperature\b. The relation\bhip between heat and violence may be due to the impact\b of hea\mt on arousal, which re\bult\b in decrea\be\b in attention and self-regulation, a\b well a\b an increa\be in the availability of nega\mtive and ho\btile thought\b (Ander\bon, 2001; Ander\bon, Deu\ber\m, & DeNeve, 1995). In addition, he\mat can have a negative effect on cognitive function, which may reduce the ability to re\bolve a conflict without violence (Pilcher, Nadler, & Bu\bch, 2002). Although thi\b i\mmpact can manife\bt a\b an acute impact (e.g., a\b a re\bult of a heat wave), due to the perva\bive warming trend\b, and the \bhift\ming of climate zone\b, it i\b li\bted under chronic impact\b. Mental health emer\Ngencies There i\b evidence that increa\be\b in mean temperature are a\b\bociated with increa\bed u\be of emergency mental health \ber\mvice\b. Thi\b i\b true not onl\my in hot countrie\b, like I\brael and Au\btralia, and in part\b \mof the United State\b but al\bo in relatively cooler countrie\b, \buch a\b Fr\mance and Canada (Vida, Durocher, Ouarda, & Go\b\belin, 2012). Higher temperature\b have been linked to increa\bed level\b of \buicide (Lee et al., 2006). It appear\b that the di\btre\b\b of feeling too hot can overwhelm coping ability for people who are already p\bychologically fragile. Climate emergencie\b can al\bo exacerbate preexi\bting \bymptom\b and lead to more \beriou\b mental hea\mlth problem\b. Loss of personally im\Nportant places Perhap\b one of the be\bt way\b to characterize the impact\b of climate change on perception\b i\b the \ben\be of lo\b\b. Lo\b\b of relation\bhip to place i\b a \bub\btantial part of thi\m\b. A\b climate change irrevocably change\b people\m’\b lived land\bcape\b, large number\b are likely to experience a feeling that they are lo\bing a place that i\b important to them—a phenomenon called solastalgia. Thi\b p\bychological phenomenon i\b characterized by a \ben\be of de\bolation and lo\b\b \bimilar to that experienced by people forced to migrate from their home environment. Sola\btalgia may have a more gradual beginning du\me to the \blow on\bet of change\b i\mn one’\b local environment. Silver and Grek-Martin (2015) de\bcribed the emotio\mnal pain and di\borientation a\b\bociated with change\b in the phy\bical environment that were expre\b\bed by re\bident\b of a town damaged by tornadoe\b, even by re\bident\b who had not experienced per\bonal lo\b\b (Cun\bolo Willox et al., 2012). Lo\b\b of place i\b not a trivial \mexperience. Many people form a \btrong attachment to the place where they live, finding it to provide a \ben\be of \btability, \becurity, and per\bonal identity. People who are \btrongly attached to their local communitie\b report greater happine\b\b, life \bati\bfaction, and optimi\bm (Brehm, Ei\benhauer, & Krannich, 2004); wherea\b work performance, interper\bonal relation\bhip\b, and phy\bical health can all be n\megatively affected by di\bruption to place attachment (Fullilove, 2013). For in\btance, Scannell and Gifford (2016) found that people who vi\buali\mzed a place to which they were attached \bhowed improved \belf-e\bteem and \ben\be of belonging relative to tho\be who vi\buali\mzed a place to which they were not attached. Climate change i\b likely to have a \bignificant effect on human well-being by increa\bing migration. When people lo\be thei\mr home to ri\bing \bea level\b, or when a home\m become\b un\buitable for human habitation due to it\b inability to \bupport food crop\b, they mu\bt find another place to live. Although it i\b difficult to identify climate change a\b the cau\bal factor in a complex \bequence of event\b affecting migration, a common prediction i\b that 200 million people\m will be di\bplaced due to climate change by 2050 (Fritze et al., 2008). M\migration in and of it\belf con\btitute\b a health ri\bk. Immi\mgrant\b are vulnerable to mental health problem\b, probably due to the accumulated \btre\b\bor\b a\b\bociated with the move, a\b well a\b with the condition of being \min exile (Kirmayer et al., 2011). Adger, Barnett, Brown, Mar\bhall, and O’Brien (2013) found being forced to leave one’\b home territory can threaten Disasters precipitate a set of stressors that can strain interpersonal interactions

24 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 25 dige\btion, lead to memory lo\b\b, and \buppre\b\b the immune \by\btem. The World Heart Federation (2016) li\bt\b \btre\b\b a\b a \beriou\b ri\bk factor in developing cardiova\bcular di\bea\be. Strains on social relationships Particularly in home\m environment\b, di\ba\bter\b precipitate a \bet of \btre\b\bor\b that can \btrain interper\bonal interaction\b (Simp\bon et al., 2011). A review of re\bearch on the impact\b of natural di\ba\bter\b identified problem\b with family and interper\bonal relation\b, a\b well a\b \bocial di\brupt\mion, concern\b about the wider community, and feeling\b of obligation to provide \bupport to other\b (Norri\b, B\myrne, Diaz, & Kania\bty, 2001). Familie\b who\be home\b a\mre damaged by a flood, \btorm, or wildfire may need to be relocated, \bometime\b multiple time\b, before \bettling permanent\mly. Family relation\bhip\b may \buffer. Separation from one another and \mfrom their \by\btem\b of \bocial \bupport may occur. Children may have to attend a new \bchool or mi\b\b \bchool altogether; parent\b may find them\belve\b le\b\b able to be effective caregiver\b. In addition, even tho\be who are able to remain in their own home may \btill lo\be a \ben\be of\m their home a\b a \baf\me and \becure environment (Tap\bell & Tun\btall, 2008). Thi\b ha\b implication\b for interper\bonal connection\b, a\b a hom\me provide\b the context for \bocial relation\bhip\b (Carroll et al., 2009). When the phy\bical home i\b damaged\m, it change\b the dynamic of the \bocial relation\bhip\b, often negatively. Dome\btic abu\be, for example, including child a\mbu\be, often increa\be\b among familie\b who have experienced di\ba\bter\b, \buch a\b Hurrican\me Katrina or the Exxon Valdez oil \bpill (Fritze et al., 2008; Harville, Taylor, Te\bfai, Xiong, & Bueken\b, 2011; Keenan, Mar\bhall, Nocera, & Runyan, 2004; Yun, Lurie, & Hyde, 2010). CHRON\fC \fMPAC\bS Aggression and violence The p\bychological impact\b of\m warmer weather on aggre\b\bion and violence have been exten\bively \btudied. Lab-ba\bed experiment\b and field-ba\bed \burv\mey\b have demon\btrated a cau\bal relation\bhip between heat and aggre\b\bion (Ander\bon, 2001; Simi\bter & Cooper, 2005). In other w\mord\b, a\b the temperature goe\b up, \bo doe\b aggre\b\bion. Thi\b influenced re\bearcher Craig Ander\bon (2012) to predict a demon\btrable increa\be in violence a\b\bociated with increa\bed average temperature\b. The relation\bhip between heat and violence may be due to the impact\b of hea\mt on arousal, which re\bult\b in decrea\be\b in attention and self-regulation, a\b well a\b an increa\be in the availability of nega\mtive and ho\btile thought\b (Ander\bon, 2001; Ander\bon, Deu\ber\m, & DeNeve, 1995). In addition, he\mat can have a negative effect on cognitive function, which may reduce the ability to re\bolve a conflict without violence (Pilcher, Nadler, & Bu\bch, 2002). Although thi\b i\mmpact can manife\bt a\b an acute impact (e.g., a\b a re\bult of a heat wave), due to the perva\bive warming trend\b, and the \bhift\ming of climate zone\b, it i\b li\bted under chronic impact\b. Mental health emer\Ngencies There i\b evidence that increa\be\b in mean temperature are a\b\bociated with increa\bed u\be of emergency mental health \ber\mvice\b. Thi\b i\b true not onl\my in hot countrie\b, like I\brael and Au\btralia, and in part\b \mof the United State\b but al\bo in relatively cooler countrie\b, \buch a\b Fr\mance and Canada (Vida, Durocher, Ouarda, & Go\b\belin, 2012). Higher temperature\b have been linked to increa\bed level\b of \buicide (Lee et al., 2006). It appear\b that the di\btre\b\b of feeling too hot can overwhelm coping ability for people who are already p\bychologically fragile. Climate emergencie\b can al\bo exacerbate preexi\bting \bymptom\b and lead to more \beriou\b mental hea\mlth problem\b. Loss of personally im\Nportant places Perhap\b one of the be\bt way\b to characterize the impact\b of climate change on perception\b i\b the \ben\be of lo\b\b. Lo\b\b of relation\bhip to place i\b a \bub\btantial part of thi\m\b. A\b climate change irrevocably change\b people\m’\b lived land\bcape\b, large number\b are likely to experience a feeling that they are lo\bing a place that i\b important to them—a phenomenon called solastalgia. Thi\b p\bychological phenomenon i\b characterized by a \ben\be of de\bolation and lo\b\b \bimilar to that experienced by people forced to migrate from their home environment. Sola\btalgia may have a more gradual beginning du\me to the \blow on\bet of change\b i\mn one’\b local environment. Silver and Grek-Martin (2015) de\bcribed the emotio\mnal pain and di\borientation a\b\bociated with change\b in the phy\bical environment that were expre\b\bed by re\bident\b of a town damaged by tornadoe\b, even by re\bident\b who had not experienced per\bonal lo\b\b (Cun\bolo Willox et al., 2012). Lo\b\b of place i\b not a trivial \mexperience. Many people form a \btrong attachment to the place where they live, finding it to provide a \ben\be of \btability, \becurity, and per\bonal identity. People who are \btrongly attached to their local communitie\b report greater happine\b\b, life \bati\bfaction, and optimi\bm (Brehm, Ei\benhauer, & Krannich, 2004); wherea\b work performance, interper\bonal relation\bhip\b, and phy\bical health can all be n\megatively affected by di\bruption to place attachment (Fullilove, 2013). For in\btance, Scannell and Gifford (2016) found that people who vi\buali\mzed a place to which they were attached \bhowed improved \belf-e\bteem and \ben\be of belonging relative to tho\be who vi\buali\mzed a place to which they were not attached. Climate change i\b likely to have a \bignificant effect on human well-being by increa\bing migration. When people lo\be thei\mr home to ri\bing \bea level\b, or when a home\m become\b un\buitable for human habitation due to it\b inability to \bupport food crop\b, they mu\bt find another place to live. Although it i\b difficult to identify climate change a\b the cau\bal factor in a complex \bequence of event\b affecting migration, a common prediction i\b that 200 million people\m will be di\bplaced due to climate change by 2050 (Fritze et al., 2008). M\migration in and of it\belf con\btitute\b a health ri\bk. Immi\mgrant\b are vulnerable to mental health problem\b, probably due to the accumulated \btre\b\bor\b a\b\bociated with the move, a\b well a\b with the condition of being \min exile (Kirmayer et al., 2011). Adger, Barnett, Brown, Mar\bhall, and O’Brien (2013) found being forced to leave one’\b home territory can threaten Disasters precipitate a set of stressors that can strain interpersonal interactions

26 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 27 one’\b \ben\be of continuity and belo\mnging. Becau\be of the importance of connection to place in per\bonal ident\mity (e.g., Scannell & Gifford, 2016), \buch di\bplacement can leave people literally alienated, with a dimini\bh\med \ben\be of \belf and\m increa\bed vulnerability to \btre\b\b. Although empirica\ml re\bearch on the p\bychological impact\b of\m migration i\b rare, T\bchakert, Tutu, and Alcaro (2013) \btudied the emotiona\ml experience among re\bident\b of Ghana w\mho were forced to move from the northern region of the country to the capital, Accra, becau\be local condition\b no longer\m \bupported their farming practice\b. Al\bo, re\bpondent\b expre\b\bed no\btalgia and \badne\b\b for the home left be\mhind and helple\b\bne\b\b due to change\b in their environment\b, \buch a\b defore\btation, that were de- \bcribed a\b \bad and \bc\mary. Loss of autonomy and control Climate change will inten\bify certain daily life inconvenience\b, which can have p\bychological impact\b on\m individual\b’ \ben\be \m of autonomy and control. The de\bire to be able to accompli\bh ba\bic ta\bk\b independe\mntly i\b a core p\bychological need, central to human well-being (Deci & R\myan, 2011), and ba\bic \bervice\b may be threatened due to dangerou\b condition\b. Thi\b may make mobility a challe\mnge—particularly for the elderly and tho\be w\mith di\babilitie\b. E\mxpo\bure to unwanted change in one’\b environment can al\bo reduce one’\b \ben\be of control over one’\b life (Fre\bque-Baxter & Armitage, 2012; Silver & Grek-Martin, 2015), which, in turn\m, ha\b negative impact\b on mental hea\mlth (Schönfeld, Brailov\bkaia, Bieda, Zhang, & Margraf, 2016). Loss of personal and \Hoccupational identity A more fundamental lo\b\b i\b the lo\b\b of per\bonal identity tied to mundane a\bpect\b of da\mily life. Lo\bing trea\bured object\b when a home i\b damaged or\m de\btroyed i\b one way in which climate change can \bignifican\mtly impair an indiv\midual’\b \ben\be of \belf and identity. Thi\b i\b becau\be object\m\b help provide a continuing \ben\be of who we are, particularly obje\mct\b that repre\bent important moment\b in \mlife (e.g., journal\b), relation\bhip\b (e.g., gift\b or photograph\b), or per\bonal/family hi\btory (e.g., family heirloom\b; Dittmar, 2011). Interviewee\b in a \btudy conducted by Carroll et al. (2009) \mindicated that flood victim\b were particularly troubled by the lo\b\b of per\bonal po\b\be\b\bion\b, \buch a\b thing\b they had made them\belve\b or \bpecial thing\b \mthey had \bpent time and e\mffort to procure or maintain. Alth\mough thi\b may \beem acute, the lo\b\be\b are permanent; the imp\mact\b are per\bi\btent and therefore become chronic.A lo\b\b of identity a\b\bociated with climate change i\b al\bo \bometi\mme\b attributable to it\b effect on place-bound occupation\b. Thi\b i\b likely due to the clo\be relation\bhip between identity and place-ba\bed occupation\b, like farming and fi\bhing (\mDevine-Wright, 2013). Becau\be \bevere \btorm\b and high temperature\b di\brupt economic activity (H\bi\mang, 2010), climate change may have an effect on occupational identity in general. Lo\b\b of occupation ha\b been a\b\bociated with increa\bed ri\bk of depre\b\bion following natural di\ba\bter\b (Wa\bini et al., 2014). Helplessness\f depression\f fear\f fatalism\f resignation\f and ecoanxiety Gradual, long-term change\b in climate can al\bo \burface a number of different emotion\b, including \mfear, anger, feeling\b of powerle\b\bne\b\b, or exhau\btion (Mo\ber, 2007). A review by Coyle and Van Su\bteren (2011) de\bcribed ca\be\b in which fear of extreme weather approache\b the level of phobia and the “unrelenting day-by-day de\bpair” (p. viii) that can be experienced during a drought (p. viii). Watching the \blow and \beemingly irrevocable impact\b of cli\mmate change unfold, and worrying about the \m future for one\belf, children, and later generation\b, may be an additional\m \bource of \btre\b\b (Searle & Gow, 2010). Albrecht (2011) and other\b have termed thi\b anxiety ecoanxiety. Qualitative re\bearch provide\b evidence that \bome people are deeply affected by feeling\b of lo\b\b, helple\b\bne\b\b, and fru\btration due to their inability \mto feel like they are making a difference in \btopping climate change (Mo\ber, 2013). Some writer\b \btre\b\b the po\b\bible detrimental i\mmpact of guilt, a\b people contemplate the impact of their own behavior on future generation\b. Although the impact\b\m of climate change are not alway\b vi\bible, they perpetuate a delayed de\btruction that, like the damage to climate, are incremental and can be \mju\bt a\b damaging a\b acute climate impact\b (Nixon, 2011). Following di\ba\bter\b, damage to \bocial or community infra\btructural component\b, \buch a\b food \by\btem\b and medical \bervi\mce\b, re\bult\b in many acute con\bequence\b for p\bychological well-being. In contra\bt, gradual impact\b of clim\mate change, like change\b in weather pattern\b and ri\bing \bea level\b, will cau\be \bome \mof the mo\bt re\bounding chronic p\bychological con\bequence\b. Acute and chronic mental health \meffect\b include the following\f • Trauma and \bhock • Po\bt-traumatic \btre\b\b di\border • Compounded \btre\b\b • Strain\b on \bocial relation\bhip\b • Depre\b\bion • Anxiety • Suicide • Sub\btance abu\be • Aggre\b\bion and violence • Lo\b\b of per\bonally impor\mtant place\b • Lo\b\b of autonomy and control • Lo\b\b of per\bonal and oc\mcupational identity • Feeling\b of helple\b\bne\b\b, fear, fatali\bm, \bola\btalgia, and ecoanxiety K\bY TAK\bAWAYS: Impacts on Individu\Hals

26 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 27 one’\b \ben\be of continuity and belo\mnging. Becau\be of the importance of connection to place in per\bonal ident\mity (e.g., Scannell & Gifford, 2016), \buch di\bplacement can leave people literally alienated, with a dimini\bh\med \ben\be of \belf and\m increa\bed vulnerability to \btre\b\b. Although empirica\ml re\bearch on the p\bychological impact\b of\m migration i\b rare, T\bchakert, Tutu, and Alcaro (2013) \btudied the emotiona\ml experience among re\bident\b of Ghana w\mho were forced to move from the northern region of the country to the capital, Accra, becau\be local condition\b no longer\m \bupported their farming practice\b. Al\bo, re\bpondent\b expre\b\bed no\btalgia and \badne\b\b for the home left be\mhind and helple\b\bne\b\b due to change\b in their environment\b, \buch a\b defore\btation, that were de- \bcribed a\b \bad and \bc\mary. Loss of autonomy and control Climate change will inten\bify certain daily life inconvenience\b, which can have p\bychological impact\b on\m individual\b’ \ben\be \m of autonomy and control. The de\bire to be able to accompli\bh ba\bic ta\bk\b independe\mntly i\b a core p\bychological need, central to human well-being (Deci & R\myan, 2011), and ba\bic \bervice\b may be threatened due to dangerou\b condition\b. Thi\b may make mobility a challe\mnge—particularly for the elderly and tho\be w\mith di\babilitie\b. E\mxpo\bure to unwanted change in one’\b environment can al\bo reduce one’\b \ben\be of control over one’\b life (Fre\bque-Baxter & Armitage, 2012; Silver & Grek-Martin, 2015), which, in turn\m, ha\b negative impact\b on mental hea\mlth (Schönfeld, Brailov\bkaia, Bieda, Zhang, & Margraf, 2016). Loss of personal and \Hoccupational identity A more fundamental lo\b\b i\b the lo\b\b of per\bonal identity tied to mundane a\bpect\b of da\mily life. Lo\bing trea\bured object\b when a home i\b damaged or\m de\btroyed i\b one way in which climate change can \bignifican\mtly impair an indiv\midual’\b \ben\be of \belf and identity. Thi\b i\b becau\be object\m\b help provide a continuing \ben\be of who we are, particularly obje\mct\b that repre\bent important moment\b in \mlife (e.g., journal\b), relation\bhip\b (e.g., gift\b or photograph\b), or per\bonal/family hi\btory (e.g., family heirloom\b; Dittmar, 2011). Interviewee\b in a \btudy conducted by Carroll et al. (2009) \mindicated that flood victim\b were particularly troubled by the lo\b\b of per\bonal po\b\be\b\bion\b, \buch a\b thing\b they had made them\belve\b or \bpecial thing\b \mthey had \bpent time and e\mffort to procure or maintain. Alth\mough thi\b may \beem acute, the lo\b\be\b are permanent; the imp\mact\b are per\bi\btent and therefore become chronic.A lo\b\b of identity a\b\bociated with climate change i\b al\bo \bometi\mme\b attributable to it\b effect on place-bound occupation\b. Thi\b i\b likely due to the clo\be relation\bhip between identity and place-ba\bed occupation\b, like farming and fi\bhing (\mDevine-Wright, 2013). Becau\be \bevere \btorm\b and high temperature\b di\brupt economic activity (H\bi\mang, 2010), climate change may have an effect on occupational identity in general. Lo\b\b of occupation ha\b been a\b\bociated with increa\bed ri\bk of depre\b\bion following natural di\ba\bter\b (Wa\bini et al., 2014). Helplessness\f depression\f fear\f fatalism\f resignation\f and ecoanxiety Gradual, long-term change\b in climate can al\bo \burface a number of different emotion\b, including \mfear, anger, feeling\b of powerle\b\bne\b\b, or exhau\btion (Mo\ber, 2007). A review by Coyle and Van Su\bteren (2011) de\bcribed ca\be\b in which fear of extreme weather approache\b the level of phobia and the “unrelenting day-by-day de\bpair” (p. viii) that can be experienced during a drought (p. viii). Watching the \blow and \beemingly irrevocable impact\b of cli\mmate change unfold, and worrying about the \m future for one\belf, children, and later generation\b, may be an additional\m \bource of \btre\b\b (Searle & Gow, 2010). Albrecht (2011) and other\b have termed thi\b anxiety ecoanxiety. Qualitative re\bearch provide\b evidence that \bome people are deeply affected by feeling\b of lo\b\b, helple\b\bne\b\b, and fru\btration due to their inability \mto feel like they are making a difference in \btopping climate change (Mo\ber, 2013). Some writer\b \btre\b\b the po\b\bible detrimental i\mmpact of guilt, a\b people contemplate the impact of their own behavior on future generation\b. Although the impact\b\m of climate change are not alway\b vi\bible, they perpetuate a delayed de\btruction that, like the damage to climate, are incremental and can be \mju\bt a\b damaging a\b acute climate impact\b (Nixon, 2011). Following di\ba\bter\b, damage to \bocial or community infra\btructural component\b, \buch a\b food \by\btem\b and medical \bervi\mce\b, re\bult\b in many acute con\bequence\b for p\bychological well-being. In contra\bt, gradual impact\b of clim\mate change, like change\b in weather pattern\b and ri\bing \bea level\b, will cau\be \bome \mof the mo\bt re\bounding chronic p\bychological con\bequence\b. Acute and chronic mental health \meffect\b include the following\f • Trauma and \bhock • Po\bt-traumatic \btre\b\b di\border • Compounded \btre\b\b • Strain\b on \bocial relation\bhip\b • Depre\b\bion • Anxiety • Suicide • Sub\btance abu\be • Aggre\b\bion and violence • Lo\b\b of per\bonally impor\mtant place\b • Lo\b\b of autonomy and control • Lo\b\b of per\bonal and oc\mcupational identity • Feeling\b of helple\b\bne\b\b, fear, fatali\bm, \bola\btalgia, and ecoanxietyK\bY TAK\bAWAYS: Impacts on Individu\Hals

28 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 29 A CLOSER LOOK A Clinical Psycholo\fist’s Ta\be on Climate Chan\fe, Thoma\b Doherty, P\byD Re\bearch on the mental he\malth impact\b of di\ba\bter\b typically di\btingui\bhe\b between event\b that are con\bidered natural or technological (Doher\mty & Clayton, 2011). Becau\be natural di\ba\bter\b may \beem part of the natural order, and are con\bidered to be beyond human control, they are relatively ea\bier to cope with in p\bychological term\b. The\be calamitie\b tend to bring people together to help tho\be impacted. Technological di\ba\bter\b, meanwhile, are typically cau\bed b y human accident or negligence and often involve long-term, my\bteriou\b ri\bk\b. The\be di\ba\bter\b tend to divide communitie\b over how to compen\bate tho\be affected and hold accountable tho\be who were re\bpon\bible. Poorer area\b tend to be at higher ri\bk for the\be incident\b, and community divi\bion\b o\mften come down to privilege, cla\b\b, and race. Climate change combine\b natural and technological element\m\b. Human technologie\b are driving va\bt change\b in global\m climate and weather, increa\bing the ri\bk\b for a range of natural di\ba\bter\b. Climate change i\b an emergency that affect\b and divide\b the global community. I have coun\beled many people experiencing varying cri\be\b of mea\mning and re\bpon\bibility about climate change\f a \bcienti\bt who ha\b \bailed in the “Pacific garbage patch,” di\btre\b\bed by neighbor\b’ con\bumer habit\b; an environmental engineer w\mho ha\b “run the number\b” and do\me\bn’t \bee a way to effectively addre\b\b carbon emi\b\bion\b; a ranger in Glacier Na\mtional Park, trying to remain po\bitive while educating vi\bitor\b about the\be receding landmark\b; an\md a per\bon \bhocked by a new\b \btory about the dire con\bequence\b of ri\bing ocean temperature\b. An unexpected benefit for me of confronting the\be complex, troubling i\b\bue\b i\b that I regularly interact with people who take climate change a\b \beriou\bly a\b I do, \buch a\b public heal\mth official\b fr om around the United State\b u\bing the Center\b for Di\bea\be Control and Prevention\b’ Building R\me\bilience Again\bt Climate Effect\b (BRACE) framework. Such interaction\b allow me to maintain my creativity and motivation, avoid i\bolation, and find a \ben\be of \m\bhar ed purpo\be with other\b. A\b a p\bychologi\bt, I know that engaging with clima\mte change lead\b to con\bciou\bne\b\b-rai\bing about one’\b environmental identity a\mnd ethic\b. Any of the interlinked problem\b within climate change—poverty, inequality, lo\b\b of trea\bured place\b, \bpecie\b extinction, threat\b t o our well-being or livelihood—can hook u\b\m emotionally and int\mellectually. The\be i\b\bue\b lead to feeling\b of curio\bity\m and in\bight, a\b well a\b fatigue and de\bpair. Clinician\b can help individual\b to thrive in the face of climate change by identifying which\m \bpecific i\b\bue\b activate their unique vulnerabilitie\b or per\bona\ml worrie\b and developing a \bpecific pla\mn or activity to giv e them a \ben\be of control about how they re\bpond. Similarly , the BRACE model can help communitie\b \beeking t\mo become more re\bilient by anticipating local health o\mr economic impact\b, ident\mifying vulnerable group\b that need protection, and proactively implementing a community-wide adaptation plan that can be reevaluated a\b more become\b known about changing l\mocal c ondition\b. Coping with climate change require\b in\bight and per\be\mverance. Cooperation among profe\b\bional\b can help people adapt and thr\mive. IMPACTS ON COMMUNITY AND SOCIE\mTY In addition to the effects on individual health \band well- bein\f, climate chan\fe affects how individuals interact in communities and r elate to each other\b For example, natural disasters can have a ne\fative impact on community bonds\b A chan\fin\f climate will likely affect aspects of community well-bein\f, includin\b\f social cohesion, a\f\fression, and social relationships\bSOCIAL COHESION AND COMMUNITY CONTINUITY Compounded \btre\b\b from climate change ha\b been ob\berved among variou\b communitie\b. For example, Cun\bolo Willox et al. (2013) examined the impact\b of\m climate change on a \bmall Inuit community. b Member\b of the community, who all reported a \btrong attachment to the land, \baid th\mey had noticed change\b i n the local climate and that the\be change\b contributed to negative effect\b on them\belve\b. A\b a re\bult of altered interaction\b with the en\mvironment, community member\b reported food in\becurity, \badne\b\b, anger, increa\bed family \btre\b\b, and a belief tha\mt their \ben\be of \bel\mf-worth and community cohe\bion had decrea\bed. Elder\b expre\b\bed \bpecific c oncern for the pre\bervation of Inuit lang\muage and culture a\b they directly influence mental well-being and \bocial cohe\bion (O\btapchuk, Harper\b, Cu\mn\bolo Willox, Edge, & Rigolet Inuit Community Government, 2015). Social cohe\bion and social capital can protect communitie\b again\bt mental and phy\bical health impact\b \mduring a climate- related di\ba\bter. Regardle\b\b of \bocioeconomic or cultural background\b, communitie\b with high level\b of \bocial capital a nd community leader\bhip experience the quicke\bt recoverie\b after a di\ba\bter and the highe\bt \bati\bfaction with community rebuilding (Aldrich \m& Meyer, 2014). W hen local condition\b become practically uninhabit\mable, ecomigration, leading to environmental refugees, can re\bult. Such migration\b erode \bocial network\b, a\b communitie\b di\bper\be in different direction\b. Becau\be \boci\mal network\b provide important practical and emotiona\ml re\bource\b that are a\b\bociated with health and\m well-being, the lo\b\b of \buch network\b place\b people’\b \ben\be of continuity and belo\mnging a t ri\bk. The current Syrian conflict, which ha\b re\bulted in ma\b\b migration, may partially \btem from climate change– driven precipitation change\b, ri\bing\m mean \bea level\b, and a decrea\be in \boil moi\bture. The\be climate impact\b were exacerbated during the drought from 2007 to 2010 due to human di\bruption\b wi\mthin natural \by\btem\b, leading to crop failure and large-\bcale conflict, hunger, and de\bperation. Although \buch civil \munre\bt cannot be attributed to a \bingle cau\be, recent evidence \bugge\bt\b climate-cau\bed drought may have played a \bignificant role in the unraveling of an already vulnerable political and ecologica l climate (Kelley, Mohtadi, Cane, Seager, & Ku\bhnir, 2015). AGGRESSION Heightened anxiety and u\mncertainty about one\m’\b own future can reduce the ability to focu\b on the need\b of\m other\b— negatively impacting \bocial \mrelation\bhip\b with frien\md\b and

28 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 29 A CLOSER LOOK A Clinical Psycholo\fist’s Ta\be on Climate Chan\fe, Thoma\b Doherty, P\byD Re\bearch on the mental he\malth impact\b of di\ba\bter\b typically di\btingui\bhe\b between event\b that are con\bidered natural or technological (Doher\mty & Clayton, 2011). Becau\be natural di\ba\bter\b may \beem part of the natural order, and are con\bidered to be beyond human control, they are relatively ea\bier to cope with in p\bychological term\b. The\be calamitie\b tend to bring people together to help tho\be impacted. Technological di\ba\bter\b, meanwhile, are typically cau\bed b y human accident or negligence and often involve long-term, my\bteriou\b ri\bk\b. The\be di\ba\bter\b tend to divide communitie\b over how to compen\bate tho\be affected and hold accountable tho\be who were re\bpon\bible. Poorer area\b tend to be at higher ri\bk for the\be incident\b, and community divi\bion\b o\mften come down to privilege, cla\b\b, and race. Climate change combine\b natural and technological element\m\b. Human technologie\b are driving va\bt change\b in global\m climate and weather, increa\bing the ri\bk\b for a range of natural di\ba\bter\b. Climate change i\b an emergency that affect\b and divide\b the global community. I have coun\beled many people experiencing varying cri\be\b of mea\mning and re\bpon\bibility about climate change\f a \bcienti\bt who ha\b \bailed in the “Pacific garbage patch,” di\btre\b\bed by neighbor\b’ con\bumer habit\b; an environmental engineer w\mho ha\b “run the number\b” and do\me\bn’t \bee a way to effectively addre\b\b carbon emi\b\bion\b; a ranger in Glacier Na\mtional Park, trying to remain po\bitive while educating vi\bitor\b about the\be receding landmark\b; an\md a per\bon \bhocked by a new\b \btory about the dire con\bequence\b of ri\bing ocean temperature\b. An unexpected benefit for me of confronting the\be complex, troubling i\b\bue\b i\b that I regularly interact with people who take climate change a\b \beriou\bly a\b I do, \buch a\b public heal\mth official\b fr om around the United State\b u\bing the Center\b for Di\bea\be Control and Prevention\b’ Building R\me\bilience Again\bt Climate Effect\b (BRACE) framework. Such interaction\b allow me to maintain my creativity and motivation, avoid i\bolation, and find a \ben\be of \m\bhar ed purpo\be with other\b. A\b a p\bychologi\bt, I know that engaging with clima\mte change lead\b to con\bciou\bne\b\b-rai\bing about one’\b environmental identity a\mnd ethic\b. Any of the interlinked problem\b within climate change—poverty, inequality, lo\b\b of trea\bured place\b, \bpecie\b extinction, threat\b t o our well-being or livelihood—can hook u\b\m emotionally and int\mellectually. The\be i\b\bue\b lead to feeling\b of curio\bity\m and in\bight, a\b well a\b fatigue and de\bpair. Clinician\b can help individual\b to thrive in the face of climate change by identifying which\m \bpecific i\b\bue\b activate their unique vulnerabilitie\b or per\bona\ml worrie\b and developing a \bpecific pla\mn or activity to giv e them a \ben\be of control about how they re\bpond. Similarly , the BRACE model can help communitie\b \beeking t\mo become more re\bilient by anticipating local health o\mr economic impact\b, ident\mifying vulnerable group\b that need protection, and proactively implementing a community-wide adaptation plan that can be reevaluated a\b more become\b known about changing l\mocal c ondition\b. Coping with climate change require\b in\bight and per\be\mverance. Cooperation among profe\b\bional\b can help people adapt and thr\mive. IMPACTS ON COMMUNITY AND SOCIE\mTY In addition to the effects on individual health \band well- bein\f, climate chan\fe affects how individuals interact in communities and r elate to each other\b For example, natural disasters can have a ne\fative impact on community bonds\b A chan\fin\f climate will likely affect aspects of community well-bein\f, includin\b\f social cohesion, a\f\fression, and social relationships\bSOCIAL COHESION AND COMMUNITY CONTINUITY Compounded \btre\b\b from climate change ha\b been ob\berved among variou\b communitie\b. For example, Cun\bolo Willox et al. (2013) examined the impact\b of\m climate change on a \bmall Inuit community. b Member\b of the community, who all reported a \btrong attachment to the land, \baid th\mey had noticed change\b i n the local climate and that the\be change\b contributed to negative effect\b on them\belve\b. A\b a re\bult of altered interaction\b with the en\mvironment, community member\b reported food in\becurity, \badne\b\b, anger, increa\bed family \btre\b\b, and a belief tha\mt their \ben\be of \bel\mf-worth and community cohe\bion had decrea\bed. Elder\b expre\b\bed \bpecific c oncern for the pre\bervation of Inuit lang\muage and culture a\b they directly influence mental well-being and \bocial cohe\bion (O\btapchuk, Harper\b, Cu\mn\bolo Willox, Edge, & Rigolet Inuit Community Government, 2015). Social cohe\bion and social capital can protect communitie\b again\bt mental and phy\bical health impact\b \mduring a climate- related di\ba\bter. Regardle\b\b of \bocioeconomic or cultural background\b, communitie\b with high level\b of \bocial capital a nd community leader\bhip experience the quicke\bt recoverie\b after a di\ba\bter and the highe\bt \bati\bfaction with community rebuilding (Aldrich \m& Meyer, 2014). W hen local condition\b become practically uninhabit\mable, ecomigration, leading to environmental refugees, can re\bult. Such migration\b erode \bocial network\b, a\b communitie\b di\bper\be in different direction\b. Becau\be \boci\mal network\b provide important practical and emotiona\ml re\bource\b that are a\b\bociated with health and\m well-being, the lo\b\b of \buch network\b place\b people’\b \ben\be of continuity and belo\mnging a t ri\bk. The current Syrian conflict, which ha\b re\bulted in ma\b\b migration, may partially \btem from climate change– driven precipitation change\b, ri\bing\m mean \bea level\b, and a decrea\be in \boil moi\bture. The\be climate impact\b were exacerbated during the drought from 2007 to 2010 due to human di\bruption\b wi\mthin natural \by\btem\b, leading to crop failure and large-\bcale conflict, hunger, and de\bperation. Although \buch civil \munre\bt cannot be attributed to a \bingle cau\be, recent evidence \bugge\bt\b climate-cau\bed drought may have played a \bignificant role in the unraveling of an already vulnerable political and ecologica l climate (Kelley, Mohtadi, Cane, Seager, & Ku\bhnir, 2015). AGGRESSION Heightened anxiety and u\mncertainty about one\m’\b own future can reduce the ability to focu\b on the need\b of\m other\b— negatively impacting \bocial \mrelation\bhip\b with frien\md\b and

30 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 31 b. A \bmall native Inuit community of 259 member\b i\b located in Rigolet, Nunat\biavut, within the Ca\mnadian province of Newfoundland and Labrador. co-worker\b (Palinka\b, Down\b, Petter\bon, & Ru\b\bell, 1993), a\b well a\b attitude\b toward other people in gen\meral. Interpersonal violenc\Ye High temperature\b a\b\bociated with climate change may increa\be people’\b aggre\b\bive tendencie\b. Aggre\b\bion can al\bo be exacerbated by decrea\bed acce\b\b to \btre\b\b- reducing green \bpace\b and \bupportive \bocial network\b. Ri\bing level\b of fru\btration in \bociety con\bequently lead to interper\bonal aggre\b\bion (\buch a\b dome\btic violence, a\b\bault, and rape). Ran\bon (2012) calculated that between 2010 and 2099, climate change w ould cau\be an e\btimated additional 30,000 murder\b, 200,000 ca\be\b of rape, and 3.2 million bur\mglarie\b due to increa\bed average temperature\b. Intergroup aggression Climate change may increa\be conflict through \beveral mechani\bm\b. Violence may increa\be when competition for \bcarce natural re\bource\b increa\be\b or when ecomigration bring\b formerly \beparate communitie\b into contact and they compete for re\bource\b, like job\b and land. In\m a recent meta- analy\bi\b, H\biang, Burke, and Miguel (2013) found evidence that climate change can contribute to the frequency of intergroup violence (i.e., political conflict and war). For example, in Hou\bton, Texa\b, crime rate\b increa\bed \bignificantly following Hurricane Katrina, although Katrina migrant\b have not been definitively \bourced a\b the cau\be (And\mer\bon & Deli\bi, 2011). Meanwhile, re\btraint\b on crime weaken when exi\bting \bocial in\btitution\b are di\brupted, thu\b increa\bing the probability of criminal behavior. For example, when government re\bource\b are devoted to damaged infra\btructure from natural di\ba\bter\b, tho\be re\bource\b may be diverted a way from criminal ju\btice \by\btem\b, mental health agencie\b, an\md educational in\btitution\b, all of which tend to help mitigate crime (Agnew, 2012). Agnew (2012) further pointed out that the effect\b of climate change are likely to promote crime by “increa\bing \btrain, reducing \bocial control, [and] weakening \bocial \bupport.” Intergroup attitude\b can al\bo be\m negatively impacted by climate change. In a recent \btudy, \burv ey re\bpondent\b di\bplayed more negative attitude\b toward policie\b to \bupport minoritie\b and immigrant\b when temperature\b were high (Cohen & Krueger, 2016). An experimental \btudy \bhowed that people who were thinking about climate change became more h o\btile to individual\b out\bi\mde their \bocial group (that i\b, people they con\bider to be unlike them) and more likely to \bupport the \btatu\b quo and it\b accompanying \bocial inequitie\b (Frit\bche\m, Cohr\b, Ke\b\bler, & Bauer, 2012). Ho\btility toward individual\b out\bi\mde one’\b \bocial group can be a way of affirming one’\b own group identity in the face of a perceived threat. In a viciou\b cycle, lower level\b of \bocial cohe\bion and connectedne\b\b, greater \bocial inequalit\mie\b, lack of tru\bt between community member\b and \mfor in\btitution\b, and othe\mr factor\b that inhibit c ommunity member\b from working together are a\b\bociated with intergroup aggre\b\bion (Norri\b, Steven\b, Pfefferbaum, Wyche, & Pfefferbaum, 2008). KEY \fAKEAWAYS\b Impacts on Community and Societ\Yy • Decrea\bed \ben\be of cohe\bion • Di\brupted \ben\be of continuity and belonging • Increa\bed interper\bonal aggre\b\bion, \buch a\b dome\btic abu\be and crime • Increa\bed intergroup aggre\b\bion, \buch a\b political conflict and war THE PROBLEM OF INE\mQUITY \fhe impacts of clim\Yate change are not distributed equally. Some people will experience natural disasters firsthand, some will be affected more gradually over time, and some will experience only indirect impacts. \fhis section describes some of the popula\Ytions that are more vulnerable to the mental health impa\Ycts of climate change, including people who live in risk-prone areas, indigenous communities, low-income groups, certain communities of color, women, children, older adults, \Yand people with disabi\Ylities or chronic illnesses. A thorough review of demographic differences in vulnerability to climate change can be found in Dodgen et al. (\Y2016).RISK-PRONE AREAS Communities in whic\ah people’s livelihoods a\fe di\fectly tied to the natu\fal envi\fonment, th\fough ag\ficultu\fe, \bshing, o\f tou\fism, a\fe at g\feate\f \fisk. Some part\b of the world are geologically more vulnerable to \btorm\b, ri\bing \bea\b, wildfire\b, or drought. There are detailed report\b of farmer\b in Au\btralia who have been negatively affected by prolonged period\b of \mdrought cau\bed by changing weather pattern\b (Hanigan et al\m., 2012). Additionally, communitie\b in low-lying area\b, \buch a\b coa\btal Loui\biana and i\bland\m\b in the Che\bapeake Bay, are lo\bing their land\m to ero\bion and ri\bing \bea\b (Davenport & Robert\bon, 2016). Thi\b pa\bt year, re\bident\b of I\ble de \mJean Charle\b, Loui\biana, became the\m fir\bt climate refugee\b in the Unit\med State\b; a $48 million b\mudget wa\b allocated to relocate re\bident\b to a le\b\b flood-prone area (Margolin, 2016). Inhabitant\b of \mindigenou\b communitie\b often depend on natural re\bource\b for their livelihood\b and are located in geographically vulnerable region\b (e.g., Cun\bolo Willox et al., 2013, 2014; Maldonado, Colombi, & Pandya, 2013). Communities that lack \fesou\fces, both physical and \bnancial, can expe\fience climate impacts mo\fe seve\fely. Thi\b can be demon\btrated by higher incident\b \mof extreme weather within impoveri\bhed communitie\b. In di\ba\bter\b, \bocioeconomically di\badvantaged communitie\b often \buffer the mo\bt. For example, following Hurricane Sand\my, lower- income re\bident\b reported weak or ab\bent \bocial\m \bupport network\b and had the gr\meate\bt percentage\b of \bevere mental di\btre\b\b and diagno\bi\b of d\mepre\b\bion or anxiety aft\mer the hurricane. Furthermore, 35% of children living in a hou\m\behold that earn\b le\b\b than $20,000 annually experienced feeling\b of \badne\b\b, depre\b\bion, fear, or nervou\bne\b\b following the hurricane (Abram\bon et al., 2015). INDIGENOUS COMMUNI\fIES Indigenous communities a\fe at \fisk of losing th\aei\f cultu\fal he\fitage, as well as thei\f homes.\a Imperiled indigenou\m\b communitie\b are found around the world, including the\m United State\b. In Ala\bka, for example, \bome native Ala\bkan\b have \been their villag\me\b literally vani\bh due to the thawing permafro\bt, and other\b are facing a \bimilar outcome in the near future (Chapin et al., 2014). For indigenou\b communitie\b, climate change may threaten not only their \mphy\bical home but al\bo their life\btyle, including acce\b\b to traditional food and culturally meaningful practice\b (Cochran et al., 2013;

30 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 31 b. A \bmall native Inuit community of 259 member\b i\b located in Rigolet, Nunat\biavut, within the Ca\mnadian province of Newfoundland and Labrador. co-worker\b (Palinka\b, Down\b, Petter\bon, & Ru\b\bell, 1993), a\b well a\b attitude\b toward other people in gen\meral. Interpersonal violenc\Ye High temperature\b a\b\bociated with climate change may increa\be people’\b aggre\b\bive tendencie\b. Aggre\b\bion can al\bo be exacerbated by decrea\bed acce\b\b to \btre\b\b- reducing green \bpace\b and \bupportive \bocial network\b. Ri\bing level\b of fru\btration in \bociety con\bequently lead to interper\bonal aggre\b\bion (\buch a\b dome\btic violence, a\b\bault, and rape). Ran\bon (2012) calculated that between 2010 and 2099, climate change w ould cau\be an e\btimated additional 30,000 murder\b, 200,000 ca\be\b of rape, and 3.2 million bur\mglarie\b due to increa\bed average temperature\b. Intergroup aggression Climate change may increa\be conflict through \beveral mechani\bm\b. Violence may increa\be when competition for \bcarce natural re\bource\b increa\be\b or when ecomigration bring\b formerly \beparate communitie\b into contact and they compete for re\bource\b, like job\b and land. In\m a recent meta- analy\bi\b, H\biang, Burke, and Miguel (2013) found evidence that climate change can contribute to the frequency of intergroup violence (i.e., political conflict and war). For example, in Hou\bton, Texa\b, crime rate\b increa\bed \bignificantly following Hurricane Katrina, although Katrina migrant\b have not been definitively \bourced a\b the cau\be (And\mer\bon & Deli\bi, 2011). Meanwhile, re\btraint\b on crime weaken when exi\bting \bocial in\btitution\b are di\brupted, thu\b increa\bing the probability of criminal behavior. For example, when government re\bource\b are devoted to damaged infra\btructure from natural di\ba\bter\b, tho\be re\bource\b may be diverted a way from criminal ju\btice \by\btem\b, mental health agencie\b, an\md educational in\btitution\b, all of which tend to help mitigate crime (Agnew, 2012). Agnew (2012) further pointed out that the effect\b of climate change are likely to promote crime by “increa\bing \btrain, reducing \bocial control, [and] weakening \bocial \bupport.” Intergroup attitude\b can al\bo be\m negatively impacted by climate change. In a recent \btudy, \burv ey re\bpondent\b di\bplayed more negative attitude\b toward policie\b to \bupport minoritie\b and immigrant\b when temperature\b were high (Cohen & Krueger, 2016). An experimental \btudy \bhowed that people who were thinking about climate change became more h o\btile to individual\b out\bi\mde their \bocial group (that i\b, people they con\bider to be unlike them) and more likely to \bupport the \btatu\b quo and it\b accompanying \bocial inequitie\b (Frit\bche\m, Cohr\b, Ke\b\bler, & Bauer, 2012). Ho\btility toward individual\b out\bi\mde one’\b \bocial group can be a way of affirming one’\b own group identity in the face of a perceived threat. In a viciou\b cycle, lower level\b of \bocial cohe\bion and connectedne\b\b, greater \bocial inequalit\mie\b, lack of tru\bt between community member\b and \mfor in\btitution\b, and othe\mr factor\b that inhibit c ommunity member\b from working together are a\b\bociated with intergroup aggre\b\bion (Norri\b, Steven\b, Pfefferbaum, Wyche, & Pfefferbaum, 2008). KEY \fAKEAWAYS\b Impacts on Community and Societ\Yy • Decrea\bed \ben\be of cohe\bion • Di\brupted \ben\be of continuity and belonging • Increa\bed interper\bonal aggre\b\bion, \buch a\b dome\btic abu\be and crime • Increa\bed intergroup aggre\b\bion, \buch a\b political conflict and war THE PROBLEM OF INE\mQUITY \fhe impacts of clim\Yate change are not distributed equally. Some people will experience natural disasters firsthand, some will be affected more gradually over time, and some will experience only indirect impacts. \fhis section describes some of the popula\Ytions that are more vulnerable to the mental health impa\Ycts of climate change, including people who live in risk-prone areas, indigenous communities, low-income groups, certain communities of color, women, children, older adults, \Yand people with disabi\Ylities or chronic illnesses. A thorough review of demographic differences in vulnerability to climate change can be found in Dodgen et al. (\Y2016).RISK-PRONE AREAS Communities in whic\ah people’s livelihoods a\fe di\fectly tied to the natu\fal envi\fonment, th\fough ag\ficultu\fe, \bshing, o\f tou\fism, a\fe at g\feate\f \fisk. Some part\b of the world are geologically more vulnerable to \btorm\b, ri\bing \bea\b, wildfire\b, or drought. There are detailed report\b of farmer\b in Au\btralia who have been negatively affected by prolonged period\b of \mdrought cau\bed by changing weather pattern\b (Hanigan et al\m., 2012). Additionally, communitie\b in low-lying area\b, \buch a\b coa\btal Loui\biana and i\bland\m\b in the Che\bapeake Bay, are lo\bing their land\m to ero\bion and ri\bing \bea\b (Davenport & Robert\bon, 2016). Thi\b pa\bt year, re\bident\b of I\ble de \mJean Charle\b, Loui\biana, became the\m fir\bt climate refugee\b in the Unit\med State\b; a $48 million b\mudget wa\b allocated to relocate re\bident\b to a le\b\b flood-prone area (Margolin, 2016). Inhabitant\b of \mindigenou\b communitie\b often depend on natural re\bource\b for their livelihood\b and are located in geographically vulnerable region\b (e.g., Cun\bolo Willox et al., 2013, 2014; Maldonado, Colombi, & Pandya, 2013). Communities that lack \fesou\fces, both physical and \bnancial, can expe\fience climate impacts mo\fe seve\fely. Thi\b can be demon\btrated by higher incident\b \mof extreme weather within impoveri\bhed communitie\b. In di\ba\bter\b, \bocioeconomically di\badvantaged communitie\b often \buffer the mo\bt. For example, following Hurricane Sand\my, lower- income re\bident\b reported weak or ab\bent \bocial\m \bupport network\b and had the gr\meate\bt percentage\b of \bevere mental di\btre\b\b and diagno\bi\b of d\mepre\b\bion or anxiety aft\mer the hurricane. Furthermore, 35% of children living in a hou\m\behold that earn\b le\b\b than $20,000 annually experienced feeling\b of \badne\b\b, depre\b\bion, fear, or nervou\bne\b\b following the hurricane (Abram\bon et al., 2015). INDIGENOUS COMMUNI\fIES Indigenous communities a\fe at \fisk of losing th\aei\f cultu\fal he\fitage, as well as thei\f homes.\a Imperiled indigenou\m\b communitie\b are found around the world, including the\m United State\b. In Ala\bka, for example, \bome native Ala\bkan\b have \been their villag\me\b literally vani\bh due to the thawing permafro\bt, and other\b are facing a \bimilar outcome in the near future (Chapin et al., 2014). For indigenou\b communitie\b, climate change may threaten not only their \mphy\bical home but al\bo their life\btyle, including acce\b\b to traditional food and culturally meaningful practice\b (Cochran et al., 2013;

32 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 33 Durkalec, Furgal, Skinner, & Sheldon, 2015; Rigby, Ro\ben, Berry, & Hart, 2011; Vogge\b\ber, Lynn, Daigle, Lake, & Ranco, 2013). Chief Albert \mNaquin of a Loui\biana tribal community threatened by climate change \btated, “We’re going to lo\be all our heritage, all our culture” (quoted in Davenport & Robert\bon, 2016). Cun\bolo, Willox et al. (2013) reviewed ca\be \btudie\b of \beveral Inuit communitie\b and reported weakening \bocial network\b, increa\bed level\b of conflict, and \bignificant \btre\b\b a\b\bociated with relocation or even thinking about relocation. In evocative language, Inuit community member\b interviewed by Durkalec et al. (2015) reported that an inability to go out on the \bea\m ice (due to a changing climate) would make them feel like they “have no health” and “can’t breathe,” and they would “be very \bad,” “be lo\bt,” or “go crazy” (p. 21). The lo\b\b of any community i\b tragic, but the impact\m on native communitie\b i\b particu\mlarly notable becau\m\be it dimini\bhe\b the cultu\mral heritage and be\mcau\be indigenou\b communitie\b are often defined by a \bpecial connection to the natural environment (Cun\bolo Willox et al., 2012, 2013, 2014; Durkalec et al., 2015). Thi\b connection include\b \m traditional pattern\b of behavior and environmental knowledge about the \bpecific l\mocal eco\by\btem—knowledge that i\b di\bappearing (F\mord, Pearce, Duerden, Furgal, & Smit, 2010)—and about how to adapt to changing environment\b that could help u\b a\b a br\moader \bociety a\b we adapt to the con\bequence\b of climate change (Wildcat, 2013). A CLOSER LOOK Inuit Mental Healt\f\H and Climate C\fange\b A\bhlee Cun\bolo, PhD “We are people of the se\na ice. If there’s no \fore sea ice, how can we be people of the sea ice\b” The circumpolar north i\b warming at more than twice the rate of the global average. A\b a re\bult, local indige\mnou\b people\b are at the frontline\b in experiencing climate change effect\b. Inuit in Cana\mda \btill carry out active tradition\b of hunting\m, trapping, fi\bhing, foraging, and harve\bting, and a\b a re\bult, even a \bubtle alteration in the climate and environment can impact the\mir mental well-being. For the Inuit, the \mland i\b everything. • It i\b family, the \bource of cultural continuity. A local leader \btated, “ We feel part of the la\nnd. It’s \fe. It’s us. It’s \fy people. I always feel that sense of belonging, and that attach\fent.” • It i\b a place of \bolace and healing, foundational for all well-being. “I think for the Inuit, going\n out on the land is\n just as \fuch a part of\n our life as breathing...So if we don’t get out, th\nen, for our \fental well-being, it’s like you are not fulfilled.” Five Inuit communitie\b in Nunat\biavut, Newfoundland and Labrador, Canada have been working together to proactively \btudy the relation\bhip\b between climate change and mental health i\mn the North. Thi\b re\bearch di\bcovered wide-ranging con\bequence\b for individual and community well-being\f 1. S trong e\fotional reactions Emotional re\bpon\be\b to the climatic and environmental change\b inc\mluded “\badne\b\b,” “fear,” “anxiety,” “\btre\b\b,” “di\btre\b\b,” and “fru\btration.” People called the change\b “\mdeva\btating,” “\bcary,” and “depre\b\bing.” A young hunter explained, “People like to go out on the land to feel good. If they can’t go out on the\n land, they don’t feel like people.” 2. Increased drug and alcohol usage Many mental health profe\b\bional\b expre\b\bed \beriou\b concern about increa\be\b in drug and a\mlcohol u\be, which interviewee\b de\bcribed a\b a way to fill the newly “empty” time from decrea\bed opportunitie\b \mfor land-ba\bed activiti\me\b. 3. Reduced self-efficacy and self- regulation A\b previou\bly mentioned, \m many expre\b\bed concern over lo\bing control of their tradition\b and livelihood\b, which, in\m turn, lead\b to a lo\b\b of cultural identity and \belf-worth. One hunter explained, “If a way of life is taken away because of circu\fstances that you have no control over, then you lose control of a part of your life.” 4. A\fplification of existing stressors Finally, climate change compounded other mental health threat\b by removing a \bource of healing, cultu\mral \btrength, food \becurity, and autonomy. A coun\belor \btated, “When people are unable to spend ti\fe on the \nland, they have \fore ti\fe to dwell on the negative, to re\fe\fber things like residential school experiences when they felt really trapped and unable to leave.” It i\b clear that climate change i\b no long\mer ab\btract or theoretical. People globally, \buch a\b the Inuit in the\m North, are experiencing a range of p\bycho-\bocial re\bpon\be\b. Climate change impact\b on men\mtal health mu\bt be further under\btood and con\bidered in policy and deci\bion-making \mfor mitigation, adaptation, and health r\me\bpon\be\b. “We are people of t\fe sea\H ice. If t\fere’s no more sea ice\b \fow can we be people of t\fe \Hsea ice?” - one member of the inuit\m communitie\b, Canada

32 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 33 Durkalec, Furgal, Skinner, & Sheldon, 2015; Rigby, Ro\ben, Berry, & Hart, 2011; Vogge\b\ber, Lynn, Daigle, Lake, & Ranco, 2013). Chief Albert \mNaquin of a Loui\biana tribal community threatened by climate change \btated, “We’re going to lo\be all our heritage, all our culture” (quoted in Davenport & Robert\bon, 2016). Cun\bolo, Willox et al. (2013) reviewed ca\be \btudie\b of \beveral Inuit communitie\b and reported weakening \bocial network\b, increa\bed level\b of conflict, and \bignificant \btre\b\b a\b\bociated with relocation or even thinking about relocation. In evocative language, Inuit community member\b interviewed by Durkalec et al. (2015) reported that an inability to go out on the \bea\m ice (due to a changing climate) would make them feel like they “have no health” and “can’t breathe,” and they would “be very \bad,” “be lo\bt,” or “go crazy” (p. 21). The lo\b\b of any community i\b tragic, but the impact\m on native communitie\b i\b particu\mlarly notable becau\m\be it dimini\bhe\b the cultu\mral heritage and be\mcau\be indigenou\b communitie\b are often defined by a \bpecial connection to the natural environment (Cun\bolo Willox et al., 2012, 2013, 2014; Durkalec et al., 2015). Thi\b connection include\b \m traditional pattern\b of behavior and environmental knowledge about the \bpecific l\mocal eco\by\btem—knowledge that i\b di\bappearing (F\mord, Pearce, Duerden, Furgal, & Smit, 2010)—and about how to adapt to changing environment\b that could help u\b a\b a br\moader \bociety a\b we adapt to the con\bequence\b of climate change (Wildcat, 2013). A CLOSER LOOK Inuit Mental Healt\f\H and Climate C\fange\b A\bhlee Cun\bolo, PhD “We are people of the se\na ice. If there’s no \fore sea ice, how can we be people of the sea ice\b” The circumpolar north i\b warming at more than twice the rate of the global average. A\b a re\bult, local indige\mnou\b people\b are at the frontline\b in experiencing climate change effect\b. Inuit in Cana\mda \btill carry out active tradition\b of hunting\m, trapping, fi\bhing, foraging, and harve\bting, and a\b a re\bult, even a \bubtle alteration in the climate and environment can impact the\mir mental well-being. For the Inuit, the \mland i\b everything. • It i\b family, the \bource of cultural continuity. A local leader \btated, “ We feel part of the la\nnd. It’s \fe. It’s us. It’s \fy people. I always feel that sense of belonging, and that attach\fent.” • It i\b a place of \bolace and healing, foundational for all well-being. “I think for the Inuit, going\n out on the land is\n just as \fuch a part of\n our life as breathing...So if we don’t get out, th\nen, for our \fental well-being, it’s like you are not fulfilled.” Five Inuit communitie\b in Nunat\biavut, Newfoundland and Labrador, Canada have been working together to proactively \btudy the relation\bhip\b between climate change and mental health i\mn the North. Thi\b re\bearch di\bcovered wide-ranging con\bequence\b for individual and community well-being\f 1. S trong e\fotional reactions Emotional re\bpon\be\b to the climatic and environmental change\b inc\mluded “\badne\b\b,” “fear,” “anxiety,” “\btre\b\b,” “di\btre\b\b,” and “fru\btration.” People called the change\b “\mdeva\btating,” “\bcary,” and “depre\b\bing.” A young hunter explained, “People like to go out on the land to feel good. If they can’t go out on the\n land, they don’t feel like people.” 2. Increased drug and alcohol usage Many mental health profe\b\bional\b expre\b\bed \beriou\b concern about increa\be\b in drug and a\mlcohol u\be, which interviewee\b de\bcribed a\b a way to fill the newly “empty” time from decrea\bed opportunitie\b \mfor land-ba\bed activiti\me\b. 3. Reduced self-efficacy and self- regulation A\b previou\bly mentioned, \m many expre\b\bed concern over lo\bing control of their tradition\b and livelihood\b, which, in\m turn, lead\b to a lo\b\b of cultural identity and \belf-worth. One hunter explained, “If a way of life is taken away because of circu\fstances that you have no control over, then you lose control of a part of your life.” 4. A\fplification of existing stressors Finally, climate change compounded other mental health threat\b by removing a \bource of healing, cultu\mral \btrength, food \becurity, and autonomy. A coun\belor \btated, “When people are unable to spend ti\fe on the \nland, they have \fore ti\fe to dwell on the negative, to re\fe\fber things like residential school experiences when they felt really trapped and unable to leave.” It i\b clear that climate change i\b no long\mer ab\btract or theoretical. People globally, \buch a\b the Inuit in the\m North, are experiencing a range of p\bycho-\bocial re\bpon\be\b. Climate change impact\b on men\mtal health mu\bt be further under\btood and con\bidered in policy and deci\bion-making \mfor mitigation, adaptation, and health r\me\bpon\be\b. “We are people of t\fe sea\H ice. If t\fere’s no more sea ice\b \fow can we be people of t\fe \Hsea ice?” - one member of the inuit\m communitie\b, Canada

34 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 35 CHILDREN AND INFANTS Climate \fhange ha\b a big imp\ea\ft on young people. Children are more vulnerable to many of the effect\b due to their \bmall \bize, developing organ\b and nervou\b \by\btem\b, and rapid metaboli\bm\b (Bartlet\mt, 2008). Children are more \ben\bitive to temperature, becau\be their phy\biological regulatory \by\btem\b may be le\b\b effective (e.g., they \bweat le\b\b) and becau\be they are more likely to depend on other\b \mto help them regulate their behavior (Zivin & Shrader, 2016). Their \bmall \bize make\b very young children more \bu\bceptible to dehydration, and children under age five living in poverty repre\bent 80% of victim\b of \banita\mtion-related illne\b\be\b and diarrheal \m di\bea\be (Bartlett, \m2008). Climate impa\ft\b may have long-term and even permanent effe\ft\b, \bu\fh a\b \fhanging t\ehe developmental potential and traje\ftory of a \fhild. Currie and Almond (\m2011) reviewed evidence that even minor di\bturbance\b during childhood\m may have effect\b on health and \mearning potential that la\bt into adulthood. Studie\b have \bhown that children who experience a flood or a drought during key developmental period\b are \bhorter, on average, a\b adult\b (Bartle\mtt, 2008). Fetu\be\b are vulnerable to heat wave\b, with re\bearch \bhow\b that expo\bure to heat wave\b e\bpecially during\m the \becond and third trime\bter\b of pregnancy lead\b to a lower average birth weight and po\b\bibly a greater incidence of preterm birth (Kou\bky, 2016). Malnouri\bhment\m or \bevere threat to health during the \mearly year\b i\b a\b\bociated with fewer year\b of \bchooling and reduced economic activity a\b a\mdult\b, a\b well a\b with behavioral and motor problem\b and reduced IQ (Kou\bky, 2016). Additionally, early expo\bure to di\bea\be provoked by climate change can have a major and perman\ment impact on neurological development, a\b can be \mdramatically \been in children expo\bed prenatally to the Zika viru\b (e.g., Mlakar et al., 2016). Children \fan experien\fe PTSD and depre\b\bion following traumati\f or \btre\b\bful experien\fe\b with more \beverity and prevalen\fe than adult\b. After climate event\b, children typically demon\btrate more \bevere di\btre\b\b than adult\b (Fritze et al., 2008; So\mma\bundaram & van de Put, 2006). Furthermore, the prevalence of di\btre\b\b i\b al\bo higher; higher rate\b of PTSD were found in children two year\b after a flood (Fernandez et al., 2015). Children’\b mental health can al\bo be affected not only by their experience\b of \btre\b\bor\b, \buch a\b natural di\ba\bter\b, extreme weather, and ecomigration, but al\bo by the mental health of their car\megiver\b (Simp\bon et al., 2011). Children al\bo have the potential to be emotionally affected if they become \beparated from their primary car\megiver\b. Similar to phy\bical experience\b, traumatic mental experience\b can have lifelong effect\b. Of cour\be, early childhood i\m\b critical for brain development. Studie\b have documented that high level\b of \btre\b\b during childhood \m can affect the development of neural pathway\b, in way\b that impair memory, executive function, and dec\mi\bion-making in later life (e.g., Shonkoff, Garner, & the Committee on P\bycho\bocial A\bpect\b of Child and Family Health, Committee on Early Childhood, A\mdoption, and Depend\ment Care, and Section on De\mvelopmental and Behavioral Pediatric\b, 2012). Children are al\bo at in\frea\bed ri\bk from di\bruption\b to the edu\fational \by\btem (Kou\bky, 2016). Natural di\ba\bter\b, in particular, can damage or de\btroy \bchool\b or make them inacce\b\bible to teacher\b and \btudent\b. After Hurricane Katrina, for example, 196,000 public \bchool \btudent\b had to change \bchool\b, and \mmany of them mi\b\bed a month or more of \bchooling. In \mthi\b ca\be, becau\be the harde\bt-hit \bchool di\btrict\b were al\bo \bome of the w\mor\bt-performing one\b, \bome \btudent\b benefitted by tran\bferring to better \bchool\b. However, the effect\b on \bchool achievement were negative (Kou\bky, 2016). Di\ba\bter\b may \fau\be \fhildren to lo\be their \bo\fial \bupport network\b to a greater extent. During adver\bity, people draw upon all of their per\bonal re\bource\b—emotional and material. Although \boc\mial network\b can fill the gap\b when indiv\midual re\bource\b become depleted during extreme trauma (Hobfoll, 1989; Ungar & Liebenb\merg, 2013), the re\bource\b available from a tight-knit community may not go far, e\bpecially if the network i\b \bmall or the \mcommunity i\b poor. When di\ba\bter\b hit an area, they affect everyone and put entire neighborhood\b in \m need of help. A \btudy of children impacted by Hurricane Katrina found that tho\be who were hit harde\bt by the \btorm al\bo experienced le\b\b \bocial \bupport, lik\mely becau\be people in th\meir immediate \bupport network were them\belve\b \buffering (Bank\b & Weem\b, 2014). Children are more vulnerable to many of the effe\fts due to their small size, develo\bing organs and nervous systems, and ra\bid metabolisms (Bartlett, 2008).

34 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 35 CHILDREN AND INFANTS Climate \fhange ha\b a big imp\ea\ft on young people. Children are more vulnerable to many of the effect\b due to their \bmall \bize, developing organ\b and nervou\b \by\btem\b, and rapid metaboli\bm\b (Bartlet\mt, 2008). Children are more \ben\bitive to temperature, becau\be their phy\biological regulatory \by\btem\b may be le\b\b effective (e.g., they \bweat le\b\b) and becau\be they are more likely to depend on other\b \mto help them regulate their behavior (Zivin & Shrader, 2016). Their \bmall \bize make\b very young children more \bu\bceptible to dehydration, and children under age five living in poverty repre\bent 80% of victim\b of \banita\mtion-related illne\b\be\b and diarrheal \m di\bea\be (Bartlett, \m2008). Climate impa\ft\b may have long-term and even permanent effe\ft\b, \bu\fh a\b \fhanging t\ehe developmental potential and traje\ftory of a \fhild. Currie and Almond (\m2011) reviewed evidence that even minor di\bturbance\b during childhood\m may have effect\b on health and \mearning potential that la\bt into adulthood. Studie\b have \bhown that children who experience a flood or a drought during key developmental period\b are \bhorter, on average, a\b adult\b (Bartle\mtt, 2008). Fetu\be\b are vulnerable to heat wave\b, with re\bearch \bhow\b that expo\bure to heat wave\b e\bpecially during\m the \becond and third trime\bter\b of pregnancy lead\b to a lower average birth weight and po\b\bibly a greater incidence of preterm birth (Kou\bky, 2016). Malnouri\bhment\m or \bevere threat to health during the \mearly year\b i\b a\b\bociated with fewer year\b of \bchooling and reduced economic activity a\b a\mdult\b, a\b well a\b with behavioral and motor problem\b and reduced IQ (Kou\bky, 2016). Additionally, early expo\bure to di\bea\be provoked by climate change can have a major and perman\ment impact on neurological development, a\b can be \mdramatically \been in children expo\bed prenatally to the Zika viru\b (e.g., Mlakar et al., 2016). Children \fan experien\fe PTSD and depre\b\bion following traumati\f or \btre\b\bful experien\fe\b with more \beverity and prevalen\fe than adult\b. After climate event\b, children typically demon\btrate more \bevere di\btre\b\b than adult\b (Fritze et al., 2008; So\mma\bundaram & van de Put, 2006). Furthermore, the prevalence of di\btre\b\b i\b al\bo higher; higher rate\b of PTSD were found in children two year\b after a flood (Fernandez et al., 2015). Children’\b mental health can al\bo be affected not only by their experience\b of \btre\b\bor\b, \buch a\b natural di\ba\bter\b, extreme weather, and ecomigration, but al\bo by the mental health of their car\megiver\b (Simp\bon et al., 2011). Children al\bo have the potential to be emotionally affected if they become \beparated from their primary car\megiver\b. Similar to phy\bical experience\b, traumatic mental experience\b can have lifelong effect\b. Of cour\be, early childhood i\m\b critical for brain development. Studie\b have documented that high level\b of \btre\b\b during childhood \m can affect the development of neural pathway\b, in way\b that impair memory, executive function, and dec\mi\bion-making in later life (e.g., Shonkoff, Garner, & the Committee on P\bycho\bocial A\bpect\b of Child and Family Health, Committee on Early Childhood, A\mdoption, and Depend\ment Care, and Section on De\mvelopmental and Behavioral Pediatric\b, 2012). Children are al\bo at in\frea\bed ri\bk from di\bruption\b to the edu\fational \by\btem (Kou\bky, 2016). Natural di\ba\bter\b, in particular, can damage or de\btroy \bchool\b or make them inacce\b\bible to teacher\b and \btudent\b. After Hurricane Katrina, for example, 196,000 public \bchool \btudent\b had to change \bchool\b, and \mmany of them mi\b\bed a month or more of \bchooling. In \mthi\b ca\be, becau\be the harde\bt-hit \bchool di\btrict\b were al\bo \bome of the w\mor\bt-performing one\b, \bome \btudent\b benefitted by tran\bferring to better \bchool\b. However, the effect\b on \bchool achievement were negative (Kou\bky, 2016). Di\ba\bter\b may \fau\be \fhildren to lo\be their \bo\fial \bupport network\b to a greater extent. During adver\bity, people draw upon all of their per\bonal re\bource\b—emotional and material. Although \boc\mial network\b can fill the gap\b when indiv\midual re\bource\b become depleted during extreme trauma (Hobfoll, 1989; Ungar & Liebenb\merg, 2013), the re\bource\b available from a tight-knit community may not go far, e\bpecially if the network i\b \bmall or the \mcommunity i\b poor. When di\ba\bter\b hit an area, they affect everyone and put entire neighborhood\b in \m need of help. A \btudy of children impacted by Hurricane Katrina found that tho\be who were hit harde\bt by the \btorm al\bo experienced le\b\b \bocial \bupport, lik\mely becau\be people in th\meir immediate \bupport network were them\belve\b \buffering (Bank\b & Weem\b, 2014). Children are more vulnerable to many of the effe\fts due to their small size, develo\bing organs and nervous systems, and ra\bid metabolisms (Bartlett, 2008).

36 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 37 A CLOSER LOOK Children’s Em\fti\fnal Resp\fnses t\f Climate Chan\be, Elizabeth Haa\be, MD Children’\b fear\b about climate change revolve around known and my\bteriou\b future effect\b. Direct experience with natural di\ba\bter\b can cau\be \bymptom\b of po\bt-traumatic \btre\b\b di\border, including panic \bymptom\b, nightmare\b, and phobic behavior. For example, \bome pre-\bchool children who lo\bt their home\b to Hurricane Sandy developed a phobic avoidance of rain, wave\b, and thunder tha\mt generalized to panic about getting\m in bathtub\b, going to \bchool (which they feared might flood), and going to \bwimming le\b\bon\b. The emotional dysre\bulati\fn children experience after environmental trauma reflect\b the idio\byncra\bie\b in a\bcribing a\bency and causality of \bmall children. A four year old who\be parent\b’ di\bcipline method wa\b withholding toy\b held her mother re\bpon\bible for lo\bing her doll\b\m to Sandy and had rage\b in which the ch\mild accu\bed her mother of \m“taking and killing\m” her doll\b (Felix, Haa\be, & Haller, 2016). A three year old, grief-\btricken about local clear-cutting that wa\b killing large number\b of beloved local animal\b, de\mclared that he would de\btroy the perpetrator\b by “calling them a bad word.” Children, with le\b\b ability to articulate their feeling\b in language\m, are al\bo more likely to regre\b\b, \bhowing babyi\bh behavior\b, or s\fmatize, developing \btomachache\b or other phy\bical \bymptom\b to expre\b\b up\bet, a\b did one child wh\men hi\b \bchool cafeteria refu\bed to recycle. Finally, children are more dependent, and therefore are more vulnerable to \beparation reaction\b. One boy who\be dog wa\b harmed by a tornado that al\bo de\btroyed hi\b home and killed \beveral peer\b became preoccupied with \becuring\m the animal’\b \bafety; hi\b inability \mto leave hi\b dog behind when nece\b\bary curtailed hi\b f\mriend\bhip\b, a\b well a\b hi\b academic a\mnd extra-curricular achievement (Haa\be, note\b). Children al\bo develop \bymptom\b becau\be they fear lo\bing control over an unknown future. Often ob\be\b\bive-compul\bive behavior\b re\bult, \buch a\b pickin\mg up every piece of garbage on th\me way to \bchool or running relentle\b\bly through “what if” \bcenario\b. One young patient, terrified that climate ruin would leave him poi\boned by toxin\b, developed a rigid nigh\mtly \bchedule of \belf-improvement to prepare and educate him\belf. Only by checking off every evening ritual could he ward off panic attack\b and in\bomnia (Haa\be, note\b). In Inuit and Aboriginal culture\b, youth are reporting higher rate\b of \buicidal think\ming and depre\b\bion linked to lo\bt \bocial reward\b becau\be nature-ba\bed activitie\b a\mre no longer available to them (Her\bher, 2016). Alienation and depre\b\bion are common in young people who have \buffered climate con\bequence\b and are living in a cultu\mral \betting that doe\b not validate their climate concern\b. Thankfully, emerging literature \bugge\bt\b the po\b\bibility of po\bt-traumatic growth following natural di\ba\bter\b, reflected in greater re\bilience and tran\bformation to more \bu\btainable life\btyle\b. Such progre\b\b require\b the developmental and p\bychological abilitie\b to grieve and articulate feeling\b in a narrative format. Intere\btingly, data \bhow\b that in particular, prolonged reflective rumination on climate in combination with hope and \mcoping advice from \bupportive caregiver\b bring\b \buch po\bitive tran\bformation and healing. DISADVANTAGED COMMUNITIES Some commu\fities o\b color are pro\fe to experie\fce i\fcreased impacts. A per\bi\btent reality in American \mculture i\b the exi\btence of environmental inju\btice\f Some racial and ethnic group\b tend to be more expo\bed to environmental ri\bk\b and t\mo have fewer financial and politi\mcal re\bource\b to buffer the impact (e.g., Grine\bki et al.\m, 2012; Park\b & Robert\b, 2006). Thi\b i\b partly, but not completely, explained by economic \btatu\b. Communitie\b with fewer re\bource\b and greater expo\bure, for example, in Phoenix, Arizona, are likely to experience greater rate\b of high temperature impact\b than majority group\b (Luber & McGeeh\min, 2008). Lower-income communitie\b are more likely to have outdated infra\btructure, \buch a\b a lack of extreme weather warning \by\btem\b, inadequate \btorm \burge preparedne\b\b, and clogged or i\mnadequate \btorm \bewer \by\btem\b, which place\b the\be communitie\b at greater ri\bk for the impact\b of climate change. Area\b with a high number of re\bident\b who lack ac\mce\b\b to health care or health in\burance, or already experience poor health (Edward\b & Wi\beman, 2011), are more likely to be affected by climate change. Communitie\b are al\bo le\b\b re\bilient when they are weakened by \bocial \btre\b\bor\b, \buch a\b raci\bm, economic inequality, and environmental inju\btice\b. Many of the communitie\b in New Orlean\b that were affected by Hurricane Katrina po\b\be\b\bed all of the\be characteri\btic\b (Norri\b et al.,\m 2008; Yun et al., 2010), and the effect\b of racial di\bparitie\b were clearly vi\bible i\mn the aftermath of the \btorm (Luber et al., \m2014). OCCUPATIONAL GROUPS Certai\f li\fes a\fd field\us o\b work are more directly exposed to the impact o\b clim\uate cha\fge. The\be occupation\b may include but not be limited to fir\bt re\bponder\b, con\btruction worker\b, health care work- er\b, farmer\b, farm worker\b, fi\bhermen, tran\bportation worker\b, and utility work- er\b (Benedek, Fulle\mrton, & Ur\bano, 2007). Inequitable health\m outcome\b may ari\be directly through worker\b’ expo\bure to increa\bed temperature\b, air pollution, \mand extreme weather, and indirectly through vector-borne di\bea\be\b, i\mncrea\bed u\be of pe\bticide\b, and many other element\b (Center\b for Di\bea\be Control and Prevention, 2016). According to the U.S. Environmental Protection Agency, outdoor worker\b will be the fir\bt to endure the effect\b of climate change, a\b they will be expo\bed to extreme heat, which can cau\be h\meat \btroke, exhau\btion, and fatigue. A\b natural di\ba\bter\b occur more frequently, \buch a\b wildfire\b and flooding, firefighter\b and paramedic\b face increa\bed \bafety ri\bk\b. Agricultural worker\b face increa\bed vulnerability to allergen\b, in\bect\b carryin\mg di\bea\be\b, \buch a\b We\bt Nile, and pe\bticide expo\bure that are increa\bed by changing weather and in\bect migration pattern\b (U.S. Environmental Protection Agency, 2016). ADDITIONAL POPULATIONS OF CONCERN I\fdividuals o\b all a\uges with disabilitie\us or chro\fic me\ftal or physical health issues may experie\fce climate-related impacts at a greater exte\ft (Page, Hajat, Kovat\b, & Howard, 2012). Often, people living w\mith di\babilitie\b have di\bproportionately far lower acce\b\b to aid during and a\mfter climate-related di\ba\bter\b. Tho\be with mental health di\bor\mder\b can al\bo experience exacerbated \bymptom\b due to natural di\ba\bter\b. Degraded infra\btructure create\b barrier\b for people with menta\ml illne\b\be\b to receive proper medical attention, leading to additional negative mental and phy\bical health outcome\b. For in\btance, following the 2012 Wi\bcon\bin heat wave, 52% of all heat-related death\b were among individual\b\m with at lea\bt one mental illne\b\m\b. Half of

36 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 37 A CLOSER LOOK Children’s Em\fti\fnal Resp\fnses t\f Climate Chan\be, Elizabeth Haa\be, MD Children’\b fear\b about climate change revolve around known and my\bteriou\b future effect\b. Direct experience with natural di\ba\bter\b can cau\be \bymptom\b of po\bt-traumatic \btre\b\b di\border, including panic \bymptom\b, nightmare\b, and phobic behavior. For example, \bome pre-\bchool children who lo\bt their home\b to Hurricane Sandy developed a phobic avoidance of rain, wave\b, and thunder tha\mt generalized to panic about getting\m in bathtub\b, going to \bchool (which they feared might flood), and going to \bwimming le\b\bon\b. The emotional dysre\bulati\fn children experience after environmental trauma reflect\b the idio\byncra\bie\b in a\bcribing a\bency and causality of \bmall children. A four year old who\be parent\b’ di\bcipline method wa\b withholding toy\b held her mother re\bpon\bible for lo\bing her doll\b\m to Sandy and had rage\b in which the ch\mild accu\bed her mother of \m“taking and killing\m” her doll\b (Felix, Haa\be, & Haller, 2016). A three year old, grief-\btricken about local clear-cutting that wa\b killing large number\b of beloved local animal\b, de\mclared that he would de\btroy the perpetrator\b by “calling them a bad word.” Children, with le\b\b ability to articulate their feeling\b in language\m, are al\bo more likely to regre\b\b, \bhowing babyi\bh behavior\b, or s\fmatize, developing \btomachache\b or other phy\bical \bymptom\b to expre\b\b up\bet, a\b did one child wh\men hi\b \bchool cafeteria refu\bed to recycle. Finally, children are more dependent, and therefore are more vulnerable to \beparation reaction\b. One boy who\be dog wa\b harmed by a tornado that al\bo de\btroyed hi\b home and killed \beveral peer\b became preoccupied with \becuring\m the animal’\b \bafety; hi\b inability \mto leave hi\b dog behind when nece\b\bary curtailed hi\b f\mriend\bhip\b, a\b well a\b hi\b academic a\mnd extra-curricular achievement (Haa\be, note\b). Children al\bo develop \bymptom\b becau\be they fear lo\bing control over an unknown future. Often ob\be\b\bive-compul\bive behavior\b re\bult, \buch a\b pickin\mg up every piece of garbage on th\me way to \bchool or running relentle\b\bly through “what if” \bcenario\b. One young patient, terrified that climate ruin would leave him poi\boned by toxin\b, developed a rigid nigh\mtly \bchedule of \belf-improvement to prepare and educate him\belf. Only by checking off every evening ritual could he ward off panic attack\b and in\bomnia (Haa\be, note\b). In Inuit and Aboriginal culture\b, youth are reporting higher rate\b of \buicidal think\ming and depre\b\bion linked to lo\bt \bocial reward\b becau\be nature-ba\bed activitie\b a\mre no longer available to them (Her\bher, 2016). Alienation and depre\b\bion are common in young people who have \buffered climate con\bequence\b and are living in a cultu\mral \betting that doe\b not validate their climate concern\b. Thankfully, emerging literature \bugge\bt\b the po\b\bibility of po\bt-traumatic growth following natural di\ba\bter\b, reflected in greater re\bilience and tran\bformation to more \bu\btainable life\btyle\b. Such progre\b\b require\b the developmental and p\bychological abilitie\b to grieve and articulate feeling\b in a narrative format. Intere\btingly, data \bhow\b that in particular, prolonged reflective rumination on climate in combination with hope and \mcoping advice from \bupportive caregiver\b bring\b \buch po\bitive tran\bformation and healing. DISADVANTAGED COMMUNITIES Some commu\fities o\b color are pro\fe to experie\fce i\fcreased impacts. A per\bi\btent reality in American \mculture i\b the exi\btence of environmental inju\btice\f Some racial and ethnic group\b tend to be more expo\bed to environmental ri\bk\b and t\mo have fewer financial and politi\mcal re\bource\b to buffer the impact (e.g., Grine\bki et al.\m, 2012; Park\b & Robert\b, 2006). Thi\b i\b partly, but not completely, explained by economic \btatu\b. Communitie\b with fewer re\bource\b and greater expo\bure, for example, in Phoenix, Arizona, are likely to experience greater rate\b of high temperature impact\b than majority group\b (Luber & McGeeh\min, 2008). Lower-income communitie\b are more likely to have outdated infra\btructure, \buch a\b a lack of extreme weather warning \by\btem\b, inadequate \btorm \burge preparedne\b\b, and clogged or i\mnadequate \btorm \bewer \by\btem\b, which place\b the\be communitie\b at greater ri\bk for the impact\b of climate change. Area\b with a high number of re\bident\b who lack ac\mce\b\b to health care or health in\burance, or already experience poor health (Edward\b & Wi\beman, 2011), are more likely to be affected by climate change. Communitie\b are al\bo le\b\b re\bilient when they are weakened by \bocial \btre\b\bor\b, \buch a\b raci\bm, economic inequality, and environmental inju\btice\b. Many of the communitie\b in New Orlean\b that were affected by Hurricane Katrina po\b\be\b\bed all of the\be characteri\btic\b (Norri\b et al.,\m 2008; Yun et al., 2010), and the effect\b of racial di\bparitie\b were clearly vi\bible i\mn the aftermath of the \btorm (Luber et al., \m2014). OCCUPATIONAL GROUPS Certai\f li\fes a\fd field\us o\b work are more directly exposed to the impact o\b clim\uate cha\fge. The\be occupation\b may include but not be limited to fir\bt re\bponder\b, con\btruction worker\b, health care work- er\b, farmer\b, farm worker\b, fi\bhermen, tran\bportation worker\b, and utility work- er\b (Benedek, Fulle\mrton, & Ur\bano, 2007). Inequitable health\m outcome\b may ari\be directly through worker\b’ expo\bure to increa\bed temperature\b, air pollution, \mand extreme weather, and indirectly through vector-borne di\bea\be\b, i\mncrea\bed u\be of pe\bticide\b, and many other element\b (Center\b for Di\bea\be Control and Prevention, 2016). According to the U.S. Environmental Protection Agency, outdoor worker\b will be the fir\bt to endure the effect\b of climate change, a\b they will be expo\bed to extreme heat, which can cau\be h\meat \btroke, exhau\btion, and fatigue. A\b natural di\ba\bter\b occur more frequently, \buch a\b wildfire\b and flooding, firefighter\b and paramedic\b face increa\bed \bafety ri\bk\b. Agricultural worker\b face increa\bed vulnerability to allergen\b, in\bect\b carryin\mg di\bea\be\b, \buch a\b We\bt Nile, and pe\bticide expo\bure that are increa\bed by changing weather and in\bect migration pattern\b (U.S. Environmental Protection Agency, 2016). ADDITIONAL POPULATIONS OF CONCERN I\fdividuals o\b all a\uges with disabilitie\us or chro\fic me\ftal or physical health issues may experie\fce climate-related impacts at a greater exte\ft (Page, Hajat, Kovat\b, & Howard, 2012). Often, people living w\mith di\babilitie\b have di\bproportionately far lower acce\b\b to aid during and a\mfter climate-related di\ba\bter\b. Tho\be with mental health di\bor\mder\b can al\bo experience exacerbated \bymptom\b due to natural di\ba\bter\b. Degraded infra\btructure create\b barrier\b for people with menta\ml illne\b\be\b to receive proper medical attention, leading to additional negative mental and phy\bical health outcome\b. For in\btance, following the 2012 Wi\bcon\bin heat wave, 52% of all heat-related death\b were among individual\b\m with at lea\bt one mental illne\b\m\b. Half of

38 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance tho\be \buffering from mental illne\b\b were taking p\bychotropic medication\b, which impede one’\b ability to regulate one’\b body temperature. The\be medication\b that treat mental illne\b\b are one of the main underlying cau\be\b of \mheat-related death\b (Dodgen et al., 20\m16). Additionally, tho\be \buffering from ongoing a\bthma and re\bpiratory illne\b\be\b, like chronic ob\btructive pulmonary di\bea\be (COPD), are more \ben\bitive to reduced air quality. Moreover, inequalitie\b in the\m incidence of tho\be who are chronically ill ari\be a\m\b a re\bult of \beveral \bocioeconomic factor\b (Gamble et al., 2016). Due to increased health and m\gobility challenges\f the eld\gerly are very susceptible to the risks o\b clim\gate impacts. Higher rate\b of untreated depre\b\bion and other phy\bical illne\b\be\b reported among \benior\b contribute to thi\b increa\bed vulnerability. Re\bearch \bugge\bt\b the elderly, in particular, experience decline\b in cognitive ability when expo\bed to air pollution over the long term (Dodgen et al., 20\m16). A \btudy by Dominelli (2013) found that when infra\btructure broke down (e.g., road\b were impa\b\bable) due to flood\b, heat wave\b, or freeze-thaw event\b (all potentially climate-driven), formal care \bervice\b were not available to vulnerable people, \buch a\b the elderl\my. They could not get to the \bervice\b, and their normal \bervice\b could not come through. Heat can have a particularly \bevere impact on the elderl\my and on people with\m pre-exi\bting mental health problem\b; \bome of the medication\b a\b\bociated with mental illne\b\b make people more \bu\bceptible to the effect\b of heat (Martin-Latry et al., 2007). Extreme temperature\b or pollution can al\bo make it more difficult for \benior\b to engage in regular outdoor activitie\b, thu\b depriving them \mof the a\b\bociated phy\bical and mental ben\mefit\b. The stress directly related to supporting a child makes women more affected by climate change. Becau\be of a mother’\b frequent caregiver role, and becau\be, on average, women have fewer economic re\bource\b than men, women may al\bo be more affected, in general, by the \btre\b\b and trauma of natural di\ba\bter\b (Trumbo, Lueck, Marlatt, & Peek, 2011; Wa\bini et al., 2014). Po\b\bible lo\b\b of re\bource\b, \buch a\b food, water, \bhelter, and energy, may al\bo contribute to per\bonal \btre\b\b. Epidemiological \btudie\b of po\bt-di\ba\bter cohort\b and the gene\mral population, \bugge\bt that women are more likely to experience mental health problem\b a\b a re\bult of trauma. For example, the prevalence of PTSD in the general population i\b reported to be approximately twofold greater in women than in men (Soma\bundaram & van de Put, 2006). A number of population\b are e\bpecially vulnerable to the mental health\m effect\b of climate change, including\f• People living in ri\b\mk-prone area\b • Indigenou\b communitie\b • Some communitie\b of color • Certain occupational group\b with direct expo\bure • Tho\be with exi\bting di\babilitie\b o\mr chronic illne\b\b • Older adult\b, women, and children KEY TAKEAWAYS: The Problem o\b Inequity III. ADDRESSING THE MENTAL HEALTH IMPACTS

38 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance tho\be \buffering from mental illne\b\b were taking p\bychotropic medication\b, which impede one’\b ability to regulate one’\b body temperature. The\be medication\b that treat mental illne\b\b are one of the main underlying cau\be\b of \mheat-related death\b (Dodgen et al., 20\m16). Additionally, tho\be \buffering from ongoing a\bthma and re\bpiratory illne\b\be\b, like chronic ob\btructive pulmonary di\bea\be (COPD), are more \ben\bitive to reduced air quality. Moreover, inequalitie\b in the\m incidence of tho\be who are chronically ill ari\be a\m\b a re\bult of \beveral \bocioeconomic factor\b (Gamble et al., 2016). Due to increased health and m\gobility challenges\f the eld\gerly are very susceptible to the risks o\b clim\gate impacts. Higher rate\b of untreated depre\b\bion and other phy\bical illne\b\be\b reported among \benior\b contribute to thi\b increa\bed vulnerability. Re\bearch \bugge\bt\b the elderly, in particular, experience decline\b in cognitive ability when expo\bed to air pollution over the long term (Dodgen et al., 20\m16). A \btudy by Dominelli (2013) found that when infra\btructure broke down (e.g., road\b were impa\b\bable) due to flood\b, heat wave\b, or freeze-thaw event\b (all potentially climate-driven), formal care \bervice\b were not available to vulnerable people, \buch a\b the elderl\my. They could not get to the \bervice\b, and their normal \bervice\b could not come through. Heat can have a particularly \bevere impact on the elderl\my and on people with\m pre-exi\bting mental health problem\b; \bome of the medication\b a\b\bociated with mental illne\b\b make people more \bu\bceptible to the effect\b of heat (Martin-Latry et al., 2007). Extreme temperature\b or pollution can al\bo make it more difficult for \benior\b to engage in regular outdoor activitie\b, thu\b depriving them \mof the a\b\bociated phy\bical and mental ben\mefit\b. The stress directly related to supporting a child makes women more affected by climate change. Becau\be of a mother’\b frequent caregiver role, and becau\be, on average, women have fewer economic re\bource\b than men, women may al\bo be more affected, in general, by the \btre\b\b and trauma of natural di\ba\bter\b (Trumbo, Lueck, Marlatt, & Peek, 2011; Wa\bini et al., 2014). Po\b\bible lo\b\b of re\bource\b, \buch a\b food, water, \bhelter, and energy, may al\bo contribute to per\bonal \btre\b\b. Epidemiological \btudie\b of po\bt-di\ba\bter cohort\b and the gene\mral population, \bugge\bt that women are more likely to experience mental health problem\b a\b a re\bult of trauma. For example, the prevalence of PTSD in the general population i\b reported to be approximately twofold greater in women than in men (Soma\bundaram & van de Put, 2006). A number of population\b are e\bpecially vulnerable to the mental health\m effect\b of climate change, including\f• People living in ri\b\mk-prone area\b • Indigenou\b communitie\b • Some communitie\b of color • Certain occupational group\b with direct expo\bure • Tho\be with exi\bting di\babilitie\b o\mr chronic illne\b\b • Older adult\b, women, and children KEY TAKEAWAYS: The Problem o\b Inequity III. ADDRESSING THE MENTAL HEALTH IMPACTS

40 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 41 BUILDING RESILIENC\mE Developing plans to adapt and cope is critical in\m addressing the physical and psychological impacts \mo\f climate change. In this section, \be introduce psychological resilience, individually and on a community level. Resilience can be defined as t\mhe ability o\f a person (or a community) to cope \bith, gro\b through, and transcend adversity (Hob\foll, Stevens, & Zalta, 2015).Climate change i\b no long\mer a di\btant, unimaginable \mthreat; it i\b a growing reality for communitie\b acro\b\b the globe. Recognizing the ri\bk, \mmany local government\b in the Uni\mted State\b (a\b well a\b other place\b around the world) have created preparation or adaptation plan\b for \bhoring up phy\bical infra\btructure to with\btand new weather and temperature extreme\b. The\be plan\b, while an\m important \btep, generally overlook the p\bycho-\bocial impact\b of \ma changing climate and do little to create or \bupport the \bof\mt infra\btructure needed for community p\bychological well- being (Bau\b\ban & Kelly, 2016). How can communitie\b prepare them\belve\b to minimize \buffering and promote resilience in the face of the challengin\mg impact\b of climate change? Re\bilient communitie\b can create the phy\bical and \bocial infra\btructure that make\b them le\b\b \bu\bceptible to negative effect\b. On an individual l\mevel, re\bilience i\b built internally and externally through \btrategie\b, \buch a\b coping and \belf-regulation, and community \bocial \buppor\mt network\b. Mo\bt people come through adver\bity with po\bitive adju\btment and without p\bychopathology (Bonnano, 2008; Hanbury, Indart, & Saklof\bke, 2013). In fact, \bome individual\m\b may even experience what i\b called post-traumatic growth and come through a \bignificant d\mi\bruption with the \mfeeling of having gained \bomething po\b\mitive, \buch a\b \btronger \bocial relation\bhip\b or \bpecific \b\mkill\b (Lowe et al., 2013; Ram\bay & Mander\bon, 2011). Even \bo, much can be done t\mo increa\be the re\bilience capacity of individu\mal\b and communitie\b, particula\mrly in re\bpon\be to climate change. The following \bection\b de\bcrib\me factor\b that \bupport p\bycho-\bocial re\bilience in both. A CLOSER LOOK Resilience in the Face \ff Climate Change\b Victoria Derr, PhD In collaboration with Re\bilient Boulder (a project of the Rockefeller Foundation’\b 100 Re\bilient Citie\b net\mwork), Growing Up Boulder (GUB) worked with an economically and ethn\mically diver\be \bample of children and youth to develop their perception\b of re\bilience within the city of Boulder, Colorado. In the pilot pha\be of the project, children made a mural with a\bpect\b of t\mheir community that \bupported or inhibited re\bilience and took picture\b of their community that explained the\be concept\b. In an in-depth\m pha\be, elementary and high\m \bchool \btudent\b explored re\bilience at variou\b \bcale\b of the\m community through drawing\b, identification of a\b\bet\b and vulnerabilitie\b, and recommendation\b for making Boulder more re\bilient. Finally, high \bchool \btudent\b continued thi\b work through a poetry project developed in partner\bhi\mp with \beveral Latino poet\b and the \mU.S. poet laureate. Children and youth al\bo \bhared their idea\b with lo\mcal leader\b and developed recommendation\b for increa\bing the re\bilience of Boulder’\b young people. Acro\b\b all method\b, the\be\m young people identified acce\b\b to nature and family, friend\b, and \bupport\mive network\b (from \bchool and community) a\b critical\m factor\b in \bupporting re\bilience, while global clim\mate change wa\b de\bcribed a\b a vu\mlnerability. Concern\b about climate change emerged from the fir\bt brain\btorming \be\b\bion, in which youth jotted down idea\b for a\b\bet\b and vulnerabilitie\b on large butcher-paper \bheet\b. One \btudent wrote “the new\b,” and then many other \btudent\b expanded on thi\b idea, addin\mg many more new\b \bource\b. Student\b largely hear about climate change via new\b media, with littl\me opportunity to feel empowered or to take po\bitive, local action. In the high \bchool \mpoetry project, \btudent\b de\bcribed a per\bonal\m moment of re\bilience. Many of the\be \btorie\b included family lo\b\be\b and coping with poor family health, the challenge\b of immigr\mation, and \burviving\m Boulder’\b recent flood. In 2013, Boulder experienced a 100-year flood, a\b well a\b a 1,000-year rain event, which \beverely impacted the city and region, with many familie\b temporarily or permanentl\my di\bplaced. Some \btudent\b wrote about re\bilience in the context of thi\b flood, de\bcribing a family member handlin\mg it alone, without \bocial \bup\mport. Student\b focu\bed on local i\b\bue\b that impact their daily l\mive\b and their potential to \bupport re\bilience, including acce\b\b to nature. Many acro\b\b all age group\b \baid nature, from view\b of the mountain\b f\mrom their high \bchool t\mo \bmall park\b and ope\mn \bpace, helped build re\bilience. However, many of the \btudent\b in thi\b re\bearch do not have daily acce\b\b to nature de\bpite living in a relatively green city. Greater acce\b\b to nearby nature could provide young people with \bou\mrce\b for re\btoration and re\bilience. In general, youth identified clim\mate change a\b negatively impacting their \mper\bonal re\bilience and acce\b\b to nature a\b \bupporting re\bilience. However, they tended to focu\b on many \bocial and economic factor\b, \buch a\b poverty and immigration \btatu\b, that are more directly \been and felt than climate change. Thi\b focu\b \bugge\bt\b that for the\be \btudent\b, a\b for many other\b, climate change \btill \beem\b to be an ab\btract i\b\bue. Resilient c\fmmunities can create the physical and s\fcial inf\arastructure that makes them less susceptible t\f negative effects.

40 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 41 BUILDING RESILIENC\mE Developing plans to adapt and cope is critical in\m addressing the physical and psychological impacts \mo\f climate change. In this section, \be introduce psychological resilience, individually and on a community level. Resilience can be defined as t\mhe ability o\f a person (or a community) to cope \bith, gro\b through, and transcend adversity (Hob\foll, Stevens, & Zalta, 2015).Climate change i\b no long\mer a di\btant, unimaginable \mthreat; it i\b a growing reality for communitie\b acro\b\b the globe. Recognizing the ri\bk, \mmany local government\b in the Uni\mted State\b (a\b well a\b other place\b around the world) have created preparation or adaptation plan\b for \bhoring up phy\bical infra\btructure to with\btand new weather and temperature extreme\b. The\be plan\b, while an\m important \btep, generally overlook the p\bycho-\bocial impact\b of \ma changing climate and do little to create or \bupport the \bof\mt infra\btructure needed for community p\bychological well- being (Bau\b\ban & Kelly, 2016). How can communitie\b prepare them\belve\b to minimize \buffering and promote resilience in the face of the challengin\mg impact\b of climate change? Re\bilient communitie\b can create the phy\bical and \bocial infra\btructure that make\b them le\b\b \bu\bceptible to negative effect\b. On an individual l\mevel, re\bilience i\b built internally and externally through \btrategie\b, \buch a\b coping and \belf-regulation, and community \bocial \buppor\mt network\b. Mo\bt people come through adver\bity with po\bitive adju\btment and without p\bychopathology (Bonnano, 2008; Hanbury, Indart, & Saklof\bke, 2013). In fact, \bome individual\m\b may even experience what i\b called post-traumatic growth and come through a \bignificant d\mi\bruption with the \mfeeling of having gained \bomething po\b\mitive, \buch a\b \btronger \bocial relation\bhip\b or \bpecific \b\mkill\b (Lowe et al., 2013; Ram\bay & Mander\bon, 2011). Even \bo, much can be done t\mo increa\be the re\bilience capacity of individu\mal\b and communitie\b, particula\mrly in re\bpon\be to climate change. The following \bection\b de\bcrib\me factor\b that \bupport p\bycho-\bocial re\bilience in both. A CLOSER LOOK Resilience in the Face \ff Climate Change\b Victoria Derr, PhD In collaboration with Re\bilient Boulder (a project of the Rockefeller Foundation’\b 100 Re\bilient Citie\b net\mwork), Growing Up Boulder (GUB) worked with an economically and ethn\mically diver\be \bample of children and youth to develop their perception\b of re\bilience within the city of Boulder, Colorado. In the pilot pha\be of the project, children made a mural with a\bpect\b of t\mheir community that \bupported or inhibited re\bilience and took picture\b of their community that explained the\be concept\b. In an in-depth\m pha\be, elementary and high\m \bchool \btudent\b explored re\bilience at variou\b \bcale\b of the\m community through drawing\b, identification of a\b\bet\b and vulnerabilitie\b, and recommendation\b for making Boulder more re\bilient. Finally, high \bchool \btudent\b continued thi\b work through a poetry project developed in partner\bhi\mp with \beveral Latino poet\b and the \mU.S. poet laureate. Children and youth al\bo \bhared their idea\b with lo\mcal leader\b and developed recommendation\b for increa\bing the re\bilience of Boulder’\b young people. Acro\b\b all method\b, the\be\m young people identified acce\b\b to nature and family, friend\b, and \bupport\mive network\b (from \bchool and community) a\b critical\m factor\b in \bupporting re\bilience, while global clim\mate change wa\b de\bcribed a\b a vu\mlnerability. Concern\b about climate change emerged from the fir\bt brain\btorming \be\b\bion, in which youth jotted down idea\b for a\b\bet\b and vulnerabilitie\b on large butcher-paper \bheet\b. One \btudent wrote “the new\b,” and then many other \btudent\b expanded on thi\b idea, addin\mg many more new\b \bource\b. Student\b largely hear about climate change via new\b media, with littl\me opportunity to feel empowered or to take po\bitive, local action. In the high \bchool \mpoetry project, \btudent\b de\bcribed a per\bonal\m moment of re\bilience. Many of the\be \btorie\b included family lo\b\be\b and coping with poor family health, the challenge\b of immigr\mation, and \burviving\m Boulder’\b recent flood. In 2013, Boulder experienced a 100-year flood, a\b well a\b a 1,000-year rain event, which \beverely impacted the city and region, with many familie\b temporarily or permanentl\my di\bplaced. Some \btudent\b wrote about re\bilience in the context of thi\b flood, de\bcribing a family member handlin\mg it alone, without \bocial \bup\mport. Student\b focu\bed on local i\b\bue\b that impact their daily l\mive\b and their potential to \bupport re\bilience, including acce\b\b to nature. Many acro\b\b all age group\b \baid nature, from view\b of the mountain\b f\mrom their high \bchool t\mo \bmall park\b and ope\mn \bpace, helped build re\bilience. However, many of the \btudent\b in thi\b re\bearch do not have daily acce\b\b to nature de\bpite living in a relatively green city. Greater acce\b\b to nearby nature could provide young people with \bou\mrce\b for re\btoration and re\bilience. In general, youth identified clim\mate change a\b negatively impacting their \mper\bonal re\bilience and acce\b\b to nature a\b \bupporting re\bilience. However, they tended to focu\b on many \bocial and economic factor\b, \buch a\b poverty and immigration \btatu\b, that are more directly \been and felt than climate change. Thi\b focu\b \bugge\bt\b that for the\be \btudent\b, a\b for many other\b, climate change \btill \beem\b to be an ab\btract i\b\bue. Resilient c\fmmunities can create the physical and s\fcial inf\arastructure that makes them less susceptible t\f negative effects.

42 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 43 TIPS TO SUPPORT INDIVIDUALS Some people seem t\do function more effectively in di\fcult situations than others do. \bo single factor sets highly resilient individual\ds apart (Bonanno & D\diminich, 2013). Instead, an individual’s ability to recover from trauma, or to experience post- traumatic growth, depends on a complex and dynamic set o\df factors. Here, we provide tips on the factors of personal attributes and social support designed to help practitioners, polic\dymakers, and communicators support individuals’ success in becoming resilient.PERSO\bAL ATTRIBUTES A\bD ACTIO\bS 1. Build belief in \done’s own resilience. Several per\bonal di\bpo\biti\monal characteri\btic\b are a\b\bociated with individual re\bilience. People who feel po\bitive about their ability to overcome a \bource of \btre\b\b and trauma do better than people with lo\mwer self-efficacy. Belief in one’\b own re\bilience ha\b been correlated with fewer \bymptom\b of PTSD and depre\b\bion after di\ba\bter\b (Shene\bey & Langhirich\ben- Rohling, 2015). 2. Foster optimism. People who are able to reframe and find \bomethin\mg po\bitive in their circum\btance\b tend to do better than people who \m are le\b\b able to regulate their thinking, \memotion\b, and action\m\b (Bonanno & Diminich\m, 2013; Hanbury et al.,\m 2013; Harper & Pergament, 2015; Iacoviello & Charney, 2014; Petra\bek Macdonald, Ford, Cun\bolo Willox, & Ro\b\b, 2013; Prince-Embury, 2013). Po\bitively reapprai\bing one’\b circum\btance\b help\b move one forward rather than becoming \btuck in a cycle of negative emotion\b. Additionally, optimi\bm likely contribute\b to a per\bon’\b ability to feel po\bitive emotion\b during a hard time, which may help people better recover and cope (Terp\btra, 2011). In a \btudy of low-income mother\b who \burvived Hurricane Katrina, Lowe et al. (2013) found that optimi\bm helped the m\mother\b adju\bt and grow after a di\ba\bter. Of cour\be, exce\b\bive optimi\bm may re\bult in di\bappointment or \bur\mpri\be if the expected outcome doe\b not c ome to pa\b\b; therefore, the right balance i\b needed. 3. Cultivate active coping and self-regulation. Another \btrength i\b active coping, which involve\b cognitive dimen\bion\b, \buch a\b maintainin\mg an awarene\b\b of one’\b own thought\b and apprai\bal\b, and behavioral dimen\bion\b, \buch a\b continuou\bly \beeking\m \bolution\b and \buppor\mt (Iacoviello & Charney, 2014). Self-regulation, or the abili\mty to control one’\b immediate impul\be\b in favor of a more con\bidered, long-term \btrategy, i\b another characteri\btic of re\bilient individual\m\b (National Scientific Council on the Developing Child, 2015). 4. Find a source of personal mean\ding. Involvement in a faith community ha\b been ci\mted a\b a protective factor for mental health in\m \beveral interview \btudie\b with people experiencing trauma (e.g., Cline, Orom, Child, Hernandez, & Black, 2015; Fernando, 2012; Harper & Pargament, 2015; Weine et al., 2014). For many, faith give\b a \ben\be of peace during difficulty (\mMark\b, Hatch, Lu, & Cherry, 2015), and \btudie\b have \bhown that having a \bpiritual practice tend\b to boo\bt an individual’\b well-being and can b\me an important coping re\bource. In addition to the \bocial \bupport that i\b often provided by a faith community, having a \bpiritual practice can help people manage a\mnd find meaning in \buffering during \bignifi\mcant adver\bity (Ram\ba y & Mander\bon, 2011). Mindfulness can be another type\m of practice, through yoga and meditation, that give\b people a greater \ben\be of purpo\be and \mmeaning (Garland, Farb, Goldin, & Fredrick\bon, 2015). In each ca\be, the ability to flexibly reapprai\be adver\be event\b in a way that enhance\b a \ben\be of meanin\mg i\b key for promoting per\bonal well-being. 5. Boost personal preparedness. Mental health can b\me incorporated into exi\bting di\ba\bter preparation effort\b. Recommendation\b for \bhort-term di\ba\bter or emergency kit\b often include thing\b lik e food, water, \bupplie\b, and medic\mation. Yet item\b that can pre\berve and \bhore up mental health are al\bo equally impor\mtant to include (Mi\b\bouri Department of \mMental Health, 2006). The\be item\b might include comfort item\b, \buch a\b \bpiritual\m or religiou\b object\b, picture\b, blanket\b and toy\b for \bmall children, favorite food\b or treat\b to \bupplement \btable \bhelf food, recreational item\b \buch a\b book\b and\m game\b, and paper and writing i\mn\btrument\b to journal or write down important information. Pet\b, which al\bo provide \bome with a \ben\m\be of c omfort, mu\bt al\bo be con\bidered when making emergency kit\b and plan\b (Center\b for Di\bea\be Control and Prevention, 2016; American Red Cro\b\b, 2017). Public agencie\b and other \morganization\b may al\bo want to encourage community member\b to incorporate the\be item\b into their di\ba\bter preparation kit\b. Other facet\b of preparedne\b\b, including family, neighborhood, \bchoo\ml, and work re\bpon\be plan\b and other mea\b\mure\b, can help increa\be confidence and the feeling of \baf ety and reduce fear. SOCIAL CO\b\bECTIO\b 6. Support social n\iet\forks. Individual\b’ per\bonal capacity to with\btand trauma i\b increa\bed when they are connected to their network\b off-and online. One \btrategy frequently noted in re\bilience \btudie\b i\b cultivating and maintainin\mg \btrong \bocial connection\b (Iacoviello & Charney, 2014). Connectedne\b\b to other\b i\b a core p\bychological need and\m an e\b\bential foundation for well-being (e.g., Deci & Ryan, 2011). During difficult\m time\b, people turn to tho\be they are clo\be to, \buch a\b family, friend\b, and neig\mhbor\b, for emotional \bupport, a\b well a\b material help (e.g., money, food, or a temporary place to \btay). Re\bilience \bcholar\b note that \bocial \bupport i\b a critical protective re\bource during adver\bity (Kania\bty, 2012). Re\bearcher\b have found that higher level\b of \bocial \bupport during and i\mn the aftermath of a di\ba\b ter are a\b\bociated with lower rate\b of p\bychological di\btre\b\b (Greene, Paranjothy, & Palmer, 2015; Self-Brown, Ander\bon, Edward\b, & McGill, 2013). The po\bitive mental health impact\m of a \btrong \bocial \bupport \by\btem, or the negative impact\b of lower \bocial \bupport, ca\mn per\bi\bt for year\b after a di\ba\bter, \buch a\b a hurrican\me (Bank\b & Weem\b, 2014). A\b de\bcribed ab\move, a faith community, or any other tight-knit\m and \bupportive \bocial network, can provide \bignificant emotional\m and material \bupport (Cain & Barthelemy, 2008; Mark\b et al\m., 2015). People living in area\b mo\bt impacted by Hurricane Katrina reported in an interview \btudy that their “church family” (p. 256) offered them a li\btening ear, empathy, and moral \bupport in the extremely difficult aftermath of the hurricane (Mark\b et al., 2015). 7. Encoura\be connection \fith parents, family, and other role models. The \bupportof family and clo\be connection\b are particularly impor\mtant for children. Parent\b are likely the mo\bt central \bource of \bupport for children during trauma and adver\bity, and children are at higher ri\bk of

42 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 43 TIPS TO SUPPORT INDIVIDUALS Some people seem t\do function more effectively in di\fcult situations than others do. \bo single factor sets highly resilient individual\ds apart (Bonanno & D\diminich, 2013). Instead, an individual’s ability to recover from trauma, or to experience post- traumatic growth, depends on a complex and dynamic set o\df factors. Here, we provide tips on the factors of personal attributes and social support designed to help practitioners, polic\dymakers, and communicators support individuals’ success in becoming resilient.PERSO\bAL ATTRIBUTES A\bD ACTIO\bS 1. Build belief in \done’s own resilience. Several per\bonal di\bpo\biti\monal characteri\btic\b are a\b\bociated with individual re\bilience. People who feel po\bitive about their ability to overcome a \bource of \btre\b\b and trauma do better than people with lo\mwer self-efficacy. Belief in one’\b own re\bilience ha\b been correlated with fewer \bymptom\b of PTSD and depre\b\bion after di\ba\bter\b (Shene\bey & Langhirich\ben- Rohling, 2015). 2. Foster optimism. People who are able to reframe and find \bomethin\mg po\bitive in their circum\btance\b tend to do better than people who \m are le\b\b able to regulate their thinking, \memotion\b, and action\m\b (Bonanno & Diminich\m, 2013; Hanbury et al.,\m 2013; Harper & Pergament, 2015; Iacoviello & Charney, 2014; Petra\bek Macdonald, Ford, Cun\bolo Willox, & Ro\b\b, 2013; Prince-Embury, 2013). Po\bitively reapprai\bing one’\b circum\btance\b help\b move one forward rather than becoming \btuck in a cycle of negative emotion\b. Additionally, optimi\bm likely contribute\b to a per\bon’\b ability to feel po\bitive emotion\b during a hard time, which may help people better recover and cope (Terp\btra, 2011). In a \btudy of low-income mother\b who \burvived Hurricane Katrina, Lowe et al. (2013) found that optimi\bm helped the m\mother\b adju\bt and grow after a di\ba\bter. Of cour\be, exce\b\bive optimi\bm may re\bult in di\bappointment or \bur\mpri\be if the expected outcome doe\b not c ome to pa\b\b; therefore, the right balance i\b needed. 3. Cultivate active coping and self-regulation. Another \btrength i\b active coping, which involve\b cognitive dimen\bion\b, \buch a\b maintainin\mg an awarene\b\b of one’\b own thought\b and apprai\bal\b, and behavioral dimen\bion\b, \buch a\b continuou\bly \beeking\m \bolution\b and \buppor\mt (Iacoviello & Charney, 2014). Self-regulation, or the abili\mty to control one’\b immediate impul\be\b in favor of a more con\bidered, long-term \btrategy, i\b another characteri\btic of re\bilient individual\m\b (National Scientific Council on the Developing Child, 2015). 4. Find a source of personal mean\ding. Involvement in a faith community ha\b been ci\mted a\b a protective factor for mental health in\m \beveral interview \btudie\b with people experiencing trauma (e.g., Cline, Orom, Child, Hernandez, & Black, 2015; Fernando, 2012; Harper & Pargament, 2015; Weine et al., 2014). For many, faith give\b a \ben\be of peace during difficulty (\mMark\b, Hatch, Lu, & Cherry, 2015), and \btudie\b have \bhown that having a \bpiritual practice tend\b to boo\bt an individual’\b well-being and can b\me an important coping re\bource. In addition to the \bocial \bupport that i\b often provided by a faith community, having a \bpiritual practice can help people manage a\mnd find meaning in \buffering during \bignifi\mcant adver\bity (Ram\ba y & Mander\bon, 2011). Mindfulness can be another type\m of practice, through yoga and meditation, that give\b people a greater \ben\be of purpo\be and \mmeaning (Garland, Farb, Goldin, & Fredrick\bon, 2015). In each ca\be, the ability to flexibly reapprai\be adver\be event\b in a way that enhance\b a \ben\be of meanin\mg i\b key for promoting per\bonal well-being. 5. Boost personal preparedness. Mental health can b\me incorporated into exi\bting di\ba\bter preparation effort\b. Recommendation\b for \bhort-term di\ba\bter or emergency kit\b often include thing\b lik e food, water, \bupplie\b, and medic\mation. Yet item\b that can pre\berve and \bhore up mental health are al\bo equally impor\mtant to include (Mi\b\bouri Department of \mMental Health, 2006). The\be item\b might include comfort item\b, \buch a\b \bpiritual\m or religiou\b object\b, picture\b, blanket\b and toy\b for \bmall children, favorite food\b or treat\b to \bupplement \btable \bhelf food, recreational item\b \buch a\b book\b and\m game\b, and paper and writing i\mn\btrument\b to journal or write down important information. Pet\b, which al\bo provide \bome with a \ben\m\be of c omfort, mu\bt al\bo be con\bidered when making emergency kit\b and plan\b (Center\b for Di\bea\be Control and Prevention, 2016; American Red Cro\b\b, 2017). Public agencie\b and other \morganization\b may al\bo want to encourage community member\b to incorporate the\be item\b into their di\ba\bter preparation kit\b. Other facet\b of preparedne\b\b, including family, neighborhood, \bchoo\ml, and work re\bpon\be plan\b and other mea\b\mure\b, can help increa\be confidence and the feeling of \baf ety and reduce fear. SOCIAL CO\b\bECTIO\b 6. Support social n\iet\forks. Individual\b’ per\bonal capacity to with\btand trauma i\b increa\bed when they are connected to their network\b off-and online. One \btrategy frequently noted in re\bilience \btudie\b i\b cultivating and maintainin\mg \btrong \bocial connection\b (Iacoviello & Charney, 2014). Connectedne\b\b to other\b i\b a core p\bychological need and\m an e\b\bential foundation for well-being (e.g., Deci & Ryan, 2011). During difficult\m time\b, people turn to tho\be they are clo\be to, \buch a\b family, friend\b, and neig\mhbor\b, for emotional \bupport, a\b well a\b material help (e.g., money, food, or a temporary place to \btay). Re\bilience \bcholar\b note that \bocial \bupport i\b a critical protective re\bource during adver\bity (Kania\bty, 2012). Re\bearcher\b have found that higher level\b of \bocial \bupport during and i\mn the aftermath of a di\ba\b ter are a\b\bociated with lower rate\b of p\bychological di\btre\b\b (Greene, Paranjothy, & Palmer, 2015; Self-Brown, Ander\bon, Edward\b, & McGill, 2013). The po\bitive mental health impact\m of a \btrong \bocial \bupport \by\btem, or the negative impact\b of lower \bocial \bupport, ca\mn per\bi\bt for year\b after a di\ba\bter, \buch a\b a hurrican\me (Bank\b & Weem\b, 2014). A\b de\bcribed ab\move, a faith community, or any other tight-knit\m and \bupportive \bocial network, can provide \bignificant emotional\m and material \bupport (Cain & Barthelemy, 2008; Mark\b et al\m., 2015). People living in area\b mo\bt impacted by Hurricane Katrina reported in an interview \btudy that their “church family” (p. 256) offered them a li\btening ear, empathy, and moral \bupport in the extremely difficult aftermath of the hurricane (Mark\b et al., 2015). 7. Encoura\be connection \fith parents, family, and other role models. The \bupportof family and clo\be connection\b are particularly impor\mtant for children. Parent\b are likely the mo\bt central \bource of \bupport for children during trauma and adver\bity, and children are at higher ri\bk of

44 Mental Health and Our Changing Climate: \fmpacts\b \fmplications\b and Guidance American Psychological Association | ecoAmerica 45 long-term physiological and ment\:al health stress burdens when parents themselves suffer acute levels of distress (Simpson et al.\b 2011; Weine et al.\b 2014). Petrasek MacDonald et al. (2015) reported that spending time with \:family and friends helps protect the mental heal\:th of youth enduring the impact\:s of climate change on their land and \:environment. Parents and caregivers also serve as buffer against trauma and protect children from neglect and abuse by providing necessities\b such as shelter and food (Kousky\b 2016). Support for children can come from outside the family as well. The National Scientific Council on the Developing Child (2015) found that children and youth optimize resilience during adversity if they have the help of non-ca\:regiver role models\b such as teachers or coaches. These role models are especially import\:ant following natural disaster events. Children look to parents and other caregivers as models in managing their \:emotions. Effective c oping strategies should be tau\:ght during this time\b such as encouraging children to talk about the event or turning to other resilient communities that have endured natural disasters and recovered (Lazarus\b Jimerson\b & Brock\b 2002). Support networks\b such as the National Alliance on Mental Health’s Parents and Teachers as Allies program\b can help these r\:ole models identify children with mental ill\:ness and relay the proper resources to parents. 8. When possible, uphold connection to place. As climate change alters the landscape\b it also forces change upon cultu\:res tied to the land. As already noted\b indigenous communities are experiencing rapid cultural change as the climate warms and makes many traditional cultural practices difficult. Research in affected communities indicates that people do not wi\:sh to leave their homes\b despit e the changes they may experience (e.g.\b Cunsolo Willox et al.\b 2012). Staying in a place to which one feels connected can increase resilience because people are more likely to take adaptive actions\b such as preparing for flooding (A dger et al.\b 2013). \f. Maintain connections to one’s culture. New immigrant and refugee communities are another vulnerable group whose mental health bene\:fits from a connection to culture\b especially during \:adversity. Weine et al. (2014) interviewed Burundian and Liberian refugees\b many of whom were adolescents who had recently moved to the United States. The authors noted family cohesion\b participation in religious traditions\b and cultural connectedness were resources that protected individuals’ men\:tal health during difficult time\:s. Refugees may find it particularly imp\:ortant to maintain cultural connections as their \:homes have been disrupted (Fullilove\b 2013). \fn order to support individua\:ls’ success in becoming resilient\b the following are tips to consider that address personal attributes and support socia\:l cohesion: 1. Build belief in on\:e’s own resilience. 2. Foster optimism. 3. Cultivate active coping and self-regulation. 4. Find a source of personal meani\:ng. 5. Boost personal preparedness. 6. Support social netw\:orks. 7. Encourage connection to parents\b family\b and other role models. 8. Uphold connection to place. 9. Maintain connections to one’s culture. \bEY TA\bEAWAYS: Tips to Support Individual\as T\fPS TO SUPPORT COMMUN\fT\fES We know a great deal about what helps individuals\: become more resilient. \fn contrast\b little research has explored psycho-social resilience at the community level (Bonanno\b Romero\b & Klein\b 2015). A resilient and healthy community is not just the sum of many resilient individual\:s; it multiplies individual capacity\: by bringing people \:together for joint action and mutual support.\: Resilience also requires more than crisis preparedness. To be resilient in the face of climate change\b a community must have the flexibility to respond to the entire unpredictable array of potential climate impacts. Communities must be ready for sudden traumatic events\b such as extreme storms\b heat waves\b and floods. Communities should a\:lso make plans that include tools for the slow\b unsettling alterations of climate change\b such as increasingly warmer winters or changes in local wil\:dlife and plant communities. Among other benefit\:s\b communities can be a\: source of stability and safety for their citizens or members. Hum\:ans fare better when they perceive the world around them as orderly\b predictable\b and benevolent (e.g.\b Hanbury et al.\b 2013; Kaniasty\b 2012). As noted earlier\b climate change brings great unpredictability and un\:certainty for the future. Many people have difficulty coming to terms with the negative news they hear about climate change; they feel loss and despair. Similar to natural disasters and other large-scale traumas\b climate change may cause people to question their beliefs \:about themselves\b the people around them\b and the world (e.g.\b Harper & Pargament\b 2015; Marks et al.\b 2015). Similar to sufferers of physical trauma\b people need tools to manage their anx\:iety and other feelings (Bonanno\b 2008). To help restore people’s equilibrium and their faith that there is good in the world\b here are some tips to consider when buildi\:ng resilient communities. COMMUNITY SUPPORT AND PLANNING 1. Assess and expand community mental hea\alth infrastructure. \fnfrastructure plays an enormous role in shaping how vulnerable communities are to psychological impacts. A community with poor\: infrastructure is more vulnerable to the physical impacts of clim\:ate change\b which\b in turn\b aff\:ect mental health. Men\:tal health infrastructure\b in particular\b should be assessed (Weissbecker & Czinez\b 2011). Dominelli (2013) suggested that part of the assessment of the mental\: health infrastructure should include qu\:estions about who may be available on an informal basis to provide help\b care\b medicine\b and comfort when formal services break down. For example\b neighbors and community members ar\:e often Building resilience for disasters and confronting the gradual changes due to climate change will help communities alleviate adverse health outcomes. Although these tip\as are targeted toward city, state, and national planners and \apolicymakers, a range of organizations (from public health agencies to faith-based communities) can use these suggestions to advance efforts and strengthen communities’ response to disasters and gradual climate impacts.

44 Mental Health and Our Changing Climate: \fmpacts\b \fmplications\b and Guidance American Psychological Association | ecoAmerica 45 long-term physiological and ment\:al health stress burdens when parents themselves suffer acute levels of distress (Simpson et al.\b 2011; Weine et al.\b 2014). Petrasek MacDonald et al. (2015) reported that spending time with \:family and friends helps protect the mental heal\:th of youth enduring the impact\:s of climate change on their land and \:environment. Parents and caregivers also serve as buffer against trauma and protect children from neglect and abuse by providing necessities\b such as shelter and food (Kousky\b 2016). Support for children can come from outside the family as well. The National Scientific Council on the Developing Child (2015) found that children and youth optimize resilience during adversity if they have the help of non-ca\:regiver role models\b such as teachers or coaches. These role models are especially import\:ant following natural disaster events. Children look to parents and other caregivers as models in managing their \:emotions. Effective c oping strategies should be tau\:ght during this time\b such as encouraging children to talk about the event or turning to other resilient communities that have endured natural disasters and recovered (Lazarus\b Jimerson\b & Brock\b 2002). Support networks\b such as the National Alliance on Mental Health’s Parents and Teachers as Allies program\b can help these r\:ole models identify children with mental ill\:ness and relay the proper resources to parents. 8. When possible, uphold connection to place. As climate change alters the landscape\b it also forces change upon cultu\:res tied to the land. As already noted\b indigenous communities are experiencing rapid cultural change as the climate warms and makes many traditional cultural practices difficult. Research in affected communities indicates that people do not wi\:sh to leave their homes\b despit e the changes they may experience (e.g.\b Cunsolo Willox et al.\b 2012). Staying in a place to which one feels connected can increase resilience because people are more likely to take adaptive actions\b such as preparing for flooding (A dger et al.\b 2013). \f. Maintain connections to one’s culture. New immigrant and refugee communities are another vulnerable group whose mental health bene\:fits from a connection to culture\b especially during \:adversity. Weine et al. (2014) interviewed Burundian and Liberian refugees\b many of whom were adolescents who had recently moved to the United States. The authors noted family cohesion\b participation in religious traditions\b and cultural connectedness were resources that protected individuals’ men\:tal health during difficult time\:s. Refugees may find it particularly imp\:ortant to maintain cultural connections as their \:homes have been disrupted (Fullilove\b 2013). \fn order to support individua\:ls’ success in becoming resilient\b the following are tips to consider that address personal attributes and support socia\:l cohesion: 1. Build belief in on\:e’s own resilience. 2. Foster optimism. 3. Cultivate active coping and self-regulation. 4. Find a source of personal meani\:ng. 5. Boost personal preparedness. 6. Support social netw\:orks. 7. Encourage connection to parents\b family\b and other role models. 8. Uphold connection to place. 9. Maintain connections to one’s culture. \bEY TA\bEAWAYS: Tips to Support Individual\as z\fAD.zb.DAAbz.ub (\fz\fffD yW.BhEO.n.d,Wne.iWnp.nCEle.Osne.sWpMr.chicUcilnpr\a.CW’EtW . tE,W.,WrcpcWheL.\fh.’Ehe,nre\b.pceepW.,WrWn,’s.snr.WMpE,Wi. . MrS’sEvrE’cnp.,WrcpcWh’W.ne.esW.’EttlhceS.pWUWp.REhnhhE\b. EtW,E\b..wpWch\b.G1xIfL.T.,WrcpcWhe.nhi.healthy community is not just the sum of many resilient individual\:s; it multiplies individual capacity\: by bringing people \:together for joint action and mutual support.\: Resilience also requires more than crisis preparedness. To be resilient in the face of climate change\b a community must have the flexibility to respond to the entire unpredictable array of potential climate impacts. Communities must be ready for sudden traumatic events\b such as extreme storms\b heat waves\b and floods. Communities should a\:lso make plans that include tools for the slow\b unsettling alterations of climate change\b such as increasingly warmer winters or changes in local wil\:dlife and plant communities. Among other benefit\:s\b communities can be a\: source of stability and safety for their citizens or members. Hum\:ans fare better when they perceive the world around them as orderly\b predictable\b and benevolent (e.g.\b Hanbury et al.\b 2013; Kaniasty\b 2012). As noted earlier\b climate change brings great unpredictability and un\:certainty for the future. Many people have difficulty coming to terms with the negative news they hear about climate change; they feel loss and despair. Similar to natural disasters and other large-scale traumas\b climate change may cause people to question their beliefs \:about themselves\b the people around them\b and the world (e.g.\b Harper & Pargament\b 2015; Marks et al.\b 2015). Similar to sufferers of physical trauma\b people need tools to manage their anx\:iety and other feelings (Bonanno\b 2008). To help restore people’s equilibrium and their faith that there is good in the world\b here are some tips to consider when buildi\:ng resilient communities. COMMUNITY SUPPORT AND PLANNING 1. Assess and expand community mental hea\alth infrastructure. \fnfrastructure plays an enormous role in shaping how vulnerable communities are to psychological impacts. A community with poor\: infrastructure is more vulnerable to the physical impacts of clim\:ate change\b which\b in turn\b aff\:ect mental health. Men\:tal health infrastructure\b in particular\b should be assessed (Weissbecker & Czinez\b 2011). Dominelli (2013) suggested that part of the assessment of the mental\: health infrastructure should include qu\:estions about who may be available on an informal basis to provide help\b care\b medicine\b and comfort when formal services break down. For example\b neighbors and community members ar\:e often Building resilience for disasters and confronting the gradual changes due to climate change will help communities alleviate adverse health outcomes. Although these tip\as are targeted toward city, state, and national planners and \apolicymakers, a range of organizations (from public health agencies to faith-based communities) can use these suggestions to advance efforts and strengthen communities’ response to disasters and gradual climate impacts.

46 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 47 the mo\bt available and the quicke\bt to help people in their proximity (Dominelli, 2013). When a\b\be\b\bing the community mental health infra\btructure, here are \bome \bpecific que\btion\b to con\bider\f 1. Doe\b the community have a plan to \berve people in need af\mter a \bhock/di\ba\bter? 2. Doe\b the community have the capacity to \berve the potential increa\bed need\b of peopl\me a\b climate impact\b grow? 3. Currently, can all community member\b acce\b\b the mental health\m care they need? 4. What are the gap\b, and wha\mt area\b of \bervice may need to be augmented? 5. I\b there a di\ba\bter mental health coalition? Public health agenci\me\b are one channel for guiding and encouraging the expan\bion of infra\btructure for adaptation and preparation. Although many public health official\b do not yet perceive addre\b\bing climate change a\b a priori\mty for their agencie\b, tho\be who \mperceive greater ri\bk from climate change are more likely to have begun to addre\b\b it (Syal, Wil\bon, Crawford, & Lutz, 2011). 2. Facilitate social cohesion thro\fgh comm\fnity \besign. Individual mental h\mealth i\b better in communitie\b with \btronger \bocial fabric (Friedli, 2009). S\mtrong community network\b more ea\bily develop in neighborhoo\md\b with \bpace\b and organization\b that bring people together, \buch a\b community center\b, park\b, and a \btreet\bcape of \bhop\b and \bidewalk\b. Thi\b idea wa\b borne out during the 1995 Chicago heat wave, when an analy\bi\b comparing two neighborhood\b \bhowed that people living in \mChicago’\b Auburn Gre\bham neighborhood \mfared much better through the heat wave than tho\be in the adjacent and demographically \bimilar (poor and la\mrgely African American) Englewood neighborhood. \mHeat wave– related death\b in Englewood were more than three time\b that of Auburn Gre\bham, and \bcholar\b attribute the low heat wave fatality rate in Auburn Gre\bham, which wa\b lower than that of many very affluent Chicago neighborhoo\md\b, to the high \bocial cohe\bion facilitated through an urban land\bcape of \bhop\b, pu\mblic \bpace\b, and community organization\b (Klinenberg, 2013). During the he\mat wave, people in the Auburn Gre\bham neighborhood \mwere more likely to check on one anot\mher, and thu\b, the mo\bt vulnerable, \buch a\b the hou\bebound elderly, had a lifeline. 3. Train the people who\r will serve the comm\fnity \b\fring a \bisa\rster. Following a di\ba\bter, when people are in the throe\b of extreme di\btre\b\b and high emotion typical in the immediate aftermath (e.g., fear, anger, terror, helple\b\bne\b\b, \bhock, grief), it i\b crucial that the \bervice\b available to them be \ben\bitive and interactive (Raphael, 2007). However, in the ru\bh to provide ba\bic nece\b\bitie\b and to \bearch for and re\bcue mi\b\bing or injured people, thi\b type of compa\b\bion may not alway\b be pre\bent. Hobfoll (2007) offered five evidence-ba\bed principle\b to guide intervention in the aftermath of a di\ba\bter or acute event and to move re\bcue worker\b and re\bponder\b toward compa\b\bion. Communitie\b that implement the\be princ\miple\b, by training fir\bt re\bponder\b and other\b\m, can limit the lon\mg- term negative p\bychological con\bequence\b and trauma of acute event\b. The goal\b include promoting the following\f 1. A \ben\be of \bafety 2. Calmne\b\b 3. A po\bitive sense of self and a \ben\be of community efficacy 4. Connectedne\b\b 5. Hope (Continue\b on page 48\m) A CLOSER LOOK Fin\bing a Place for Psychology in Climate Change Deliberations, Linda Silka, PhD One of the overarching concern\b about climate change i\b it\b impac\mt on the infra\btructure we all depend on. What happen\b to vulnerable neighborhood\b when road\b and bridge\b are de\btroyed by extreme precipitation or when hurri\mcane\b hit a coa\btal community, leaving emergency \bervice\b unable to reach the familie\b hit harde\bt? How do communitie\b get the information they need to prepare for \buch event\b and build re\bilience in the face of the changing climate? In New England, many major citie\b are right on the ocean. Key part\b of our infra\btructure—road\b and bridge\b an\md the like—could be underwater in the not-too-di\btant future. Variou\b kind\b of experti\be are needed for the complex ta\bk of preparing for the\be impact\b. I’ve \been thi\b fir\bthand a\b part of th\me Infra\btructure and Climate Network (theicnet.org), an NSF-funded network that bring\b together infra\btructure engineer\b, climate \bcienti\bt\b, and other re\bearcher\b, \buch a\b p\bychologi\bt\b, to \btrengthen communication acro\b\b relevant di\bcipline\b. Through web\bite\b, work\bhop\b, webinar\b, and writin\mg, ICNet member\b have found innovative way\b to overcome di\bciplinary diff\merence\b, acro\b\b varying model\b of in\mfra\btructure failure and climate uncertainty, in order to provide information that can help communitie\b prepare and adapt. A\b re\bearcher\b from diver\be field\b of \btudy, we have talked together, \bhared model\b and approache\b, and worked with practitioner\b \buch a\b i\mn-\btate department\b of tran\bportation, in order to develop integrated roadmap\b for addre\b\bing climate change. After four year\b of work, we now have much more actionable \btrategie\b for how the people on the\m ground can prepare for the coming climate change. In one of our mo\b\mt exciting ICNet meetin\mg\b, a leading climate modeler involved in ICNet (Dr. Katherine Hayhoe of Texa\b Tech), along\bide \bcho\mlar\b from other di\bcipline\b,\m pre\bented climate change model\b to a room full of infra\btructure \bpeciali\bt\b from throughout New England. Participant\b repeatedly \baid afterward that for the fir\bt time they could \bee how they could actually u\be climate change information to prepare for coming challenge\b. I wa\b brought in a\b a \bocial\m and community p\bychologi\bt becau\be the ICNet\m team member\b realized that they needed experti\be in cro\b\b-di\bciplinary communication. There i\b much that p\bychology can contribute that too often goe\b untapped becau\be\m it i\b not labeled \m a\b relevant to climate change. P\bychology i\b central to much of what i\b being di\bcu\b\bed, \buch a\b the worrie\b the other di\bcipline\b expre\b\bed about how their finding\b will be impl\memented. P\bychological re\bearch can help addre\b\b group proce\b\b, community problem-\bolving, \bocia\ml cohe\bion and connectedne\b\b, lack of tru\bt between community member\b and \m in\btitution\b, difference\b in vulnerability, attitude–behavior link\b, heuri\btic\b and ri\bk perception, and fear appeal\b. We p\bychologi\bt\b have an important role to play in helping profe\b\bional\b from different field\b collaborate effectively to prepare for climate impact\b.

46 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 47 the mo\bt available and the quicke\bt to help people in their proximity (Dominelli, 2013). When a\b\be\b\bing the community mental health infra\btructure, here are \bome \bpecific que\btion\b to con\bider\f 1. Doe\b the community have a plan to \berve people in need af\mter a \bhock/di\ba\bter? 2. Doe\b the community have the capacity to \berve the potential increa\bed need\b of peopl\me a\b climate impact\b grow? 3. Currently, can all community member\b acce\b\b the mental health\m care they need? 4. What are the gap\b, and wha\mt area\b of \bervice may need to be augmented? 5. I\b there a di\ba\bter mental health coalition? Public health agenci\me\b are one channel for guiding and encouraging the expan\bion of infra\btructure for adaptation and preparation. Although many public health official\b do not yet perceive addre\b\bing climate change a\b a priori\mty for their agencie\b, tho\be who \mperceive greater ri\bk from climate change are more likely to have begun to addre\b\b it (Syal, Wil\bon, Crawford, & Lutz, 2011). 2. Facilitate social cohesion thro\fgh comm\fnity \besign. Individual mental h\mealth i\b better in communitie\b with \btronger \bocial fabric (Friedli, 2009). S\mtrong community network\b more ea\bily develop in neighborhoo\md\b with \bpace\b and organization\b that bring people together, \buch a\b community center\b, park\b, and a \btreet\bcape of \bhop\b and \bidewalk\b. Thi\b idea wa\b borne out during the 1995 Chicago heat wave, when an analy\bi\b comparing two neighborhood\b \bhowed that people living in \mChicago’\b Auburn Gre\bham neighborhood \mfared much better through the heat wave than tho\be in the adjacent and demographically \bimilar (poor and la\mrgely African American) Englewood neighborhood. \mHeat wave– related death\b in Englewood were more than three time\b that of Auburn Gre\bham, and \bcholar\b attribute the low heat wave fatality rate in Auburn Gre\bham, which wa\b lower than that of many very affluent Chicago neighborhoo\md\b, to the high \bocial cohe\bion facilitated through an urban land\bcape of \bhop\b, pu\mblic \bpace\b, and community organization\b (Klinenberg, 2013). During the he\mat wave, people in the Auburn Gre\bham neighborhood \mwere more likely to check on one anot\mher, and thu\b, the mo\bt vulnerable, \buch a\b the hou\bebound elderly, had a lifeline. 3. Train the people who\r will serve the comm\fnity \b\fring a \bisa\rster. Following a di\ba\bter, when people are in the throe\b of extreme di\btre\b\b and high emotion typical in the immediate aftermath (e.g., fear, anger, terror, helple\b\bne\b\b, \bhock, grief), it i\b crucial that the \bervice\b available to them be \ben\bitive and interactive (Raphael, 2007). However, in the ru\bh to provide ba\bic nece\b\bitie\b and to \bearch for and re\bcue mi\b\bing or injured people, thi\b type of compa\b\bion may not alway\b be pre\bent. Hobfoll (2007) offered five evidence-ba\bed principle\b to guide intervention in the aftermath of a di\ba\bter or acute event and to move re\bcue worker\b and re\bponder\b toward compa\b\bion. Communitie\b that implement the\be princ\miple\b, by training fir\bt re\bponder\b and other\b\m, can limit the lon\mg- term negative p\bychological con\bequence\b and trauma of acute event\b. The goal\b include promoting the following\f 1. A \ben\be of \bafety 2. Calmne\b\b 3. A po\bitive sense of self and a \ben\be of community efficacy 4. Connectedne\b\b 5. Hope (Continue\b on page 48\m) A CLOSER LOOK Fin\bing a Place for Psychology in Climate Change Deliberations, Linda Silka, PhD One of the overarching concern\b about climate change i\b it\b impac\mt on the infra\btructure we all depend on. What happen\b to vulnerable neighborhood\b when road\b and bridge\b are de\btroyed by extreme precipitation or when hurri\mcane\b hit a coa\btal community, leaving emergency \bervice\b unable to reach the familie\b hit harde\bt? How do communitie\b get the information they need to prepare for \buch event\b and build re\bilience in the face of the changing climate? In New England, many major citie\b are right on the ocean. Key part\b of our infra\btructure—road\b and bridge\b an\md the like—could be underwater in the not-too-di\btant future. Variou\b kind\b of experti\be are needed for the complex ta\bk of preparing for the\be impact\b. I’ve \been thi\b fir\bthand a\b part of th\me Infra\btructure and Climate Network (theicnet.org), an NSF-funded network that bring\b together infra\btructure engineer\b, climate \bcienti\bt\b, and other re\bearcher\b, \buch a\b p\bychologi\bt\b, to \btrengthen communication acro\b\b relevant di\bcipline\b. Through web\bite\b, work\bhop\b, webinar\b, and writin\mg, ICNet member\b have found innovative way\b to overcome di\bciplinary diff\merence\b, acro\b\b varying model\b of in\mfra\btructure failure and climate uncertainty, in order to provide information that can help communitie\b prepare and adapt. A\b re\bearcher\b from diver\be field\b of \btudy, we have talked together, \bhared model\b and approache\b, and worked with practitioner\b \buch a\b i\mn-\btate department\b of tran\bportation, in order to develop integrated roadmap\b for addre\b\bing climate change. After four year\b of work, we now have much more actionable \btrategie\b for how the people on the\m ground can prepare for the coming climate change. In one of our mo\b\mt exciting ICNet meetin\mg\b, a leading climate modeler involved in ICNet (Dr. Katherine Hayhoe of Texa\b Tech), along\bide \bcho\mlar\b from other di\bcipline\b,\m pre\bented climate change model\b to a room full of infra\btructure \bpeciali\bt\b from throughout New England. Participant\b repeatedly \baid afterward that for the fir\bt time they could \bee how they could actually u\be climate change information to prepare for coming challenge\b. I wa\b brought in a\b a \bocial\m and community p\bychologi\bt becau\be the ICNet\m team member\b realized that they needed experti\be in cro\b\b-di\bciplinary communication. There i\b much that p\bychology can contribute that too often goe\b untapped becau\be\m it i\b not labeled \m a\b relevant to climate change. P\bychology i\b central to much of what i\b being di\bcu\b\bed, \buch a\b the worrie\b the other di\bcipline\b expre\b\bed about how their finding\b will be impl\memented. P\bychological re\bearch can help addre\b\b group proce\b\b, community problem-\bolving, \bocia\ml cohe\bion and connectedne\b\b, lack of tru\bt between community member\b and \m in\btitution\b, difference\b in vulnerability, attitude–behavior link\b, heuri\btic\b and ri\bk perception, and fear appeal\b. We p\bychologi\bt\b have an important role to play in helping profe\b\bional\b from different field\b collaborate effectively to prepare for climate impact\b.

48 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 49 It i\b al\bo important\m that fir\bt re\bponder\b and other\b be trained to recognize the \bign\b and \bymptom\b of mental health\m di\btre\b\b, which vary widely acro\b\b cultural communitie\b and \btage\b of life. Equally a\b important i\b cro\b\b-training between mental health and fi\mr\bt re\bponder\b. Tho\be \buffering acute emotional trauma benefit from immediate a\b\bi\btance (Madrid & Grant, 2008), and it i\b important\m that available re\bource\b be focu\bed upon tho\be wh\mo need them mo\bt. Critical incident \ stress management can be u\bed to help alleviate the potential for developing PTSD (Everly, Flannery, & Eyler, 2002). Among the growing number of clima\mte refugee\b forced to relocate, \bome expert\b recommend having \bcreening tool\b to a\b\be\b\b lo\b\be\b in phy\bical and p\bychological re\bource\b, need\b, and \bymptom\b (Hollifield, Ful\mlilove, & Hobfoll, 2011). Not everyone experience\b p\bychological di\btre\b\b after a di\ba\bter, and \bome may be wor\be off if they are coerced into participating in an unnece\b\bary intervention (Bonanno, 2008). Diver\bity training i\b al\bo e\b\bential for tho\be who work in community facilitie\b, \buch a\b de\bignated cooling center\b or \bhelter\b, where people from all background\b may \beek aid and a\b\bi\btance. Tho\be running the\be facilitie\b mu\bt en\bure a \bafe and welcoming environment for all community member\b regardle\b\b of gender identit\my, age, racial or ethnic back\mground, \bexual orientation, or religion (Phadke, Manning, & Burlager, 2015). 4. Provide clear and frequent information. In an example of a \blowly evolving environmental di\ba\bter (an a\bbe\bto\b leak in a Montana town characterized by high level\b of uncertainty), people e\mxpre\b\bed the need for clear information (Cline et al., 2015). Tho\be affected by the di\ba\bter al\bo had unmet emoti\monal need\b becau\be other\b in the community did not recognize or acknowledge their \buffering. It i\b po\b\bible that tho\be feeling trauma from the gradual impact\b of climate change may experience a \bimilar need for informational and emotiona\ml \bupport. One barrier\m to thi\b kind of \buppo\mrt i\b a he\bitance that many people feel to talk about climate change with other\m\b. It i\b critical that tho\be communicating with impacted people are \been a\b reliable, legitimate, and credible (Stockholm Environment In\btitute, 2016). Information from other communitie\b that have already experienced \bignificant di\ba\bter\b can be invaluable in helping communitie\b prepare for climate change\b. \f. Reduce disparities. Communitie\b a\b a whol\me cope better with an acute event when economic di\bparity i\b reduced and the need\b of\m the economically vulnerable are attended to in advance (Iacoviello & Charney, 2014; Norri\b et al., \m2008). Wicke\b, Zahnow, Taylor, and Piquero (2015), in a \btudy of Bri\bbane, Au\btralia, re\bident\b, found greater community-wide trauma after a flood in area\b with high concentration\b of economically vulnerable people in compari\bon with a \bimilar community where re\bident\b were more affluent. After the flood, affluen\mt neighborhood\b with \macce\b\b to material re\bource\b di\bplayed greater re\bilience than le\b\b well-off communitie\b, regardle\b\b of their level of \bocial capital\m (Wicke\b et al., 2015). A community with large re\bource di\bparitie\b i\b not re\bilient. To broaden re\bilience community-wide, Bau\b\ban and Kelly (2016) \bugge\bted that communitie\b do what they can to reduce di\bparity by inve\bting in affordable hou\bing, expanding employment opportunitie\b, and i\mmproving public tran\bportation. \b. Pay special attention to vulnerable populations. A\b di\bcu\b\bed throughout thi\b report, not everyone will experience climate change in the \bame way. In particular, low-income communitie\b, indigeno\mu\b group\b, immigrant\b, refugee\b, pregnant women, children, and older adult\b are e\bpecially \bu\bceptible to the p\bychological effect\b of climate change. (See “The Problem of Inequity” \mon page 31.) Planner\b and policymaker\b \bhould take thi\b fact into account when developing program\b and protocol\b to prepare for climate change. Planner\b may al\bo choo\be to u\be climate ri\bk and vulnerability map\b, like tho\be that have been u\bed by the City of Toronto (Gower et al., 2010), to identify area\b and population\b that may be e\bpecially \bu\bceptible to impact\b on human well-being and plan \maccordingly. DISASTER PLANNING 7. Develop trusted and action-focused warning systems. An effective warning \by\btem for \bevere weather event\b can \bave live\b, reduce injurie\b, and reduce property damage from di\ba\bter\b. Unfortunately, the\be \by\btem\b do not alway\b function a\b effectively a\b they could, due, in part, to limitation\b and uncertaintie\b inherent in foreca\bting technologie\b. However, warning \by\btem\b are al\bo often le\b\b effective becau\be individua\ml\b ignore warning\b or downplay them. Re\bearch \bugge\bt\b a number of factor\b that influence the likelihood people will\m take warning\b \beriou\bly an\md take protective action. For example, people with littl\me per\bonal prior experience with a di\ba\bter or who don’t under\m\btand the \beverity of po\b\bible impact\b appear t\mo be le\b\b motivated to take the warning \beriou\bly or\m to \beek further information (e.g., Knocke & Kolivra\b, 2007; Lee, Meyer, & Bradlow, 2009). It i\b al\bo po\b\m\bible that a warning \by\btem that ha\b been wrong on numerou\b occa\bion\b may be perceived a\b unreliable, and thu\b i\b le\b\b likely to evoke a re\bpon\be (for a di\bcu\b\bion, \bee Barne\b, Gr\muntfe\bt, Hayden, Schultz, & Ben\might, 2007). Some re\bearch al\bo \bugge\bt\b that there may be important racial difference\b in how individual\b re\bpond to a warning (e.g., Lachlan, Burke, Spence & Griffin, 2009). Thi\b difference, in turn, can affect the likelihood and \beverity of p\bychological and other impact\b on\m human well-being. Communitie\b \bhould con\bider te\bting their warning \by\btem\b to be \bure that\f 1. All re\bident\b are reached. 2. All re\bident\b under\btand what the warning mean\b and th\me \btep\b they \bhould take to re\bpond to it. 3. The warning\b are perceived a\b reliable and credible. 4. The warning\b communicate that the government and other o\mrganization\b are actively taking \btep\b to care for the community. 8. Provide a fast response. After an acute trauma, \bupport mu\bt be mobilized quickly. Many p\bychological \btre\b\b \bymptom\b \btem from the early pha\be\b \mof a di\ba\bter (Simp\bon et al., \m2011), and a \ben\be that aid i\b \blow in coming, non-exi\btent, or di\btributed unfairly can contribute to people viewing their community a\b uncaring\m and unavailable (Kania\bty, 2012). Tho\be living in the community it\belf, and organization\b located there, are often the quicke\bt to come to other\b’ aid durin\mg a di\ba\bter (Bau\b\ban, 2015), which under\bcore\b the importance of community engagement \min climate re\bilience planning (\bee Section 11 “Engage community member\b” bel\mow). 9. Have a post-disaster plan. A\b noted earlier, p\bychological di\btre\b\b following a di\ba\bter may linger for \beveral year\b. Communitie\b can alleviate \bome of the long-term impact\b with po\bt-di\ba\bter planning, particular\mly targeting lower- re\bourced communitie\b that tend to be harder hit materially and emotion\mally (Bau\b\ban, 2015). One important \melement of a po\bt-di\ba\bter plan i\b the return of evacuated re\bident\b. Although \mpeople may

48 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 49 It i\b al\bo important\m that fir\bt re\bponder\b and other\b be trained to recognize the \bign\b and \bymptom\b of mental health\m di\btre\b\b, which vary widely acro\b\b cultural communitie\b and \btage\b of life. Equally a\b important i\b cro\b\b-training between mental health and fi\mr\bt re\bponder\b. Tho\be \buffering acute emotional trauma benefit from immediate a\b\bi\btance (Madrid & Grant, 2008), and it i\b important\m that available re\bource\b be focu\bed upon tho\be wh\mo need them mo\bt. Critical incident \ stress management can be u\bed to help alleviate the potential for developing PTSD (Everly, Flannery, & Eyler, 2002). Among the growing number of clima\mte refugee\b forced to relocate, \bome expert\b recommend having \bcreening tool\b to a\b\be\b\b lo\b\be\b in phy\bical and p\bychological re\bource\b, need\b, and \bymptom\b (Hollifield, Ful\mlilove, & Hobfoll, 2011). Not everyone experience\b p\bychological di\btre\b\b after a di\ba\bter, and \bome may be wor\be off if they are coerced into participating in an unnece\b\bary intervention (Bonanno, 2008). Diver\bity training i\b al\bo e\b\bential for tho\be who work in community facilitie\b, \buch a\b de\bignated cooling center\b or \bhelter\b, where people from all background\b may \beek aid and a\b\bi\btance. Tho\be running the\be facilitie\b mu\bt en\bure a \bafe and welcoming environment for all community member\b regardle\b\b of gender identit\my, age, racial or ethnic back\mground, \bexual orientation, or religion (Phadke, Manning, & Burlager, 2015). 4. Provide clear and frequent information. In an example of a \blowly evolving environmental di\ba\bter (an a\bbe\bto\b leak in a Montana town characterized by high level\b of uncertainty), people e\mxpre\b\bed the need for clear information (Cline et al., 2015). Tho\be affected by the di\ba\bter al\bo had unmet emoti\monal need\b becau\be other\b in the community did not recognize or acknowledge their \buffering. It i\b po\b\bible that tho\be feeling trauma from the gradual impact\b of climate change may experience a \bimilar need for informational and emotiona\ml \bupport. One barrier\m to thi\b kind of \buppo\mrt i\b a he\bitance that many people feel to talk about climate change with other\m\b. It i\b critical that tho\be communicating with impacted people are \been a\b reliable, legitimate, and credible (Stockholm Environment In\btitute, 2016). Information from other communitie\b that have already experienced \bignificant di\ba\bter\b can be invaluable in helping communitie\b prepare for climate change\b. \f. Reduce disparities. Communitie\b a\b a whol\me cope better with an acute event when economic di\bparity i\b reduced and the need\b of\m the economically vulnerable are attended to in advance (Iacoviello & Charney, 2014; Norri\b et al., \m2008). Wicke\b, Zahnow, Taylor, and Piquero (2015), in a \btudy of Bri\bbane, Au\btralia, re\bident\b, found greater community-wide trauma after a flood in area\b with high concentration\b of economically vulnerable people in compari\bon with a \bimilar community where re\bident\b were more affluent. After the flood, affluen\mt neighborhood\b with \macce\b\b to material re\bource\b di\bplayed greater re\bilience than le\b\b well-off communitie\b, regardle\b\b of their level of \bocial capital\m (Wicke\b et al., 2015). A community with large re\bource di\bparitie\b i\b not re\bilient. To broaden re\bilience community-wide, Bau\b\ban and Kelly (2016) \bugge\bted that communitie\b do what they can to reduce di\bparity by inve\bting in affordable hou\bing, expanding employment opportunitie\b, and i\mmproving public tran\bportation. \b. Pay special attention to vulnerable populations. A\b di\bcu\b\bed throughout thi\b report, not everyone will experience climate change in the \bame way. In particular, low-income communitie\b, indigeno\mu\b group\b, immigrant\b, refugee\b, pregnant women, children, and older adult\b are e\bpecially \bu\bceptible to the p\bychological effect\b of climate change. (See “The Problem of Inequity” \mon page 31.) Planner\b and policymaker\b \bhould take thi\b fact into account when developing program\b and protocol\b to prepare for climate change. Planner\b may al\bo choo\be to u\be climate ri\bk and vulnerability map\b, like tho\be that have been u\bed by the City of Toronto (Gower et al., 2010), to identify area\b and population\b that may be e\bpecially \bu\bceptible to impact\b on human well-being and plan \maccordingly. DISASTER PLANNING 7. Develop trusted and action-focused warning systems. An effective warning \by\btem for \bevere weather event\b can \bave live\b, reduce injurie\b, and reduce property damage from di\ba\bter\b. Unfortunately, the\be \by\btem\b do not alway\b function a\b effectively a\b they could, due, in part, to limitation\b and uncertaintie\b inherent in foreca\bting technologie\b. However, warning \by\btem\b are al\bo often le\b\b effective becau\be individua\ml\b ignore warning\b or downplay them. Re\bearch \bugge\bt\b a number of factor\b that influence the likelihood people will\m take warning\b \beriou\bly an\md take protective action. For example, people with littl\me per\bonal prior experience with a di\ba\bter or who don’t under\m\btand the \beverity of po\b\bible impact\b appear t\mo be le\b\b motivated to take the warning \beriou\bly or\m to \beek further information (e.g., Knocke & Kolivra\b, 2007; Lee, Meyer, & Bradlow, 2009). It i\b al\bo po\b\m\bible that a warning \by\btem that ha\b been wrong on numerou\b occa\bion\b may be perceived a\b unreliable, and thu\b i\b le\b\b likely to evoke a re\bpon\be (for a di\bcu\b\bion, \bee Barne\b, Gr\muntfe\bt, Hayden, Schultz, & Ben\might, 2007). Some re\bearch al\bo \bugge\bt\b that there may be important racial difference\b in how individual\b re\bpond to a warning (e.g., Lachlan, Burke, Spence & Griffin, 2009). Thi\b difference, in turn, can affect the likelihood and \beverity of p\bychological and other impact\b on\m human well-being. Communitie\b \bhould con\bider te\bting their warning \by\btem\b to be \bure that\f 1. All re\bident\b are reached. 2. All re\bident\b under\btand what the warning mean\b and th\me \btep\b they \bhould take to re\bpond to it. 3. The warning\b are perceived a\b reliable and credible. 4. The warning\b communicate that the government and other o\mrganization\b are actively taking \btep\b to care for the community. 8. Provide a fast response. After an acute trauma, \bupport mu\bt be mobilized quickly. Many p\bychological \btre\b\b \bymptom\b \btem from the early pha\be\b \mof a di\ba\bter (Simp\bon et al., \m2011), and a \ben\be that aid i\b \blow in coming, non-exi\btent, or di\btributed unfairly can contribute to people viewing their community a\b uncaring\m and unavailable (Kania\bty, 2012). Tho\be living in the community it\belf, and organization\b located there, are often the quicke\bt to come to other\b’ aid durin\mg a di\ba\bter (Bau\b\ban, 2015), which under\bcore\b the importance of community engagement \min climate re\bilience planning (\bee Section 11 “Engage community member\b” bel\mow). 9. Have a post-disaster plan. A\b noted earlier, p\bychological di\btre\b\b following a di\ba\bter may linger for \beveral year\b. Communitie\b can alleviate \bome of the long-term impact\b with po\bt-di\ba\bter planning, particular\mly targeting lower- re\bourced communitie\b that tend to be harder hit materially and emotion\mally (Bau\b\ban, 2015). One important \melement of a po\bt-di\ba\bter plan i\b the return of evacuated re\bident\b. Although \mpeople may

50 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 51 need to leave their home\b in th\me ca\be of di\ba\bter\b, their rapid return to their home environment\b will avoid the more \bignificant trauma a\b\bociated with di\bplacement. 10. Ensure equitable and tr\oansparent distribution o\f resources. Following an acute event, di\btribution of relief or help may further divide a\m community if it i\b pe\mrceived a\b being done inequitably (Kania\bty, 2012). Of cour\be, di\btribution inequity\m often fall\b along the divi\bion\b of pre-exi\bting inequalitie\b; \mtho\be with greater power and privilege ma\my receive a greater amount or more rapid a\b\bi\btance than people who o\mccupy a marginalized place in the community. Perceived inequitie\b \buch a\m\b the\be can lead to polarization within the community; thi\b kind of tear in the \bocial f\mabric of the community and the concomitant lo\b\b of empathy and connection to other\b are harmful for individual, a\b w\mell a\b group, functioning (Prince-Embury, 2013). Inequitable di\btribution of re\bource\b can al\bo create di\btru\bt of government and in\btitution\b. One way to addre\b\b thi\b inequity i\b by including con\bervation area\b for community garden\b and “foraging,” rather than zoning open \bpace for unu\bed infra\btructure. COMMUNITY ACTION 11. Engage communit\b members. Scholar\b agree that adaptation and re\bilience planning i\b mo\bt likely to \bucceed if the community i\b involved (Cox, 2012; Mo\ber & Boykoff, 2013; Mo\ber & Pike, 2015; Norri\b et al., 2008\m). Top-down di\ba\bter planning deci\bion\b ca\mn be effective in providing ba\bic infra\btructure, \buch a\b emergency re\bponder training, \bhelter\b, or emergency food, water, and energy \bupplie\b. However, given the unpredictability and unevenne\b\b of climate change impact\b, there i\b no top-down, one-\bize-fit\b-all way to prepare a community to re\bpond to climate change. In\btead, planner\b \bhould\m work to help the community, a\b a \bocial unit, prepare it\belf to collectively and creatively re\bpond to p\bychological and \bocial adver\bity (Cox, 2012; Mo\ber & Boykoff, 2013; Norri\b et al., 2\m008). Focu\bing on community-level capacitie\b may al\bo be the mo\bt efficient and effective way to build the re\bilience nece\b\bary for individual\b and communitie\b to \bucce\b\bfully prepare for and cope with the potential p\bychological impact\b of climate change (Cox, 2012; Mo\ber & Pike, 2015). Communitie\b can al\bo coordinate me\b\bage\b and effort\b acro\b\b government and non-government organization\b, which can mul\mtiply the \btrength and validity of the me\b\bage\b before, during, and after di\ba\bter\b. Community member\b \bhou\mld be engaged in all \btage\b of climate change re\biliency work, beginning wit\mh advance planning and capacity building an\md continuing through di\ba\bter management and r\mecovery (Norri\b et al., 2008). To \bcale up the\be \btrategie\b, communitie\b \bhould work with individua\ml\b already involved in communication and engagement to introduce a network that \bupport\b collaboration of the\be \bkill\m\b (Mo\ber & Pike, 2015). Deep community engagement yield\b mu\mltiple benefit\b, \buch a\b utilizing local \bkill\b and mai\mntaining cultural practice\b. A\b an intervention in Haiti demon\btrated, cultural \ben\bitivity i\b an\m e\b\bential feature to en\bure a program’\b acceptance and \bucce\b\b (Ba\btien, 2012). When community member\b are involved in planning, there i\b a greater \ben\be of autonomy and owner\bhip, which i\b likely to increa\be their \ben\be of \mefficacy. Thi\b can help combat the denial and pa\m\b\bivity that undermine effective re\bpon\be (Ojala, 2012; van Zomeren, Spear\b, & Leach, 2010) and decrea\be the \bkeptici\bm that \bome communitie\b feel toward external help (Phadke et al., 2015). Community member\b are al\bo more likely to participate if \bomeone from their \bocial netw\mork i\b already involved in effort\b and reache\b out to them per\bonally (Phadke et al., 2015). Repre\bentation from people from a wide range of background\b in the community i\b more likely to highlight differential vulnerabilitie\b acro\b\b group\b, \buch a\b race, cla\b\b, gender, or economic \btatu\b, and allow them to be addre\b\bed during planning. According to Reed et al. (2013), ameliorating the\be driver\b of inju\btice and vulnerability \bhould be t\mhe focu\b of climate change re\bilience and adaptation planning. 12. Increase cooperation and social cohesion. One problem in mobilizing\m community \bupport after a community-wide traumatic event i\b that tho\be in the \bocia\ml network, whom an individual \mmight otherwi\be count on for a\b\bi\btance or companion\bhip, are likely to al\bo be victim\b of the \bame trauma. Thi\b make\b it difficult for clo\be neighbor\b to come to each other’\b a\b\bi\btance. People within the community are unlikely to be able to repleni\bh their own emotional well-being when all\m are \buffering from a communal re\bource drain (phy\bical, financial, emotional\m). Social cohe\bion can be culti\mvated by bringing people together to di\bcu\b\b and deliberate. People can forge clo\ber \bocial bond\b, improve their communication, and come to agreement that re\bident\b will work together when neede\md. At a minimum, \btrengthening \bocial n\metwork\b may require only that community member\b and \m neighbor\b make an explicit agreement that they will help each ot\mher during adver\bity (Brigg\b & Wei\b\bbecker, 2011). Community planner\b can al\bo de\mvi\be way\b to provide re\bource\b to exi\bting \bocial network\b (Norri\b et al., 200\m2), \buch a\b churche\b and other civic group\b. 13. Provide opportunities \o\for meaning\ful action. \o Community engagement \mduring a cri\bi\b ha\b further benefit\b\m. For one thing, it \m expand\b the reach of effort\b to help tho\be \buffering; a\b the numbe\mr of community member\b involved in helping durin\mg a cri\bi\b increa\be\b, the number of\m people helped al\bo grow\b. The people doing the\m helping may benefit even more than tho\be receiving their aid. \mA well-known finding in p\bychology i\b that one’\b own well-being increa\be\b through helping other\b\m. Re\bearch in trauma-impacted communitie\b ha\b confirmed that thi\b effect hold\b true during per\bonally d\mifficult time\b (Kania\bty, 2012; Petra\bek MacDonald et a\ml., 2013). For example, familie\b experiencing trauma report that helping other\b in\mcrea\bed their own ability to cope (Lietz, 2015). In a \btudy conducted after Hurricane Katrina, interviewee\b empha\bized the importance of “giving back” to other\b in their o\mwn healing proce\b\b (Mark\b et al., 20\m15, p. 256). Becoming involved in po\bt-di\ba\bter Communities can alleviate some o\f the long-term impacts with post-disaster planning

50 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 51 need to leave their home\b in th\me ca\be of di\ba\bter\b, their rapid return to their home environment\b will avoid the more \bignificant trauma a\b\bociated with di\bplacement. 10. Ensure equitable and tr\oansparent distribution o\f resources. Following an acute event, di\btribution of relief or help may further divide a\m community if it i\b pe\mrceived a\b being done inequitably (Kania\bty, 2012). Of cour\be, di\btribution inequity\m often fall\b along the divi\bion\b of pre-exi\bting inequalitie\b; \mtho\be with greater power and privilege ma\my receive a greater amount or more rapid a\b\bi\btance than people who o\mccupy a marginalized place in the community. Perceived inequitie\b \buch a\m\b the\be can lead to polarization within the community; thi\b kind of tear in the \bocial f\mabric of the community and the concomitant lo\b\b of empathy and connection to other\b are harmful for individual, a\b w\mell a\b group, functioning (Prince-Embury, 2013). Inequitable di\btribution of re\bource\b can al\bo create di\btru\bt of government and in\btitution\b. One way to addre\b\b thi\b inequity i\b by including con\bervation area\b for community garden\b and “foraging,” rather than zoning open \bpace for unu\bed infra\btructure. COMMUNITY ACTION 11. Engage communit\b members. Scholar\b agree that adaptation and re\bilience planning i\b mo\bt likely to \bucceed if the community i\b involved (Cox, 2012; Mo\ber & Boykoff, 2013; Mo\ber & Pike, 2015; Norri\b et al., 2008\m). Top-down di\ba\bter planning deci\bion\b ca\mn be effective in providing ba\bic infra\btructure, \buch a\b emergency re\bponder training, \bhelter\b, or emergency food, water, and energy \bupplie\b. However, given the unpredictability and unevenne\b\b of climate change impact\b, there i\b no top-down, one-\bize-fit\b-all way to prepare a community to re\bpond to climate change. In\btead, planner\b \bhould\m work to help the community, a\b a \bocial unit, prepare it\belf to collectively and creatively re\bpond to p\bychological and \bocial adver\bity (Cox, 2012; Mo\ber & Boykoff, 2013; Norri\b et al., 2\m008). Focu\bing on community-level capacitie\b may al\bo be the mo\bt efficient and effective way to build the re\bilience nece\b\bary for individual\b and communitie\b to \bucce\b\bfully prepare for and cope with the potential p\bychological impact\b of climate change (Cox, 2012; Mo\ber & Pike, 2015). Communitie\b can al\bo coordinate me\b\bage\b and effort\b acro\b\b government and non-government organization\b, which can mul\mtiply the \btrength and validity of the me\b\bage\b before, during, and after di\ba\bter\b. Community member\b \bhou\mld be engaged in all \btage\b of climate change re\biliency work, beginning wit\mh advance planning and capacity building an\md continuing through di\ba\bter management and r\mecovery (Norri\b et al., 2008). To \bcale up the\be \btrategie\b, communitie\b \bhould work with individua\ml\b already involved in communication and engagement to introduce a network that \bupport\b collaboration of the\be \bkill\m\b (Mo\ber & Pike, 2015). Deep community engagement yield\b mu\mltiple benefit\b, \buch a\b utilizing local \bkill\b and mai\mntaining cultural practice\b. A\b an intervention in Haiti demon\btrated, cultural \ben\bitivity i\b an\m e\b\bential feature to en\bure a program’\b acceptance and \bucce\b\b (Ba\btien, 2012). When community member\b are involved in planning, there i\b a greater \ben\be of autonomy and owner\bhip, which i\b likely to increa\be their \ben\be of \mefficacy. Thi\b can help combat the denial and pa\m\b\bivity that undermine effective re\bpon\be (Ojala, 2012; van Zomeren, Spear\b, & Leach, 2010) and decrea\be the \bkeptici\bm that \bome communitie\b feel toward external help (Phadke et al., 2015). Community member\b are al\bo more likely to participate if \bomeone from their \bocial netw\mork i\b already involved in effort\b and reache\b out to them per\bonally (Phadke et al., 2015). Repre\bentation from people from a wide range of background\b in the community i\b more likely to highlight differential vulnerabilitie\b acro\b\b group\b, \buch a\b race, cla\b\b, gender, or economic \btatu\b, and allow them to be addre\b\bed during planning. According to Reed et al. (2013), ameliorating the\be driver\b of inju\btice and vulnerability \bhould be t\mhe focu\b of climate change re\bilience and adaptation planning. 12. Increase cooperation and social cohesion. One problem in mobilizing\m community \bupport after a community-wide traumatic event i\b that tho\be in the \bocia\ml network, whom an individual \mmight otherwi\be count on for a\b\bi\btance or companion\bhip, are likely to al\bo be victim\b of the \bame trauma. Thi\b make\b it difficult for clo\be neighbor\b to come to each other’\b a\b\bi\btance. People within the community are unlikely to be able to repleni\bh their own emotional well-being when all\m are \buffering from a communal re\bource drain (phy\bical, financial, emotional\m). Social cohe\bion can be culti\mvated by bringing people together to di\bcu\b\b and deliberate. People can forge clo\ber \bocial bond\b, improve their communication, and come to agreement that re\bident\b will work together when neede\md. At a minimum, \btrengthening \bocial n\metwork\b may require only that community member\b and \m neighbor\b make an explicit agreement that they will help each ot\mher during adver\bity (Brigg\b & Wei\b\bbecker, 2011). Community planner\b can al\bo de\mvi\be way\b to provide re\bource\b to exi\bting \bocial network\b (Norri\b et al., 200\m2), \buch a\b churche\b and other civic group\b. 13. Provide opportunities \o\for meaning\ful action. \o Community engagement \mduring a cri\bi\b ha\b further benefit\b\m. For one thing, it \m expand\b the reach of effort\b to help tho\be \buffering; a\b the numbe\mr of community member\b involved in helping durin\mg a cri\bi\b increa\be\b, the number of\m people helped al\bo grow\b. The people doing the\m helping may benefit even more than tho\be receiving their aid. \mA well-known finding in p\bychology i\b that one’\b own well-being increa\be\b through helping other\b\m. Re\bearch in trauma-impacted communitie\b ha\b confirmed that thi\b effect hold\b true during per\bonally d\mifficult time\b (Kania\bty, 2012; Petra\bek MacDonald et a\ml., 2013). For example, familie\b experiencing trauma report that helping other\b in\mcrea\bed their own ability to cope (Lietz, 2015). In a \btudy conducted after Hurricane Katrina, interviewee\b empha\bized the importance of “giving back” to other\b in their o\mwn healing proce\b\b (Mark\b et al., 20\m15, p. 256). Becoming involved in po\bt-di\ba\bter Communities can alleviate some o\f the long-term impacts with post-disaster planning

52 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 53 community effort\b may al\bo have a \belf- reinforcing po\bitive effect on people’\b perception\b of their own and the community’\b re\bilience. When people \bee fir\bthand that many other\b are participating in re\bilience-building effort\b, they become more confident not only i\mn the collective efficacy of the community but al\bo that help will be available when they them\belve\b need it (Kania\bty, 2012; Kania\bty & Norri\b, 2009).\m Additional Resources for Responding to Mental \fealth Needs \MAfter Disasters The following \bite\b provide helpful overview\b of the \btep\b emergency per\bonnel and indiv\midual\b can take to care for them\belve\b and other\b\f • Center\b for Di\bea\be Control and Prevention • U.S. Department of V\meteran Affair\b • Wa\bhington, D.C. Government • American P\bychiatric A\b\bociation • Federal Emergency Management Agency • PreventionWeb • U.S. Department of H\mealth and Human Service\b • Sub\btance Abu\be & Mental He\malth Service\b Admini\btration • The National Child Traumatic Stre\b\b Network • International Critical Inc\midence Stre\b\b Foundation • The Center for the Study of Traumatic Stre\b\b Community planner\b, po\mlicymaker\b, and additional leader\b \mmay have experience preparing for the phy\bical impact\b of climate change, but it i\b al\bo imp\mortant to be well-equipped for the potential mental health impact\m\b. Here are \bome tip\b to help with preparing and re\bponding to acute and gradual change\f \b. A\b\be\b\b and expand the community mental health infra\btructure. 2. Facilitate \bocial cohe\bion through community de\bign. 3. Train the people who \mwill \berve the community during a d\mi\ba\bter. 4. Provide clear and frequent information. 5. Reduce di\bparitie\b. 6. Pay \bpecial attention to vulnerable population\b. 7. Develop tru\bted and action- focu\bed warning \by\btem\b. 8. Provide a fa\bt re\bpon\be. 9. Have a po\bt-di\ba\bter plan. \b0. En\bure equitable and tr\man\bparent di\btribution of re\bource\b. \b\b. Engage community member\b. \b2. Increa\be cooperation and \bocial cohe\bion. \b3. Provide opportunitie\b f\mor meaningful action.KEY TAKEAWAYS: Tips to Support Communiti\fs WHAT INDIVIDUALS CAN DO P\fopl\f c\bn t\bk\f t\bngibl\f \bctions \bt hom\f \bnd in th\f community to b\fgin to pr\fp\br\f for th\f proj\fct\fd imp\bcts of clim\bt\f ch\bng\f. Th\fs\f \bctions, in turn,\n c\bn provid\f \b gr\f\bt\fr s\fns\f of individu\bl s\fcurity \b\nnd control. This s\fction outlin\fs \nsom\f k\fy st\fps individu\bls c\bn t\bk\f to pr\fp\br\f th\fm-s\flv\fs for th\f m\fnt\bl h\f\blth imp\bcts of clim\bt\f ch\bng\f. ACTIONS AT HOME \fave an emergency plan. For example, emergency- preparedne\b\b organization\b, \buch a\b the F\mederal Emergency Management Agency (FEMA), the CDC,\m and the American Red Cro\b\b, \bugge\bt having a hou\behold emergency plan that everyone i\b aware of and ha\b practiced. They al\bo \bugge\bt creating an emergency kit with \bupplie\b,\m \buch a\b a fla\bhlight, food and water, fir\bt aid \bupplie\b, and \mother thing\b one might ne\med during or after a di\ba\bter. Additional item\b to include in an eme\mrgency kit, \buch a\b a book, religiou\b literature or other \bpiritua\ml item\b, journal, toy\b, or treat\b, can \bupport menta\ml health re\bilience. Awarene\b\b of your work or \bchool’\b emergency plan\b i\b al\bo criti\mcal to en\bure a comprehen\bive plan. Doing \bo can\m help to alleviate anxiety or worry, and potentially in\btill a \ben\be of control and \becurity. Understand one’s own medical needs. \MMedication\b can have a wide number and\m variety of \bide effect\b, which can be inten\bified or pre\bent under certain change\b in \m environment. For example, p\bychotropic medication\b can impact body temperature regulation or water retention. In extreme heat, thi\b could lead to overheating and dehydration. A\bk your pharmaci\bt to explain and provide documentation on the \bide effect\b of your and your family’\b medication\b and include a cheat \bheet of thi\b inf\mormation in your emergency kit. Learn resilience interventions. Variou\b intervention program\b are offered to help people approach adver\bity with active engagement and hope\m. For example, a capacity-building intervention developed by Seligman and Peter\bon (2003) aim\b to bol\bter people’\b coping \bkill\b through a learned optimi\bm framework. The intervention help\b people \mdevelop a \btronger \ben\be of \belf-\mefficacy and feeling\b of control and encourage\b them to practice adaptive \btrategie\b rather than di\bengaging from difficulty. In addition, re\bilience \bcholar\b have noted the importance of \btaying phy\bically active (Iacoviello & Charney, 2014). Phy\bical activity help\b \mregulate mood and boo\bt\b confidence, which can be u\befu\ml if one mu\bt endure through trauma. ACTIONS IN THE COMMUNITY Develop and maintain \Msocial connections. Becau\be of the tremendou\b benefit\b of \m\bocial \bupport, it i\b\m e\b\bential that people nurture their connection to family, friend\b, neighbor\m\b, and other important\m \bocial tie\b, \buch a\b\m people from their

52 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 53 community effort\b may al\bo have a \belf- reinforcing po\bitive effect on people’\b perception\b of their own and the community’\b re\bilience. When people \bee fir\bthand that many other\b are participating in re\bilience-building effort\b, they become more confident not only i\mn the collective efficacy of the community but al\bo that help will be available when they them\belve\b need it (Kania\bty, 2012; Kania\bty & Norri\b, 2009).\m Additional Resources for Responding to Mental \fealth Needs \MAfter Disasters The following \bite\b provide helpful overview\b of the \btep\b emergency per\bonnel and indiv\midual\b can take to care for them\belve\b and other\b\f • Center\b for Di\bea\be Control and Prevention • U.S. Department of V\meteran Affair\b • Wa\bhington, D.C. Government • American P\bychiatric A\b\bociation • Federal Emergency Management Agency • PreventionWeb • U.S. Department of H\mealth and Human Service\b • Sub\btance Abu\be & Mental He\malth Service\b Admini\btration • The National Child Traumatic Stre\b\b Network • International Critical Inc\midence Stre\b\b Foundation • The Center for the Study of Traumatic Stre\b\b Community planner\b, po\mlicymaker\b, and additional leader\b \mmay have experience preparing for the phy\bical impact\b of climate change, but it i\b al\bo imp\mortant to be well-equipped for the potential mental health impact\m\b. Here are \bome tip\b to help with preparing and re\bponding to acute and gradual change\f \b. A\b\be\b\b and expand the community mental health infra\btructure. 2. Facilitate \bocial cohe\bion through community de\bign. 3. Train the people who \mwill \berve the community during a d\mi\ba\bter. 4. Provide clear and frequent information. 5. Reduce di\bparitie\b. 6. Pay \bpecial attention to vulnerable population\b. 7. Develop tru\bted and action- focu\bed warning \by\btem\b. 8. Provide a fa\bt re\bpon\be. 9. Have a po\bt-di\ba\bter plan. \b0. En\bure equitable and tr\man\bparent di\btribution of re\bource\b. \b\b. Engage community member\b. \b2. Increa\be cooperation and \bocial cohe\bion. \b3. Provide opportunitie\b f\mor meaningful action. KEY TAKEAWAYS: Tips to Support Communiti\fs HihYPPPhYrhYt P\fopl\f c\bn t\bk\f t\bngibl\f \bctions \bt hom\f \bnd in th\f community to b\fgin to pr\fp\br\f for th\f proj\fct\fd imp\bcts of clim\bt\f ch\bng\f. Th\fs\f \bctions, in turn,\n c\bn provid\f \b gr\f\bt\fr s\fns\f of individu\bl s\fcurity \b\nnd control. This s\fction outlin\fs \nsom\f k\fy st\fps individu\bls c\bn t\bk\f to pr\fp\br\f th\fm-s\flv\fs for th\f m\fnt\bl h\f\blth imp\bcts of clim\bt\f ch\bng\f. ACTIONS AT HOME \fave an emergency plan. For example, emergency- preparedne\b\b organization\b, \buch a\b the F\mederal Emergency Management Agency (FEMA), the CDC,\m and the American Red Cro\b\b, \bugge\bt having a hou\behold emergency plan that everyone i\b aware of and ha\b practiced. They al\bo \bugge\bt creating an emergency kit with \bupplie\b,\m \buch a\b a fla\bhlight, food and water, fir\bt aid \bupplie\b, and \mother thing\b one might ne\med during or after a di\ba\bter. Additional item\b to include in an eme\mrgency kit, \buch a\b a book, religiou\b literature or other \bpiritua\ml item\b, journal, toy\b, or treat\b, can \bupport menta\ml health re\bilience. Awarene\b\b of your work or \bchool’\b emergency plan\b i\b al\bo criti\mcal to en\bure a comprehen\bive plan. Doing \bo can\m help to alleviate anxiety or worry, and potentially in\btill a \ben\be of control and \becurity. Understand one’s own medical needs. \MMedication\b can have a wide number and\m variety of \bide effect\b, which can be inten\bified or pre\bent under certain change\b in \m environment. For example, p\bychotropic medication\b can impact body temperature regulation or water retention. In extreme heat, thi\b could lead to overheating and dehydration. A\bk your pharmaci\bt to explain and provide documentation on the \bide effect\b of your and your family’\b medication\b and include a cheat \bheet of thi\b inf\mormation in your emergency kit. Learn resilience interventions. Variou\b intervention program\b are offered to help people approach adver\bity with active engagement and hope\m. For example, a capacity-building intervention developed by Seligman and Peter\bon (2003) aim\b to bol\bter people’\b coping \bkill\b through a learned optimi\bm framework. The intervention help\b people \mdevelop a \btronger \ben\be of \belf-\mefficacy and feeling\b of control and encourage\b them to practice adaptive \btrategie\b rather than di\bengaging from difficulty. In addition, re\bilience \bcholar\b have noted the importance of \btaying phy\bically active (Iacoviello & Charney, 2014). Phy\bical activity help\b \mregulate mood and boo\bt\b confidence, which can be u\befu\ml if one mu\bt endure through trauma. ACTIONS IN THE COMMUNITY Develop and maintain \Msocial connections. Becau\be of the tremendou\b benefit\b of \m\bocial \bupport, it i\b\m e\b\bential that people nurture their connection to family, friend\b, neighbor\m\b, and other important\m \bocial tie\b, \buch a\b\m people from their

54 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 55 faith community. Taking the lead in organizing \bomething \mthat bring\b people together, \buch a\b a community event, help\b increa\be community \bocial cohe\bion. A\b already noted, participating in community-level action ha\b multip\mle benefit\b for the individual \mand the community. Support solutions \mto reduce and prevent further climate chan\fe. One way to take action to addre\b\b climate change within the community can be through public awarene\b\b of clean energy or other approache\b to climate change mitigation. Di\bcu\b\bing the co-benefit\b of clean \m energy with family and friend\b \bpr\mead\b the knowledge and facilitate\b change from the ground up. Thi\b proactive approach can help provide tho\be who are concerned about climate change \bome level of p\bychological “relief” and a \ben\be of accompli\bhment in helpin\mg other\b and the environment. Start a community resilience project. Building community re\bilience before climate di\bruption\b pay\b dividend\b in the aftermath of trauma. Although the\b\me effort\b traditionally might h\mave been initiated by a government agency, communitie\b are beginning to under\btand that they are capable of organizing and \bpearheading \buch project\b from within and that the\be effort\b can \btrengthen the fabric of communitie\b in \bu\btainable way\b. Here are a few point\b to keep in mind when building a community re\bilience project\f \b. Gather a diver\be team of \btakeholder\b to create a \bhared vi\bion, catalog local re\bource\b, identify gap\b in \berv\mice\b, and create a manageable plan\m. 2. Be flexible and inclu\bive, re\bpect cultural \ben\bitivitie\b, keep an open mind about what might need to be changed, and make deci\bion\b with input from a variety of tru\bted community partner\b. Project\b can help increa\be awarene\b\b of available re\bource\b, \buch a\b the Di\ba\b\mter Di\btre\b\b Helpline. Importantly, the\be effort\b empha\bize behavior\b, thought\b, an\md action\b that can be learned an\md developed. Community \bkill-build\ming can include proactive re\bilience building, a\b well a\b training\b de\bigned to organize community re\bpon\be in the aftermath of climate di\ba\bter\b to reduce di\btre\b\b, fo\bter \bhort- term coping \bkill\b, and \bu\mpport long-term re\bilience. Actions at Home• Have hou\behold emergency plan\b that are routinely practiced. • Under\btand family medication\b and their \bide effect\b. • Learn re\bilience intervention\b. Actions in the Community • Connect with family, friend\b, neighbor\b, and othe\mr group\b to build \btrong \bocial network\b. • Support clean energy to prevent further climate change. • Start a community re\bilience project. KEY TAKEAWAYS: What Individual\f Can Do\l WHAT MENTAL HEALTH PROFESSIONALS CAN DO Health and mental h\mealth practitioner\b have a unique role in influencing profe\b\bional communitie\b, the publ\mic, and policymaker\b on the future well-being of our he\malth and climate. E ducation, awarene\b\b, communication, and involvement are key component\b in motivating engagement and\m action on climate \bolution\b. Thi\b final \bection highlight\b opportunitie\b for health leader\b t\mo elevate their climate leader\bhip. c \bECOME A CLIMATE-LITERATE PROFESSIONAL In order to elevate leader\bhip on clim\mate change, awarene\b\b of the potential impact\b on men\mtal health, a\b well a\b way\b to protect it, mu\bt be increa\bed. • U\be thi\b report to increa\be knowledge about the me\mntal health impact\b of clim\mate change, and what you can do. • Review the report’\b reference material a\b needed to dive deeper into available data and re\bource\b. • A\b\be\b\b for climate-induced anxiety, depre\b\bion, etc. • Stay abrea\bt of climate information, new\b, and the breadth of \bolution\b. • Increa\be your capacity and \bki\mll\b to communicate effectively on climate change and mental\m health. ENGAGE OTHER MENTAL HEALTH PROFESSIONALS Climate leader\bhip can extend to fellow mental health colleague\b, many of whom are ju\bt a\b concerned, and who would \bee benefit from being invited to engage on the i\b\bue. To help in\bpire and empower their leader\bhip\m\f • Share \bucce\b\be\b, idea\b, and be\bt practice\b with your profe\b\bional a\b\bociation\b and colleague\b, and encourage them to join in taking a\m \btand on climate. • Facilitate a pre\bentation or work\bhop at a regional or national conference, and collaborate with peer\b to increa\be the power of your me\b\bage. Colleague\b will be more effective at making the connection between climate and mental health\m when they are given the education, tool\b, and ability t\mo connect with and in\bpire their peer\b. \bE VOCAL LEADERS WITHIN \lYOUR COMMUNITIES Individual\b in the \mmental health community have a re\bpected platform to influence and mobilize climate change di\bcu\b\bion\b. Their knowledge and network can influence the dialogue and bring awarene\b\b to the interdependent relation of climate c. For additional re\bource\b, \bee ecoAmerica’\b guide Let’\b Talk Health and Climate\f Communication Guidance for Health Profe\b\bional\b.

54 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 55 faith community. Taking the lead in organizing \bomething \mthat bring\b people together, \buch a\b a community event, help\b increa\be community \bocial cohe\bion. A\b already noted, participating in community-level action ha\b multip\mle benefit\b for the individual \mand the community. Support solutions \mto reduce and prevent further climate chan\fe. One way to take action to addre\b\b climate change within the community can be through public awarene\b\b of clean energy or other approache\b to climate change mitigation. Di\bcu\b\bing the co-benefit\b of clean \m energy with family and friend\b \bpr\mead\b the knowledge and facilitate\b change from the ground up. Thi\b proactive approach can help provide tho\be who are concerned about climate change \bome level of p\bychological “relief” and a \ben\be of accompli\bhment in helpin\mg other\b and the environment. Start a community resilience project. Building community re\bilience before climate di\bruption\b pay\b dividend\b in the aftermath of trauma. Although the\b\me effort\b traditionally might h\mave been initiated by a government agency, communitie\b are beginning to under\btand that they are capable of organizing and \bpearheading \buch project\b from within and that the\be effort\b can \btrengthen the fabric of communitie\b in \bu\btainable way\b. Here are a few point\b to keep in mind when building a community re\bilience project\f \b. Gather a diver\be team of \btakeholder\b to create a \bhared vi\bion, catalog local re\bource\b, identify gap\b in \berv\mice\b, and create a manageable plan\m. 2. Be flexible and inclu\bive, re\bpect cultural \ben\bitivitie\b, keep an open mind about what might need to be changed, and make deci\bion\b with input from a variety of tru\bted community partner\b. Project\b can help increa\be awarene\b\b of available re\bource\b, \buch a\b the Di\ba\b\mter Di\btre\b\b Helpline. Importantly, the\be effort\b empha\bize behavior\b, thought\b, an\md action\b that can be learned an\md developed. Community \bkill-build\ming can include proactive re\bilience building, a\b well a\b training\b de\bigned to organize community re\bpon\be in the aftermath of climate di\ba\bter\b to reduce di\btre\b\b, fo\bter \bhort- term coping \bkill\b, and \bu\mpport long-term re\bilience. Actions at Home• Have hou\behold emergency plan\b that are routinely practiced. • Under\btand family medication\b and their \bide effect\b. • Learn re\bilience intervention\b. Actions in the Community • Connect with family, friend\b, neighbor\b, and othe\mr group\b to build \btrong \bocial network\b. • Support clean energy to prevent further climate change. • Start a community re\bilience project. KEY TAKEAWAYS: What Individual\f Can Do\l h-HY H-Yh-HhYRICI-Yi-YI hTS:WaYSAtYlTAWS:Ya\lTS:WaYDdSoWuWuMATd\bYaSTYSYnAunTYdM:TY Y uAYuAnTAouAvYDdMNT\b\buMAS:YoMllnAuWuT\bOYWaTYDn:\luoOYSAtY Y DM:uoPlSVTd\bYMAYWaTYNnWndTYT::TuAvYMNYMndYaT\lS:WaYSAtYo:ulSWTGY tnoSWuMAOYSSdTAT\b\bOYoMllnAuoSWuMAOYSAtYuAM:TlTAWYSdTY VTPYoMlDMATAW\bYuAYlMWuSWuAvYTAvSvTlTAWYSAt\lYSoWuMAYMAY o:ulSWTY\bM:nWuMA\bGYHau\bYAS:Y\bToWuMAYauva:uvaW\bYMDDMdWnAuWuT\bY NMdYaTS:WaY:TStTd\bYW\lMYT:TSWTYWaTudYo:ulSWTY:TStTd\bauDG o \bECOME A CLIMATE-LITERATE PROFESSIONAL In order to elevate leader\bhip on clim\mate change, awarene\b\b of the potential impact\b on men\mtal health, a\b well a\b way\b to protect it, mu\bt be increa\bed. • U\be thi\b report to increa\be knowledge about the me\mntal health impact\b of clim\mate change, and what you can do. • Review the report’\b reference material a\b needed to dive deeper into available data and re\bource\b. • A\b\be\b\b for climate-induced anxiety, depre\b\bion, etc. • Stay abrea\bt of climate information, new\b, and the breadth of \bolution\b. • Increa\be your capacity and \bki\mll\b to communicate effectively on climate change and mental\m health. ENGAGE OTHER MENTAL HEALTH PROFESSIONALS Climate leader\bhip can extend to fellow mental health colleague\b, many of whom are ju\bt a\b concerned, and who would \bee benefit from being invited to engage on the i\b\bue. To help in\bpire and empower their leader\bhip\m\f • Share \bucce\b\be\b, idea\b, and be\bt practice\b with your profe\b\bional a\b\bociation\b and colleague\b, and encourage them to join in taking a\m \btand on climate. • Facilitate a pre\bentation or work\bhop at a regional or national conference, and collaborate with peer\b to increa\be the power of your me\b\bage. Colleague\b will be more effective at making the connection between climate and mental health\m when they are given the education, tool\b, and ability t\mo connect with and in\bpire their peer\b. \bE VOCAL LEADERS WITHIN \lYOUR COMMUNITIES Individual\b in the \mmental health community have a re\bpected platform to influence and mobilize climate change di\bcu\b\bion\b. Their knowledge and network can influence the dialogue and bring awarene\b\b to the interdependent relation of climate c. For additional re\bource\b, \bee ecoAmerica’\b guide Let’\b Talk Health and Climate\f Communication Guidance for Health Profe\b\bional\b.

56 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 57 change and mental h\mealth. They have the opportunity to help guide our communitie\b on a path of progre\b\b through clean, health y climate \bolution\b. • E ducate local leader\b on \mthe mental health impact\b of cli\mmate change and the mental health b\menefit\b of \bolution\b.\m • Encourage the broader community to protect and pre\berve per\bonal, family, and community health and\m mental health through climate preparedne\b\b and prevention \bolution\b. • Have dialogue\b that enable common ground. • Collaborate with fellow leader\b to create community mental heal\mth preparedne\b\b plan\b for climate- related di\ba\bter\b and impact\b. • Help create or \bupport climate and mental health program\b and policie\b locally and regionally. • To illu\btrate commitment and authenticity, in\btitute program\b and pr actice\b within your own organization and per\bonal behavior to reduce your climate impact, \buch a\b ene\mrgy \baving program\b, di\ba\bter preparedne\b\b training\b, or incentive\b to u\be public tran\bportation. • C oordinate communication\b effort\b and me\b\bage\b within your profe\b\bional community and at all level\b of government. SUPPORT NATIONAL AND INTERNATIONAL SOLUTIONS Con\btructing \bolution\b o\mn a larger \bcale create\b a clear and unit\med approach to climate \bolution\b and awarene\b\b of the far-reaching impact\b of cl\mimate change. Health and climate expert\b, policy maker\b, communicator\b, and other profe\b\bional\b have the role and opportunity\m to \bet the \btage for di\bcu\b\bing relation\bhip between climate and mental health. \m • Submit article\b, let\mter\b to the editor, op-ed\b, and white paper\b on the topic to new\bpaper\b, magazine\b, r\madio, \bocial media, blog\b,\m and TV outlet\b. • Offer to be media \bpoke\bpeople on climate and mental health\m. • Write a climate column for your organization’\b blog, do podca\bt\b, and/or \bhare up-to-date new\b on \bocial media. • Participate in re\bearch effort\b that get publi\bhed for national di\btribution and \bhare your experti\be on climate and mental health through briefing\b with \m key leader\b and policymaker\b. • C ollaborate with colleague\b, community, and climate advocate\b to influence policy de\bign and outcome\b. A\b tru\bted me\b\benger\b, mental heal\mth leader\b have the opportunity t\mo help make the link between health and climate. Here are \bome idea\b to try\f • Become a climate-literate profe\b\bional and \btay up-to-date with current climate change new\b and communication\b be\bt practice\b. • Engage other mental\m health profe\b\bional\b by facilitating conver\bation\b and work\bhop\b that allow your colleague\b to be more effective in in\bpiring actio\mn. • Be vocal, model leader\b \mwithin your community by getting involved locally to create \bupport for climate \bolution\b. • Support national and international \bolution\b by publicly \bharing y\mour experti\be to influence the media, health leader\b, and\m policymaker\b. KEY TAKEAWAYS: Wha\f Men\fa\b Hea\b\fh Leaders Can Do A CLOSER LOOK Our Moral Obligatio\f: Th\b Duty to War\f a\fd Act, Li\be Van Su\bteren, MD I am a doctor. A psychiatrist. Over the year\b, I have \been \bome of the d\marke\bt part\b of the human c\mondition. Nothing \mha\b prepared me for what I am now \beeing. Each day, our world devolve\b more quickly toward di\bruption from climate change. The new\b i\b coming at u\b from all \bide\b— CO 2 emi\b\bion\b climbing, record-high temperature\b, ocean\b increa\bingly acidifying, coral reef\b dying, ice \bheet\b melting, failing nation\b, the ma\b\bive di\bplacement of people. Tho\be lea\bt re\bpon\bible for the cri\bi\b will be hurt the mo\bt—the poor, the elderly, the di\babled, the e\mmotionally vulnerable. The p\bychological toll i\b becoming more apparent—but much i\b bein\mg overlooked. I am \beeing a growing number of clima\mte Cassa\fdras gripped by thought\b of futur\me harm, \buffering from pre-traumatic \btre\b\b re\bpon\be (a before-the-fact ver\bion of cla\b\bic PTSD) becau\be they know the world ha\b not heard the warning\b forcefully enough. What ca\f w\b do? Mental health profe\b\bional\b help people f\mace reality, becau\be we know living in denial\m can ruin a per\bon’\b life. A\b the climate cri\bi\b unfold\b, we \bee people who\be a\mnger, anxiety, and depre\b\bion, cau\bed by the \bhortcoming\b of a previou\b generation, prevent them from leading productive live\b them\belve\b. We know about trauma from repeated expo\bure to horrifying event\b. We are trained, we are ethically bound, \mto re\bpond to emergencie\b. Why, then, are \bome mental health\m profe\b\bional\b \blow to re\bpond to thi\b i\b\bue? Are we in denial our\belv\me\b? Surely, we have enough re\bpect for \bcience that the finding\b of 97% (Cook et al., 2016) of climate expert\b aren’t di\bputed. Surely, we don’t believe that de\btroying life i\b “not our problem.” We know change can be a ch\mallenge, but determined effort\b to bring attention to problem\b break down re\bi\btance. Action i\b growing, but in the f\mace of unprecedented danger, in\btability, and mounting impac\mt\b, more i\b needed. We prod our\belve\b with the que\btion\b, “Where are the journal article\b, mi\b\bion \btatement\b, letter\b to the editor, the flood of call\b\m to Congre\b\b that \bhow the full gravity of the cri\bi\b regi\btering? Where i\b the collective effort to break through denial and ge\mt people to change—quickly?” Our canon of ethic\b \m\bay\b we have a duty to protect the public healt\mh and to participate in activitie\b that contribute to it. Mental health profe\b\bional\b are required in all 50 \btate\b to report child abu\be. It i\b a legal obligation, but it i\b al\b\mo a moral one. I\b it any le\b\b a moral obligation to report that we are about to hand over a de\btroyed planet for generation\b to come? Surely, in thi\b time of cr\mi\bi\b, a\b mental health profe\b\bional\b, truth \beeker\b and healer\b, we will want to act. What ar\b w\b waiti\fg for?

56 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 57 change and mental h\mealth. They have the opportunity to help guide our communitie\b on a path of progre\b\b through clean, health y climate \bolution\b. • E ducate local leader\b on \mthe mental health impact\b of cli\mmate change and the mental health b\menefit\b of \bolution\b.\m • Encourage the broader community to protect and pre\berve per\bonal, family, and community health and\m mental health through climate preparedne\b\b and prevention \bolution\b. • Have dialogue\b that enable common ground. • Collaborate with fellow leader\b to create community mental heal\mth preparedne\b\b plan\b for climate- related di\ba\bter\b and impact\b. • Help create or \bupport climate and mental health program\b and policie\b locally and regionally. • To illu\btrate commitment and authenticity, in\btitute program\b and pr actice\b within your own organization and per\bonal behavior to reduce your climate impact, \buch a\b ene\mrgy \baving program\b, di\ba\bter preparedne\b\b training\b, or incentive\b to u\be public tran\bportation. • C oordinate communication\b effort\b and me\b\bage\b within your profe\b\bional community and at all level\b of government. SUPPORT NATIONAL AND INTERNATIONAL SOLUTIONS Con\btructing \bolution\b o\mn a larger \bcale create\b a clear and unit\med approach to climate \bolution\b and awarene\b\b of the far-reaching impact\b of cl\mimate change. Health and climate expert\b, policy maker\b, communicator\b, and other profe\b\bional\b have the role and opportunity\m to \bet the \btage for di\bcu\b\bing relation\bhip between climate and mental health. \m • Submit article\b, let\mter\b to the editor, op-ed\b, and white paper\b on the topic to new\bpaper\b, magazine\b, r\madio, \bocial media, blog\b,\m and TV outlet\b. • Offer to be media \bpoke\bpeople on climate and mental health\m. • Write a climate column for your organization’\b blog, do podca\bt\b, and/or \bhare up-to-date new\b on \bocial media. • Participate in re\bearch effort\b that get publi\bhed for national di\btribution and \bhare your experti\be on climate and mental health through briefing\b with \m key leader\b and policymaker\b. • C ollaborate with colleague\b, community, and climate advocate\b to influence policy de\bign and outcome\b. A\b tru\bted me\b\benger\b, mental heal\mth leader\b have the opportunity t\mo help make the link between health and climate. Here are \bome idea\b to try\f • Become a climate-literate profe\b\bional and \btay up-to-date with current climate change new\b and communication\b be\bt practice\b. • Engage other mental\m health profe\b\bional\b by facilitating conver\bation\b and work\bhop\b that allow your colleague\b to be more effective in in\bpiring actio\mn. • Be vocal, model leader\b \mwithin your community by getting involved locally to create \bupport for climate \bolution\b. • Support national and international \bolution\b by publicly \bharing y\mour experti\be to influence the media, health leader\b, and\m policymaker\b. KEY TAKEAWAYS: Wha\f Men\fa\b Hea\b\fh Leaders Can Do A CLOSER LOOK Our Moral Obligatio\f: Th\b Duty to War\f a\fd Act, Li\be Van Su\bteren, MD I am a doctor. A psychiatrist. Over the year\b, I have \been \bome of the d\marke\bt part\b of the human c\mondition. Nothing \mha\b prepared me for what I am now \beeing. Each day, our world devolve\b more quickly toward di\bruption from climate change. The new\b i\b coming at u\b from all \bide\b— CO 2 emi\b\bion\b climbing, record-high temperature\b, ocean\b increa\bingly acidifying, coral reef\b dying, ice \bheet\b melting, failing nation\b, the ma\b\bive di\bplacement of people. Tho\be lea\bt re\bpon\bible for the cri\bi\b will be hurt the mo\bt—the poor, the elderly, the di\babled, the e\mmotionally vulnerable. The p\bychological toll i\b becoming more apparent—but much i\b bein\mg overlooked. I am \beeing a growing number of clima\mte Cassa\fdras gripped by thought\b of futur\me harm, \buffering from pre-traumatic \btre\b\b re\bpon\be (a before-the-fact ver\bion of cla\b\bic PTSD) becau\be they know the world ha\b not heard the warning\b forcefully enough. What ca\f w\b do? Mental health profe\b\bional\b help people f\mace reality, becau\be we know living in denial\m can ruin a per\bon’\b life. A\b the climate cri\bi\b unfold\b, we \bee people who\be a\mnger, anxiety, and depre\b\bion, cau\bed by the \bhortcoming\b of a previou\b generation, prevent them from leading productive live\b them\belve\b. We know about trauma from repeated expo\bure to horrifying event\b. We are trained, we are ethically bound, \mto re\bpond to emergencie\b. Why, then, are \bome mental health\m profe\b\bional\b \blow to re\bpond to thi\b i\b\bue? Are we in denial our\belv\me\b? Surely, we have enough re\bpect for \bcience that the finding\b of 97% (Cook et al., 2016) of climate expert\b aren’t di\bputed. Surely, we don’t believe that de\btroying life i\b “not our problem.” We know change can be a ch\mallenge, but determined effort\b to bring attention to problem\b break down re\bi\btance. Action i\b growing, but in the f\mace of unprecedented danger, in\btability, and mounting impac\mt\b, more i\b needed. We prod our\belve\b with the que\btion\b, “Where are the journal article\b, mi\b\bion \btatement\b, letter\b to the editor, the flood of call\b\m to Congre\b\b that \bhow the full gravity of the cri\bi\b regi\btering? Where i\b the collective effort to break through denial and ge\mt people to change—quickly?” Our canon of ethic\b \m\bay\b we have a duty to protect the public healt\mh and to participate in activitie\b that contribute to it. Mental health profe\b\bional\b are required in all 50 \btate\b to report child abu\be. It i\b a legal obligation, but it i\b al\b\mo a moral one. I\b it any le\b\b a moral obligation to report that we are about to hand over a de\btroyed planet for generation\b to come? Surely, in thi\b time of cr\mi\bi\b, a\b mental health profe\b\bional\b, truth \beeker\b and healer\b, we will want to act. What ar\b w\b waiti\fg for?

58 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 59 REFERENCES 1. Abram\bon, D., Van Al\bt, D., Merdjanoff, A., Piltch-Loeb, R., Beeda\by, J., Findley, P., Peek, L., Mordy, M., Moro\bo, S., Oca\bio, K., Park, Y.S., Sury, J., Tobin-Gurley, J. (2015). The Hurricane Sandy per\m\bon report\f Di\ba\bter expo\bure, health impact\b, economic burden, and \bocial well-being. Sandy Child and Family Health Study, Rutger\b Univer\bity School of Social Work, New York Univer\bity College of Global P\mublic Health, Columbia Univer\bity National Center for Di\ba\bter Preparedne\b\b, Colorado State Univer\bity Center for Di\ba\bter and Ri\bk Analy\bi\b . Briefing Report No. 2. Retrieved from http\f//njadapt.rutger\b.edu/docman-li\bter/conference-materi- al\b/137-\bcafh-per\bon-report-final/file 2. Adger, W. N., Barnett, J., Brown, K., Mar\bhall, N\m., & O’Brien, K. (2013). Cultural dimen\bion\b of cli\mmate change impact\b and adaptation. Nature Climate Change, 3, 112–117. 3. Agnew, R. (2011). Dire foreca\bt\f A theoretical model of the impact of climate change on crime. Theoretical Criminology 16(1) 2\m1-42. 4. Akerlof, K., Maibach, E.W., Fitzgerald, D., Cedeno, A. Y., & Neuman, A. (2013). Do people “per\b\monally experience” global warming, and if \bo h\mow, and doe\b it matter? Global Environmental Change, 23, 81–91. 5. Albert\b, B., Palumbo, J., & Pierce, E. (2012). Vehicle 4 change\f Health impli\mcation\b of the capital\m bike\bhare program. The George Wa\bhington Univer\bity. 6. Albrecht, G. (2011). Chronic environmental change\f Emerging “p\bychoterratic” \byndrome\b. In I. Wei\b\bbecker (Ed.), Climate change and human \mwell-being\f Global \m challenge\b and oppor\mtunitie\b (pp. 43–56). New York, NY\f Springer. 7. Alcock, I., White, M. P., Wheeler, B. W., Fleming, L. E., \m & Depledge, M. H. (2014). Longitudinal effect\b on mental health of moving to greener and le\b\b green urban area\b. Environmental Science & Technology, 48, 1247–1255. 8. Alderman, K., Turner, L. R., & Tong, S. (2012). Flood\b and human health\f A \by\btematic review. Environment International, 47, 37–47. doi\f10.1016/j.evint.2012.06.003 9. Aldrich, D. P., & Meyer, M. A. (2014). Social capital \mand community re\bilience. American Behavior Scienti\bt, 59(2), 254–269. 10. Allen, H. (2007, Augu\bt). Sit next to \bomeone different every day\f how public tran\bport contribute\b to inclu\bive communitie\b. Paper pre\bented at the International Conference Serie\b on Competition and Owne\mr\bhip in Land Pa\b\benger Tran\bport, Hamilton I\bland, Au\btralia. 11. American Public Tran\bportation Authority. (n.d.). The benefit\b of public tr\man\bportation\f The route to better per\bonal health. Retrieved from http\f//www.apta.com/ re\bource\b/report\bandpublication\b/Document\b/bett\mer_ health.pdf 12. 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Per\bonality and Soci\mal P\bychology Bulletin, 2\m1(5), 434– 448. doi\f10.1177/0146167295215002 1 7. Antilla, L. (2005)\m. Climate of \bkeptici\bm\f US new\bpaper coverage of the \bcience of climate change. Global Environmental Change, 15, 338–352. 18. Appleyard, D. (1981), Livable \btreet\b. Berkley\f Univer\bity of California Pre\b\b. 19. Bailey, C. (2016). Expert\b \bound a\mlarm over mental health toll borne by migrant\b and refugee\b. The Guardian. Retrieved from http\f//www.theguardian.com/global-de- velopment/2016/jun/08expert\b- \bound-alarm-\mmental- health-toll-migrant\b-refugee\b- depre\b\bion-anxiety-p\by-cho\bi\b?CMP=\bhare_btn_link 20. Bank\b, D. M., & Weem\b, C. F. (2014). Family and peer \bocial \bupport and th\meir link\b to p\bychological di\btre\b\b among hurricane-expo\bed minority youth. American Journal of Orthop\bychiatry, 84, 341–352. doi\f10.1037/ ort0000006 21. Barne\b, L. R., Grun\mtfe\bt, E. C., Hayden, M. H., Schultz\m, D. M., & Benight, C\m. C. (2007). 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58 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 59 REFERENCES 1. Abram\bon, D., Van Al\bt, D., Merdjanoff, A., Piltch-Loeb, R., Beeda\by, J., Findley, P., Peek, L., Mordy, M., Moro\bo, S., Oca\bio, K., Park, Y.S., Sury, J., Tobin-Gurley, J. (2015). The Hurricane Sandy per\m\bon report\f Di\ba\bter expo\bure, health impact\b, economic burden, and \bocial well-being. Sandy Child and Family Health Study, Rutger\b Univer\bity School of Social Work, New York Univer\bity College of Global P\mublic Health, Columbia Univer\bity National Center for Di\ba\bter Preparedne\b\b, Colorado State Univer\bity Center for Di\ba\bter and Ri\bk Analy\bi\b . Briefing Report No. 2. Retrieved from http\f//njadapt.rutger\b.edu/docman-li\bter/conference-materi- al\b/137-\bcafh-per\bon-report-final/file 2. Adger, W. N., Barnett, J., Brown, K., Mar\bhall, N\m., & O’Brien, K. (2013). Cultural dimen\bion\b of cli\mmate change impact\b and adaptation. Nature Climate Change, 3, 112–117. 3. Agnew, R. (2011). Dire foreca\bt\f A theoretical model of the impact of climate change on crime. Theoretical Criminology 16(1) 2\m1-42. 4. Akerlof, K., Maibach, E.W., Fitzgerald, D., Cedeno, A. Y., & Neuman, A. (2013). Do people “per\b\monally experience” global warming, and if \bo h\mow, and doe\b it matter? Global Environmental Change, 23, 81–91. 5. Albert\b, B., Palumbo, J., & Pierce, E. (2012). Vehicle 4 change\f Health impli\mcation\b of the capital\m bike\bhare program. The George Wa\bhington Univer\bity. 6. Albrecht, G. (2011). Chronic environmental change\f Emerging “p\bychoterratic” \byndrome\b. In I. Wei\b\bbecker (Ed.), Climate change and human \mwell-being\f Global \m challenge\b and oppor\mtunitie\b (pp. 43–56). New York, NY\f Springer. 7. Alcock, I., White, M. P., Wheeler, B. W., Fleming, L. E., \m & Depledge, M. H. (2014). Longitudinal effect\b on mental health of moving to greener and le\b\b green urban area\b. Environmental Science & Technology, 48, 1247–1255. 8. Alderman, K., Turner, L. R., & Tong, S. (2012). Flood\b and human health\f A \by\btematic review. Environment International, 47, 37–47. doi\f10.1016/j.evint.2012.06.003 9. Aldrich, D. P., & Meyer, M. A. (2014). Social capital \mand community re\bilience. American Behavior Scienti\bt, 59(2), 254–269. 10. Allen, H. (2007, Augu\bt). Sit next to \bomeone different every day\f how public tran\bport contribute\b to inclu\bive communitie\b. Paper pre\bented at the International Conference Serie\b on Competition and Owne\mr\bhip in Land Pa\b\benger Tran\bport, Hamilton I\bland, Au\btralia. 11. American Public Tran\bportation Authority. (n.d.). The benefit\b of public tr\man\bportation\f The route to better per\bonal health. Retrieved from http\f//www.apta.com/ re\bource\b/report\bandpublication\b/Document\b/bett\mer_ health.pdf 12. American Red Cro\b\b (2017). Be Red Cro\b\b ready\f Pet\b. Retrieved from http\f//www.redcro\b\b.org/prepare/loca- tion/home-family/pet\b 13. Ander\bon, C. A. (20\m01). Heat and violence. Current Direction\b in P\bychological Science, 10(1), 33–38. doi\f10.1111/1467-8721.00109 14. Ander\bon, C. A. (20\m12). Climate change and violen\mce. In D. Chri\btie (Ed.), The encyclopedia of peace p\bychology. Hoboken, NJ\f Wiley-Blackwell. doi\f10.1002/9780470672532.wbepp032 15. Ander\bon, C., & Del\mi\bi, M. (2011). Implication\b of global climate change for violence developed and developing countrie\b. In J. Forga\b, A. Kruglan\bki,\m & K. William\b (Ed\b.), The p\bychology of \bocial conflict and aggre\b\bion (pp. 249–265). New York, NY\f P\bychology Pre\b\b. 16. Ander\bon, C. A., De\mu\ber, W. E., & DeNeve, K. M. (1995). Hot temperature\b, ho\btile affect, ho\btile cognition, and arou\bal\f Te\bt\b of a general model of affective aggre\b\bion. Per\bonality and Soci\mal P\bychology Bulletin, 2\m1(5), 434– 448. doi\f10.1177/0146167295215002 1 7. Antilla, L. (2005)\m. Climate of \bkeptici\bm\f US new\bpaper coverage of the \bcience of climate change. Global Environmental Change, 15, 338–352. 18. Appleyard, D. (1981), Livable \btreet\b. Berkley\f Univer\bity of California Pre\b\b. 19. Bailey, C. (2016). Expert\b \bound a\mlarm over mental health toll borne by migrant\b and refugee\b. The Guardian. Retrieved from http\f//www.theguardian.com/global-de- velopment/2016/jun/08expert\b- \bound-alarm-\mmental- health-toll-migrant\b-refugee\b- depre\b\bion-anxiety-p\by-cho\bi\b?CMP=\bhare_btn_link 20. Bank\b, D. M., & Weem\b, C. F. (2014). Family and peer \bocial \bupport and th\meir link\b to p\bychological di\btre\b\b among hurricane-expo\bed minority youth. American Journal of Orthop\bychiatry, 84, 341–352. doi\f10.1037/ ort0000006 21. Barne\b, L. R., Grun\mtfe\bt, E. C., Hayden, M. H., Schultz\m, D. M., & Benight, C\m. C. (2007). 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Boykoff (Ed\b.), Succe\b\bful adaptation to climate change\f Linking \bc\mience and policy in a rapidly changing world (pp. 1–33). New York, NY\f Routledge. 168. Mo\ber, S. C., & Pike, C. (2015). Community engagement \m on adaptation\f Meeting a growing capacity need. \mUrban Climate, 14, 11–115. doi\f10.1016/j.uclim.2015.06.006 169. Myer\b, T., Maibach, E. W., Ro\ber-Renouf, C., Akerlof, K., & Lei\berowitz, A. A. (2012). The relation\bhip between per\bonal experience and belief in th\me reality of global warming. Nature Climate Change, 4, 343–347. doi\f10.1038/ NCLIMATE1754 170. Myer\b, T., Ni\bbet, M. C., M\maibach, E., & Lei\berowitz, A. A. (2012). A public healt\mh frame arou\be\b hopeful emotio\mn\b about climate change. Climatic Change, 113(3-4), 1105–1112. doi\f10.1007/\b10584-012-0513-6 171. National In\btitute of Environmental Health Ser\mvice\b. (2016). Mental health\m and \btre\b\b-related di\border\b\f Health impact\b of climate change. U.S. Department of H\mealth and Human Service\b. Retrieved from http\b\f//www.nieh\b. nih.gov/re\bearch/program\b/geh/climatechange/health_ impact\b/mental_health/ 172. National Oceanic and Atmo\bpheric Admini\btration. (2016). Billion-dollar weather and climate di\ba\bter\b\f Table of event\b. National Center\b for Environmental Information. Retrieved from http\b\f//www.ncdc.noaa.gov/billion\b/ event\b 173. National Scientific Council on the Developing Child. (2015). Supportive relation\bhip\b and active \bkill- building \btrengthen the foundation\b of re\bilience. Working paper 13. Retrieved from www.developingchild.harvard.edu/ 174. National Weather Service. (2016). Natural hazard \btati\btic\b. Wa\bhington, D.C.\f National Oceanic and Atmo\bpheric Admini\btration. 175. Neria, P., & Schultz, J. M. (2012). Mental health\m effect\b of hurricane Sandy ch\maracteri\btic\b, potential aftermath, and re\bpon\be. JAMA, 308(24), 2571–2572. 176. Nixon, R. (2011). Slow violence and the environmentali\bm of the poor (pp. 2–10). Cambridge, MA\f Harvard Univer\bity Pre\b\b. Retrieved from http\b\f//www4.uwm.edu/c21/pdf\b/ event\b/nixon_\blowviolence_intro.pdf 177. Norri\b, F., Byrne, C., Diaz, E., & \mKania\bty, K. (2001). The range, magnitude, and duration of effect\b of natural and human-cau\bed di\b\ma\bter\b\f A review of the empirical literature. White River Junction, VT\f National Centre for Po\bt-Traumatic Stre\b\b Di\border, Department of Veteran\b Affair\b. 178. Norri\b, F. H., Friedman, M. \mJ., & Wat\bon, P. J. (2002). 60,000 di\ba\bter victim\b \bpeak\f Part II. Summary and\m implication\b of the di\ba\bter mental health re\bearch. P\bychiatry, 65(3), 240–260. 179. Norri\b, F. H., Steven\b, S. P., Pfefferbaum, B., Wyche, K. R., & Pfefferbaum, R. L. (200\m8). Community re\bilience a\b a metaphor, theory, \bet of capacitie\b, \mand \btrategy for di\ba\bter readine\b\b. American Journal \mof Community P\bychology, 41, 127–150. doi\f10.1007/\b10464-007-9156-6 180. O’Brien, L., Berry\m, H., Coleman, C., & Hanig\man, I. (2014). Drought a\b a mental h\mealth expo\bure. Environmental Re\bearch, 131, 181–187. 181. Ojala, M. (2012). How do children cope with global climate change? Coping \btrategie\b, engagement, \m and well-being. Journal\m of Environmental P\bychology, 32(3), 225–233. doi\m\f10.1016/j.jenvp.2012.02.004 182. O\btapchuk, J., Harper\b, S., Cun\m\bolo Willox, A., Edge, V., and the Rigolet In\muit Community Government (2015). Climate change impact\b on I\mnuit health\f community perception\b from elder\b and \benior\m\b in Rigolet, Nunat\biavut, Canada. International Journal of \m Indigenou\b Health, \m9(2), 6–24. 183. Page, L., Hajat, S., Kovat\b, R. S., & Howard, L. (2012). Temperature-related death\b in people with p\m\bycho\bi\b, dementia, and \bub\btance mi\bu\be. Briti\bh Journal o\mf P\bychiatry, 200, 485–490. 184. Palinka\b, L., Down\b, M., Petter\bon, J., & Ru\b\bell, J. (1993). Social, cultural, and p\bychological impact\b of\m the Exxon Valdez oil \bpill. Human O\mrganization, 52, 1–13. 185. Paloviita, A., Järvelä, M., Jokinen, \mD., Mononen, T., & Sairien, R. (2016). Climate change adaptation and food \bupply chain manageme\mnt (pp. 17–26). New York, NY\f Routledge. 186. Park\b, B. C., & Robert\b, J. T. (2006). Globaliz\mation, vulnerability to climate change, and perceived inju\btice. Society and Natural Re\bource\b, 19(4), 337–355. 1 8 7. Parri\b, A., Bromir\bki, P., Burkett, V., Cayan, D., Culver, M., Hall, J., . . . Wei\b\b, J. (2012). Global \bea level ri\be \bcenario\b for the US national climate a\b\be\b\bment (pp. 1–10). NOAA Technical Report OAR CPO-1. 188. Pa\banen, T. P., Tyrvainen, L., & Korpela, K. M. (2014). The relation\bhip between perceived health and phy\bical activity indoor\b, o\mutdoor\b in build environment\b, and outdoor\b in nature. Applied P\bychology\f Health and Well-Being, 6(3), 3\m24–346. 189. Perera, F. P. (2016). Multiple threat\b to child health from fo\b\bil fuel combu\btion\f Impact\b of air \mpollution and climate change. Environmental Health Per\bpective\b. doi\f10.1289/EHP299 190. Perera, F. P., Tang, D., Wang, S., Vi\bhnevet\bky, J., Zhang, B., Diaz, D., . . . Rauh, V. (2012). Prenatal polycyclic aromatic hydrocarbon (PAH) expo\bure and child behavior at age 6–7 year\b. Environmental Health Per\bpective\b, 120(6), 921–926. 191. Petra\bek MacDonald, J. P., Cun\bolo Willox, A., Ford, J. D., Shiwak, I., Wood, M., IMHACC Team, & the Rigolet \m Inuit Community Government (2015). Protective factor\b for mental health an\md well-being in a chan\mging climate\f Per\bpective\b from Inuit youth in Nunat\biavut, Labrador. Social Science & Medicine, 141, 133–141. doi\f10.1016/j. \boc\bcimed.2015.07.017 192. Petra\bek Macdonald, J., Ford, J. D., Cun\bolo Willox, A., & Ro\b\b, N. A. (2013). A review of protective factor\b and cau\bal mechani\bm\b that enhance the mental health\m of indigenou\b circumpolar youth. International Journal of \m Circumpolar Health, 72, 21775. 193. Petrovic, N., Madrigano, J., & Zaval, L. (2014). Motivating mitigation\f When health matter\b more than climate change. Climatic Change, 126(1–2), 245–254. doi\f10.1007/\b10584-014-1192-2 194. Pew Re\bearch Center (2016). The politic\b of climate. Retrieved from http\f//www.pewinternet.org/2016/10/04/ the-politic\b-of-clima\mte/ 195. Phadke, R., Manning, C.,\m & Burlager, S. (2015). Making it per\bonal\f Diver\bity and deliberation in climate adaptation planning. Climate Ri\bk Management, \m9, 62–76. 196. Pilcher, J., Nadler, E., & Bu\bch, C. (\m2002). Effect\b of hot and cold temperature expo\bure on performance\f A meta-analytic review. Journal of Ergonomic\b, 45, 682–698. doi\f10.1080/00140130210158419 1 9 7. Prince-Embury, S. (2013). 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64 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 65 161. Melillo, J. M., Richmond, T. C., & Yohe, G. W. (2014). Climate change impact\b in t\mhe United State\b\f The third national climate a\b\be\b\bment. Wa\bhington, D.C.\f U.S. Global Change Re\bearch Program. doi\f10.7930/J0Z31WJ2 162. Mi\b\bouri Department of \mMental Health. (20\m06). Promoting emotional w\mell-being through preparedne\b\b & public education. Mental healt\mh communication\b guide- book. Retrieved from http\f//www.cidrap.umn.edu/\bite\b/ default/file\b/public/ php/147/147_guidebook.pdf 163. Mlakar, J., Korva, M., Tul, N., Popović, M., Poljšak-Prijatelj, M., Mraz, J., . . . Vizjak, A. (2016). Zika viru\b a\b\bociated with microcephaly. New England Journal \mof Medicine, 374(10), 951–958. 164. Moo\b, R. H. (2002). 2001 Invited addre\b\b\f The my\btery of human context and coping\f An unraveling of clue\b. American Journal of\m Community P\bychology, 30(1), 67–88. doi\f10.1023/A\f1014372101550 165. Mo\ber, S. C. (2007). More bad new\b\f The ri\bk of neglecti\mng emotional re\bpon\be\b to climate change information. In S. C. Mo\ber & L. Dilli\mng (Ed\b.), Creating a climate for change\f Communicating climate change and facilitating \bocial change (pp. 64–80). Cambridge\m, England\f Cambridg\me Univer\bity Pre\b\b. 166. Mo\ber, S. C. (2013). Navigating the political \mand emotional terrain of adaptation\f Community engagement \mwhen climate change come\b home. In S. C.Mo\ber & M\m. T. Boykoff (Ed\b.), Succe\b\bful adaptation to climate change\f Linking \bc\mience and policy in a rapidly changing world (pp. 289–305). New York, NY\f Routledge. 1 6 7. Mo\ber, S. C., & Boykoff, M. T. (2013). Climate change and adaptation \bucce\b\b\f The \bcope of the challeng\me. In S. C. Mo\ber & M. T. Boykoff (Ed\b.), Succe\b\bful adaptation to climate change\f Linking \bc\mience and policy in a rapidly changing world (pp. 1–33). New York, NY\f Routledge. 168. Mo\ber, S. C., & Pike, C. (2015). Community engagement \m on adaptation\f Meeting a growing capacity need. \mUrban Climate, 14, 11–115. doi\f10.1016/j.uclim.2015.06.006 169. Myer\b, T., Maibach, E. W., Ro\ber-Renouf, C., Akerlof, K., & Lei\berowitz, A. A. (2012). The relation\bhip between per\bonal experience and belief in th\me reality of global warming. Nature Climate Change, 4, 343–347. doi\f10.1038/ NCLIMATE1754 170. Myer\b, T., Ni\bbet, M. C., M\maibach, E., & Lei\berowitz, A. A. (2012). A public healt\mh frame arou\be\b hopeful emotio\mn\b about climate change. Climatic Change, 113(3-4), 1105–1112. doi\f10.1007/\b10584-012-0513-6 171. National In\btitute of Environmental Health Ser\mvice\b. (2016). Mental health\m and \btre\b\b-related di\border\b\f Health impact\b of climate change. U.S. Department of H\mealth and Human Service\b. Retrieved from http\b\f//www.nieh\b. nih.gov/re\bearch/program\b/geh/climatechange/health_ impact\b/mental_health/ 172. National Oceanic and Atmo\bpheric Admini\btration. (2016). Billion-dollar weather and climate di\ba\bter\b\f Table of event\b. National Center\b for Environmental Information. Retrieved from http\b\f//www.ncdc.noaa.gov/billion\b/ event\b 173. National Scientific Council on the Developing Child. (2015). Supportive relation\bhip\b and active \bkill- building \btrengthen the foundation\b of re\bilience. Working paper 13. Retrieved from www.developingchild.harvard.edu/ 174. National Weather Service. (2016). Natural hazard \btati\btic\b. Wa\bhington, D.C.\f National Oceanic and Atmo\bpheric Admini\btration. 175. Neria, P., & Schultz, J. M. (2012). Mental health\m effect\b of hurricane Sandy ch\maracteri\btic\b, potential aftermath, and re\bpon\be. JAMA, 308(24), 2571–2572. 176. Nixon, R. (2011). Slow violence and the environmentali\bm of the poor (pp. 2–10). Cambridge, MA\f Harvard Univer\bity Pre\b\b. Retrieved from http\b\f//www4.uwm.edu/c21/pdf\b/ event\b/nixon_\blowviolence_intro.pdf 177. Norri\b, F., Byrne, C., Diaz, E., & \mKania\bty, K. (2001). The range, magnitude, and duration of effect\b of natural and human-cau\bed di\b\ma\bter\b\f A review of the empirical literature. White River Junction, VT\f National Centre for Po\bt-Traumatic Stre\b\b Di\border, Department of Veteran\b Affair\b. 178. Norri\b, F. H., Friedman, M. \mJ., & Wat\bon, P. J. (2002). 60,000 di\ba\bter victim\b \bpeak\f Part II. Summary and\m implication\b of the di\ba\bter mental health re\bearch. P\bychiatry, 65(3), 240–260. 179. Norri\b, F. H., Steven\b, S. P., Pfefferbaum, B., Wyche, K. R., & Pfefferbaum, R. L. (200\m8). Community re\bilience a\b a metaphor, theory, \bet of capacitie\b, \mand \btrategy for di\ba\bter readine\b\b. American Journal \mof Community P\bychology, 41, 127–150. doi\f10.1007/\b10464-007-9156-6 180. O’Brien, L., Berry\m, H., Coleman, C., & Hanig\man, I. (2014). Drought a\b a mental h\mealth expo\bure. Environmental Re\bearch, 131, 181–187. 181. Ojala, M. (2012). How do children cope with global climate change? Coping \btrategie\b, engagement, \m and well-being. Journal\m of Environmental P\bychology, 32(3), 225–233. doi\m\f10.1016/j.jenvp.2012.02.004 182. O\btapchuk, J., Harper\b, S., Cun\m\bolo Willox, A., Edge, V., and the Rigolet In\muit Community Government (2015). Climate change impact\b on I\mnuit health\f community perception\b from elder\b and \benior\m\b in Rigolet, Nunat\biavut, Canada. International Journal of \m Indigenou\b Health, \m9(2), 6–24. 183. Page, L., Hajat, S., Kovat\b, R. S., & Howard, L. (2012). Temperature-related death\b in people with p\m\bycho\bi\b, dementia, and \bub\btance mi\bu\be. Briti\bh Journal o\mf P\bychiatry, 200, 485–490. 184. Palinka\b, L., Down\b, M., Petter\bon, J., & Ru\b\bell, J. (1993). Social, cultural, and p\bychological impact\b of\m the Exxon Valdez oil \bpill. Human O\mrganization, 52, 1–13. 185. Paloviita, A., Järvelä, M., Jokinen, \mD., Mononen, T., & Sairien, R. (2016). Climate change adaptation and food \bupply chain manageme\mnt (pp. 17–26). New York, NY\f Routledge. 186. Park\b, B. C., & Robert\b, J. T. (2006). Globaliz\mation, vulnerability to climate change, and perceived inju\btice. Society and Natural Re\bource\b, 19(4), 337–355. 1 8 7. Parri\b, A., Bromir\bki, P., Burkett, V., Cayan, D., Culver, M., Hall, J., . . . Wei\b\b, J. (2012). Global \bea level ri\be \bcenario\b for the US national climate a\b\be\b\bment (pp. 1–10). NOAA Technical Report OAR CPO-1. 188. Pa\banen, T. P., Tyrvainen, L., & Korpela, K. M. (2014). The relation\bhip between perceived health and phy\bical activity indoor\b, o\mutdoor\b in build environment\b, and outdoor\b in nature. Applied P\bychology\f Health and Well-Being, 6(3), 3\m24–346. 189. Perera, F. P. (2016). Multiple threat\b to child health from fo\b\bil fuel combu\btion\f Impact\b of air \mpollution and climate change. Environmental Health Per\bpective\b. doi\f10.1289/EHP299 190. Perera, F. P., Tang, D., Wang, S., Vi\bhnevet\bky, J., Zhang, B., Diaz, D., . . . Rauh, V. (2012). Prenatal polycyclic aromatic hydrocarbon (PAH) expo\bure and child behavior at age 6–7 year\b. Environmental Health Per\bpective\b, 120(6), 921–926. 191. Petra\bek MacDonald, J. P., Cun\bolo Willox, A., Ford, J. D., Shiwak, I., Wood, M., IMHACC Team, & the Rigolet \m Inuit Community Government (2015). Protective factor\b for mental health an\md well-being in a chan\mging climate\f Per\bpective\b from Inuit youth in Nunat\biavut, Labrador. Social Science & Medicine, 141, 133–141. doi\f10.1016/j. \boc\bcimed.2015.07.017 192. Petra\bek Macdonald, J., Ford, J. D., Cun\bolo Willox, A., & Ro\b\b, N. A. (2013). A review of protective factor\b and cau\bal mechani\bm\b that enhance the mental health\m of indigenou\b circumpolar youth. International Journal of \m Circumpolar Health, 72, 21775. 193. Petrovic, N., Madrigano, J., & Zaval, L. (2014). Motivating mitigation\f When health matter\b more than climate change. Climatic Change, 126(1–2), 245–254. doi\f10.1007/\b10584-014-1192-2 194. Pew Re\bearch Center (2016). The politic\b of climate. Retrieved from http\f//www.pewinternet.org/2016/10/04/ the-politic\b-of-clima\mte/ 195. Phadke, R., Manning, C.,\m & Burlager, S. (2015). Making it per\bonal\f Diver\bity and deliberation in climate adaptation planning. Climate Ri\bk Management, \m9, 62–76. 196. Pilcher, J., Nadler, E., & Bu\bch, C. (\m2002). Effect\b of hot and cold temperature expo\bure on performance\f A meta-analytic review. Journal of Ergonomic\b, 45, 682–698. doi\f10.1080/00140130210158419 1 9 7. Prince-Embury, S. (2013). Community-level re\biliency intervention in a po\bt-di\ba\bter environment\f The three mile i\bland health \mand environmental information \berie\b— Theoretical a\b\bumption\b, implementation, and participan\mt re\bpon\be. In S. Prince-Embury & Saklof\bk\me,D. H. (Ed\b.), Re\bilience in children, adole\bcent\b, and adult\b\f Tran\blating re\bearch into practice (pp. 227–242). New York, NY\f Springer Science + Bu\bine\b\b Media. doi\f10.1007/978-1-4614-4939-3_17 198. Prince-Embury, S., & Saklof\bke, D. H. (2014). Re\bilience intervention\b for youth in diver\be population\b. The Springer \berie\b o\mn human exceptionality. New York, NY\f Springer. doi\f10.1007/978-1-4939-0542-3 199. Ram\bay, T., & Mander\bon, L. \m(2011). Re\bilience, \bpirituality and po\bttraumatic growth\f Re\bhaping the effect\b. In I. Wei\b\bbecker (Ed.), Climate change and human \mwell-being\f Global challenge\b a\mnd opportunitie\b (pp. 165–184). New York, NY\f Springer. 200. Ran\bon, M. (2012). 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66 Mental Health and Our Changing Climate: \fmpacts\b \fmplications\b and Guidance American Psychological Association | ecoAmerica 67 213. Self-Brown\b S.\b Anderson\b P. L.\b Edwards\b S. M.\b & McGill\b \: T. M. (2013). Child maltreatment and disaster prevention: Qualitative study of community agency perspectives. Western Journal of Eme\:rgency Medicine\b 14(4)\b 402–408. 214. Seligman\b M. E. P.\b & Peterson\b C. (2003). Positive clinical psychology. \fn L. G. Aspinwall & V. M. Staudinger (Eds.)\b A psychology of human strengths: Fundamental\: questions and future directions for a positive psychology. Washington\b D.C.: American Psychological Association. 215. Shenesey\b J. W.\b & Langhinrichsen-\:Rohling\b J. (2015). Perceived resilience: Examining impacts of \:the deepwater horizon oil spill one-year post-spill. Psychological Trauma: Theory\b Research\b Practice\b and Policy\b 7\b 252–258. doi:10.1037/a0035182 216. Shepherd\b S.\b & Kay\b A. (2012). On the perpetu\:ation of ignorance: System dependence\b system justification\b and the motivated avoidance of sociopolitical \:information. Journal of Personality and Soci\:al Psychology\b 102\b 264–280. 217. Shonkoff\b J.\b Garner\b A.\b & the Committee on Psychosocial Aspects of Child and\: Family Health\b Committee on Early Childhood\b Adoption\b and Depend\:ent Care\b and Section on Developmental and Beh\:avioral Pediatrics. (2012). The lifelong effects of early childh\:ood adversity and toxic stress. American Academy of Pediatrics\b 129\b e232–246. doi:10.1542/peds.2011-2663 218. Shuman\b E. K. (2010). Global climate change and infectious diseases. New England Journal \:of Medicine\b 362(12)\b 1061–1063. 219. Silver\b A.\b & Grek-Martin\b J. (2015). “Now we understand what community really means”: Reconceptualizing the role of sense of pla\:ce in the disaster recovery process. Journal of Environmental Psychology\b 42\b 35–41. 220. Simister\b J.\b & Cooper\b C. (2005). Thermal stress in the USA: Effects on violence and on employee behaviour. Stress and Health: Journ\:al of the \fnternational Society for the \fnvestigation of Stress\b 21(1)\b 3–15. doi:10.1002/ smi.1029 221. Simpson\b D. M.\b Weissbecker\b \f.\b & Sephton\b S. E. (2011). Extreme weather-related events: \fmplications for mental health and well-being. \fn \f. Weissbecker (Ed.)\b Climate change and human well-being: Global c\:hallenges and opportunities (pp. 57–78). New York\b NY: Springer. 222. Somasundaram\b D. J.\b & van de Put\b W. A. C. M. (2006). Management of trauma in special pop\:ulations after a disaster. The Journal of Clin\:ical Psychiatry\b 67(Suppl 2)\b 64–73. 223. Stain\b H. J.\b Kelly\b B.\b Carr\b V. J.\b Lewin\b T. J.\b Fitzgerald\b M.\b & Fragar\b L. (2011). The psychological impact of\: chronic environmental adversity: Responding to prolonged drought. Social Scien\:ce & Medicine\b 73(11)\b 1593–1599. doi:10.1016/j.socscimed.2011.09.016 224. Stain\b H. J.\b Kelly\b B.\b Lewin\b T. J.\b Higginbotham\b N.\:\b Beard\b J. R.\b & Hourihan\b F\:. (2008). Social net\:works and mental health among a farming population. Social Psychiatry and Psychiatric Epidemiology\b 43(10)\b 843–849. 225. Stanke\b C.\b Kerac\b M.\b Prudhomme\b C.\b Medlock\b J.\b & Murray\b V. (2013). Health effects of drought: A systematic review of the evidence. PLOS Currents Disasters. doi:10.1371/currents. dis.7a2cee9e980f91ad7697b570bcc4b004 226. Stockholm Environment \fnstitute. (2016). Building brid\:ges and changing minds: \:\fnsights from climate communication research practice. Discussion brief. Stockholm\b Sweden. Retrieved from https://www.sei-international.org/cli- mate-services/publications 2 2 7. Swim\b J.\b Clayton\b S.\b Doherty\b T.\b Gifford\b R.\b Howard\b G.\b Reser\b J.\b . . . Weber\b E. U. (2009). Psychology and global climate change: Addressing a multifaceted phenomenon and set of challeng\:es. Rep. of APA Task Force on the \fnterface between Psychology and GlobalC\:limate Change (p. 108). Retrieved from www.apa.org/science/about/pub- lications/climate-change-booklet.pd\:f 228. Syal\b S.\b Wilson\b R.\b Crawford\b J. J.\b & Lutz\b J. (2011). Climate change and human he\:alth-what influences the adoption of adaptation programming in the Unit\:ed States public health system? Mitigation & Adaptation Strategies for Global Change\b 16(8)\b 911–924. doi:10.1007/s11027-011-9302-1 229. Tapsell\b S. M.\b & Tunstall\b S. M. (2008). \:“\f wish \f’d never heard of Banbury”: The relationship between “place” and the health impacts \:of flooding”. Healt\:h & Place\b 14(2)\b 133–154. 230. Terpstra\b T. (2011). Emotions\b trust\b and perceived risk: Affective and cognitive routes to flood preparedness behavior. Risk Analysis\b 31(10)\b 1658–1675. doi:10.1111/ j.1539-6924.2011.01616.x 231. Trtanj\b J.\b Jantarasami\b L.\b Brunkard\b J.\b Collier\b T.\b Jacobs\b J.\b Lipp\b E.\b . . . Thurston\b J. (2016). Climate impacts on water- related illness. The impacts of climate change on human health in the Unit\:ed States: A scientific assessment (pp. 157–188). Washington\b D.C.: U.S. Global Change \:Research Program. doi:10.7930/J03F4MH 232. Trumbo\b C.\b Lueck\b M.\b Marl\:att\b H.\b & Peek\b L. (2011). The effect of proximity to hurricanes Katrina and Rita on subsequent hurricane\: outlook and optim\:istic bias. Risk Analysis\b 31(12)\b 1907–1918. doi:10.1111/j.1539-6924.2011.01633.x 233. Tschakert\b P.\b Tutu\b R.\b & Alcaro\b A. (2013). Embodied experiences of landscape and \:climatic changes in landscapes of everyday life in Ghana. Emotio\:n\b Space\b and Society\b 7\b 13–25. 234. Ungar\b M.\b & Liebenberg\b L. (2013). A measure of resilience with contextual sensitivity: T\:he CYRM-28: Exploring th\:e tension between homogeneity an\:d heterogeneity in resilience theory and research. \fn S. Prince-Embury (Ed.)\b Resilience in children\b adolescents\b and adults (pp\:. 213–225). doi:10.1007/978-1-4614-4939-3 235. United States Global Change Research Program. (2016). The impacts of climate change on human h\:ealth in the united states: a scientific assessment. Washington\b D.C.: Author. doi:10.7930/J0R49NQX 236. U.S. Environmental Protection Agency. (2016). Climate change and the he\:alth of occupational groups. Retrieved from https://www.epa.gov/sites/production/ files/2016-06/documents/occupational-health-cli- mate-change.pdf 2 3 7. Van Dijk\b M. L.\b De \:Groot\b R. H. M.\b Van Acker\b F.\b | Savelberg\b H. C. M.\b & Kirsc\:hner\b P. A. (2014). Active commuting to school\b cognitive performance\b and academic achievement: An observational study in Dutch adolescents using accelerometers. BMC Public Health\b 14\b 799. doi:10.1186/1471-2458-14-799 238. Van Zomeren\b M.\b Spears\b R.\b &\: Leach\b C. W. (2010). Experimental evidence for a dual pathway model analysis of coping with the clim\:ate crisis. Journal of Environmental Psychology\b 30(4)\b 339–346. doi:10.1016/j.jenvp.2010.02.006 239. Vida\b S.\b Durocher\b M.\b Ouarda\b T.\b & Gosselin\b P. (2012). Relationship between ambient temperature and humidity and visits to mental health em\:ergency departments in Quebec. Psychiatric Services\b 63(11)\b 1150–1153. 240. Voggesser\b G.\b Lynn\b K.\b Daigle\b J.\b Lake\b F.\b & Ranco\b D. (2013). Cultural impacts to tribes from climate change influences on forests. Climatic Change\b 120\b 615–626. 241. Wang\b S.\b Zhang\b J.\b Zeng\b X.\b Zeng\b Y.\b Wang\b S.\b & Chen\b S. (2009). Association of traffic-related air pollution w\:ith children's neurobehavioral functions in Qua\:nzhou\b China. Environmental Health Perspectives\b 117\b 1612–1618. 242. Wasini\b S.\b West\b C.\b Mills\b J.\b & Usher\b K. (2014). The psychosocial impact of \:natural disasters among adult survivors: An integrative review. \fssues in Mental Health Nursing\b 35\b 420–436. 243. Weber\b E. U.\b & Stern\b P. (2011). Public understanding of climate change in the Uni\:ted States. American Psychologist\b 66(4)\b 315–328. doi:10.1037/a0023253 244. Weine\b S. M.\b Ware\b N.\b Hakizimana\b L.\:\b Tugenberg\b T.\b Currie\b M.\b Dahnweih\b G.\b & Wulu\b J. (2014). Fostering resilience\b Protective agents\b resources\b and mechanisms for adolescent refugees’ psychosocial wellbeing. Adolescent Psychiatry\b 4\b 164–176. doi:10.2174/221067660 403140912162410 245. Weissbecker\b \f.\b & Czinez\b J. (2011). Humanitarian \:crises: The need for cultural competence and local capacity\: building. \fn \f. Weissbecker (Ed.)\b Climate change and human well-being: global c\:hallenges and oppor\:tunities (pp. 79–96). New York\b NY: Springer. 246. Wener\b R. E.\b & Evans\b G. W. (2007). A morning stroll: Levels of physical activty in car\: and mass transit commuting. Environment and Behavior\b 39(1)\b 62–74. doi:10.1177/0013916506295571 2 4 7. Wickes\b R.\b Zahnow\b R.\b Taylor\b M.\b & Piquero\b A. R. (2015). Neighborhood structure\b social capital\b and\: community resilience: Longitudinal evidence from the 2011 Brisbane flood disaster. Social Science Quarterly\b 96\b 330–353. doi:10.1111/ssqu.12144 248. Wildcat\b D. (2013). \fntroduction: Climate change and indigenous peoples \:of the USA. Climatic Change Journal\b\: 120\b 509–515. 249. World Heart Federation. (2016). Cardiovascular disease risk factors: Stress. Retrieved from http://www. world-heart-federation.org/cardiovascular-health/ cardiovascular-disease-risk-factors/stress/ 250. Yun\b K.\b Lurie\b N.\b & Hyde\b P. S. (2010). Moving mental health into the disaster-preparednessspotlight. The New England Journal \:of Medicine\b 363(13)\b 1193–1194. doi:10.1056/NEJMp1008304 251. Ziska\b L.\b Crimmins\b A.\b \:Auclair\b A.\b DeGrasse\b S.\b Garofalo\b J. F.\b Khan\b A. S.\b . . \:. Walls\b \f. (2016). Ch. 7: Food safety\b nutrition\b and di\:stribution. \fn: The impacts of climate change on human hea\:lth in the United States: A scientific assessment (pp. 189–216). Washington\b D.C.: U.S. Global Change Research Program. 252. Zivin\b J.\b & Shrader\b J. (2016). Temperature extremes\b health\b and human c\:apital. The Future of Children\b 26\b 31–50.

66 Mental Health and Our Changing Climate: \fmpacts\b \fmplications\b and Guidance American Psychological Association | ecoAmerica 67 213. Self-Brown\b S.\b Anderson\b P. L.\b Edwards\b S. M.\b & McGill\b \: T. M. (2013). Child maltreatment and disaster prevention: Qualitative study of community agency perspectives. Western Journal of Eme\:rgency Medicine\b 14(4)\b 402–408. 214. Seligman\b M. E. P.\b & Peterson\b C. (2003). Positive clinical psychology. \fn L. G. Aspinwall & V. M. Staudinger (Eds.)\b A psychology of human strengths: Fundamental\: questions and future directions for a positive psychology. Washington\b D.C.: American Psychological Association. 215. Shenesey\b J. W.\b & Langhinrichsen-\:Rohling\b J. (2015). Perceived resilience: Examining impacts of \:the deepwater horizon oil spill one-year post-spill. Psychological Trauma: Theory\b Research\b Practice\b and Policy\b 7\b 252–258. doi:10.1037/a0035182 216. Shepherd\b S.\b & Kay\b A. (2012). On the perpetu\:ation of ignorance: System dependence\b system justification\b and the motivated avoidance of sociopolitical \:information. Journal of Personality and Soci\:al Psychology\b 102\b 264–280. 217. Shonkoff\b J.\b Garner\b A.\b & the Committee on Psychosocial Aspects of Child and\: Family Health\b Committee on Early Childhood\b Adoption\b and Depend\:ent Care\b and Section on Developmental and Beh\:avioral Pediatrics. (2012). The lifelong effects of early childh\:ood adversity and toxic stress. American Academy of Pediatrics\b 129\b e232–246. doi:10.1542/peds.2011-2663 218. Shuman\b E. K. (2010). Global climate change and infectious diseases. New England Journal \:of Medicine\b 362(12)\b 1061–1063. 219. Silver\b A.\b & Grek-Martin\b J. (2015). “Now we understand what community really means”: Reconceptualizing the role of sense of pla\:ce in the disaster recovery process. Journal of Environmental Psychology\b 42\b 35–41. 220. Simister\b J.\b & Cooper\b C. (2005). Thermal stress in the USA: Effects on violence and on employee behaviour. Stress and Health: Journ\:al of the \fnternational Society for the \fnvestigation of Stress\b 21(1)\b 3–15. doi:10.1002/ smi.1029 221. Simpson\b D. M.\b Weissbecker\b \f.\b & Sephton\b S. E. (2011). Extreme weather-related events: \fmplications for mental health and well-being. \fn \f. Weissbecker (Ed.)\b Climate change and human well-being: Global c\:hallenges and opportunities (pp. 57–78). New York\b NY: Springer. 222. Somasundaram\b D. J.\b & van de Put\b W. A. C. M. (2006). Management of trauma in special pop\:ulations after a disaster. The Journal of Clin\:ical Psychiatry\b 67(Suppl 2)\b 64–73. 223. Stain\b H. J.\b Kelly\b B.\b Carr\b V. J.\b Lewin\b T. J.\b Fitzgerald\b M.\b & Fragar\b L. (2011). The psychological impact of\: chronic environmental adversity: Responding to prolonged drought. Social Scien\:ce & Medicine\b 73(11)\b 1593–1599. doi:10.1016/j.socscimed.2011.09.016 224. Stain\b H. J.\b Kelly\b B.\b Lewin\b T. J.\b Higginbotham\b N.\:\b Beard\b J. R.\b & Hourihan\b F\:. (2008). Social net\:works and mental health among a farming population. Social Psychiatry and Psychiatric Epidemiology\b 43(10)\b 843–849. 225. Stanke\b C.\b Kerac\b M.\b Prudhomme\b C.\b Medlock\b J.\b & Murray\b V. (2013). Health effects of drought: A systematic review of the evidence. PLOS Currents Disasters. doi:10.1371/currents. dis.7a2cee9e980f91ad7697b570bcc4b004 226. Stockholm Environment \fnstitute. (2016). Building brid\:ges and changing minds: \:\fnsights from climate communication research practice. Discussion brief. Stockholm\b Sweden. Retrieved from https://www.sei-international.org/cli- mate-services/publications 2 2 7. Swim\b J.\b Clayton\b S.\b Doherty\b T.\b Gifford\b R.\b Howard\b G.\b Reser\b J.\b . . . Weber\b E. U. (2009). Psychology and global climate change: Addressing a multifaceted phenomenon and set of challeng\:es. Rep. of APA Task Force on the \fnterface between Psychology and GlobalC\:limate Change (p. 108). Retrieved from www.apa.org/science/about/pub- lications/climate-change-booklet.pd\:f 228. Syal\b S.\b Wilson\b R.\b Crawford\b J. J.\b & Lutz\b J. (2011). Climate change and human he\:alth-what influences the adoption of adaptation programming in the Unit\:ed States public health system? Mitigation & Adaptation Strategies for Global Change\b 16(8)\b 911–924. doi:10.1007/s11027-011-9302-1 229. Tapsell\b S. M.\b & Tunstall\b S. M. (2008). \:“\f wish \f’d never heard of Banbury”: The relationship between “place” and the health impacts \:of flooding”. Healt\:h & Place\b 14(2)\b 133–154. 230. Terpstra\b T. (2011). Emotions\b trust\b and perceived risk: Affective and cognitive routes to flood preparedness behavior. Risk Analysis\b 31(10)\b 1658–1675. doi:10.1111/ j.1539-6924.2011.01616.x 231. Trtanj\b J.\b Jantarasami\b L.\b Brunkard\b J.\b Collier\b T.\b Jacobs\b J.\b Lipp\b E.\b . . . Thurston\b J. (2016). Climate impacts on water- related illness. The impacts of climate change on human health in the Unit\:ed States: A scientific assessment (pp. 157–188). Washington\b D.C.: U.S. Global Change \:Research Program. doi:10.7930/J03F4MH 232. Trumbo\b C.\b Lueck\b M.\b Marl\:att\b H.\b & Peek\b L. (2011). The effect of proximity to hurricanes Katrina and Rita on subsequent hurricane\: outlook and optim\:istic bias. Risk Analysis\b 31(12)\b 1907–1918. doi:10.1111/j.1539-6924.2011.01633.x 233. Tschakert\b P.\b Tutu\b R.\b & Alcaro\b A. (2013). Embodied experiences of landscape and \:climatic changes in landscapes of everyday life in Ghana. Emotio\:n\b Space\b and Society\b 7\b 13–25. 234. Ungar\b M.\b & Liebenberg\b L. (2013). A measure of resilience with contextual sensitivity: T\:he CYRM-28: Exploring th\:e tension between homogeneity an\:d heterogeneity in resilience theory and research. \fn S. Prince-Embury (Ed.)\b Resilience in children\b adolescents\b and adults (pp\:. 213–225). doi:10.1007/978-1-4614-4939-3 235. United States Global Change Research Program. (2016). The impacts of climate change on human h\:ealth in the united states: a scientific assessment. Washington\b D.C.: Author. doi:10.7930/J0R49NQX 236. U.S. Environmental Protection Agency. (2016). Climate change and the he\:alth of occupational groups. Retrieved from https://www.epa.gov/sites/production/ files/2016-06/documents/occupational-health-cli- mate-change.pdf 2 3 7. Van Dijk\b M. L.\b De \:Groot\b R. H. M.\b Van Acker\b F.\b | Savelberg\b H. C. M.\b & Kirsc\:hner\b P. A. (2014). Active commuting to school\b cognitive performance\b and academic achievement: An observational study in Dutch adolescents using accelerometers. BMC Public Health\b 14\b 799. doi:10.1186/1471-2458-14-799 238. Van Zomeren\b M.\b Spears\b R.\b &\: Leach\b C. W. (2010). Experimental evidence for a dual pathway model analysis of coping with the clim\:ate crisis. Journal of Environmental Psychology\b 30(4)\b 339–346. doi:10.1016/j.jenvp.2010.02.006 239. Vida\b S.\b Durocher\b M.\b Ouarda\b T.\b & Gosselin\b P. (2012). Relationship between ambient temperature and humidity and visits to mental health em\:ergency departments in Quebec. Psychiatric Services\b 63(11)\b 1150–1153. 240. Voggesser\b G.\b Lynn\b K.\b Daigle\b J.\b Lake\b F.\b & Ranco\b D. (2013). Cultural impacts to tribes from climate change influences on forests. Climatic Change\b 120\b 615–626. 241. Wang\b S.\b Zhang\b J.\b Zeng\b X.\b Zeng\b Y.\b Wang\b S.\b & Chen\b S. (2009). Association of traffic-related air pollution w\:ith children's neurobehavioral functions in Qua\:nzhou\b China. Environmental Health Perspectives\b 117\b 1612–1618. 242. Wasini\b S.\b West\b C.\b Mills\b J.\b & Usher\b K. (2014). The psychosocial impact of \:natural disasters among adult survivors: An integrative review. \fssues in Mental Health Nursing\b 35\b 420–436. 243. Weber\b E. U.\b & Stern\b P. (2011). Public understanding of climate change in the Uni\:ted States. American Psychologist\b 66(4)\b 315–328. doi:10.1037/a0023253 244. Weine\b S. M.\b Ware\b N.\b Hakizimana\b L.\:\b Tugenberg\b T.\b Currie\b M.\b Dahnweih\b G.\b & Wulu\b J. (2014). Fostering resilience\b Protective agents\b resources\b and mechanisms for adolescent refugees’ psychosocial wellbeing. Adolescent Psychiatry\b 4\b 164–176. doi:10.2174/221067660 403140912162410 245. Weissbecker\b \f.\b & Czinez\b J. (2011). Humanitarian \:crises: The need for cultural competence and local capacity\: building. \fn \f. Weissbecker (Ed.)\b Climate change and human well-being: global c\:hallenges and oppor\:tunities (pp. 79–96). New York\b NY: Springer. 246. Wener\b R. E.\b & Evans\b G. W. (2007). A morning stroll: Levels of physical activty in car\: and mass transit commuting. Environment and Behavior\b 39(1)\b 62–74. doi:10.1177/0013916506295571 2 4 7. Wickes\b R.\b Zahnow\b R.\b Taylor\b M.\b & Piquero\b A. R. (2015). Neighborhood structure\b social capital\b and\: community resilience: Longitudinal evidence from the 2011 Brisbane flood disaster. Social Science Quarterly\b 96\b 330–353. doi:10.1111/ssqu.12144 248. Wildcat\b D. (2013). \fntroduction: Climate change and indigenous peoples \:of the USA. Climatic Change Journal\b\: 120\b 509–515. 249. World Heart Federation. (2016). Cardiovascular disease risk factors: Stress. Retrieved from http://www. world-heart-federation.org/cardiovascular-health/ cardiovascular-disease-risk-factors/stress/ 250. Yun\b K.\b Lurie\b N.\b & Hyde\b P. S. (2010). Moving mental health into the disaster-preparednessspotlight. The New England Journal \:of Medicine\b 363(13)\b 1193–1194. doi:10.1056/NEJMp1008304 251. 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68 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 69 GLOSSARY Acute: A condition that i\b \bevere and \budden-on\bet. (pg. 2\m4) Adaptation: Modification to fit a changed environment or adju\bt to cultural \burrounding\b. (pg. 25) Agency: The feeling of being th\me agent exerting power over a given action. (pg. 38)\m Aggression: Ho\btile or violent be\mhavior or attitude\b toward another; readine\b\b to attack or confront. (pg. 26) Anxiety: A negative emotional \btate occurring in \bome form\b of mental di\bor\mder that cau\be nervou\bne\b\b, fear, apprehen\bion, and worry. (pg. 24) Arousal: Heightened phy\biological activity \m cau\bed by reaction to \btimuli. (pg. 26) \fassandras: With origin\b in Greek mythology, the Ca\b\bandra \byndrome occur\b when valid warning\b or concern\b are di\bmi\b\bed or di\bbelieved. (pg. 59) \fausality: The mental experience that one event follow\b another becau\be on\me cau\bed the other. (pg. 38) \fhronic: A condition that i\b a long-developing \byndrome. Note that a chronic condition may cau\be an acute condition. (pg. 24, 29) \fommunity efficacy: The \ben\be within a \m community that member\b have the re\bource\b and the ability to u\be them to achieve common goal\b. (pg. 48\m) \fritical incident s\ltress management: An adaptive, \bhort-term p\bychological helping proce\b\b that focu\be\b \bolely on an \mimmediate and identifiable problem. It can range from pre-incident preparedne\b\b to acute cri\bi\b management to po\bt-cri\bi\b follow-up. (pg. 50) \birectly: An impact that occur\b through immediate interaction of an activi\mty. (pg. 24) \bysregulation: An abnormality or \mimpairment in the metabolic, ph\my\biological, or p\bychological regulation proce\b\be\b. (pg. 38) Ecoanxiety: A chronic fear of environmental doom. (pg. 29) Ecomigration: The migration of population\b for economic or ecological rea\bon\b; often occur\b a\b a re\bult of the deterioration of land. (pg. \m31) Environmental refugees: People who have been forced to permanently or temporarily leave their traditional habitat becau\be of a natural or triggered environmental di\bturbance that \beriou\bly jeopardize\b their quality of\m life or exi\btence. (pg. 31) Food insecurity: Being without reliable acce\b\b to food that i\b \bufficient in qua\mntity and quality. (pg. 10) Food safety: Handling, preparation, and \btorage of food in way\b that prevent food-borne illne\b\b. (pg. 13) Group identity: Sen\be of belonging \mto a group. (pg. 32) Healthy community: A community with a \btrong \bocial fabric and mutual \bup\mport, that encourage\b civic involvement, allow\b people to expre\b\b them\belve\b, and maintain\b \btructure and order (Moo\b, 2008). (\mpg. 47) Indirectly: An impact that i\b produced away from or a\b a re\bult of a complex impact pathway. Al\bo known a\b \becondary or even third-level. (pg. 24) Intergroup: A group that deal\b with two or more collection\b of different people; taking \m place or being between group\b. (pg. 23) Mental health: The ability to function cognitively and emotionally\m. Meta-analysis: A \btati\btical technique that look\b for \bignificant pattern\b of re\bult\b acro\b\b multiple \bcientific \btudie\b. (pg. 24)Mindfulness: A mental \btate achieved by focu\bing one’\b awarene\b\b on the pre\bent moment, while calmly\m acknowledging and accepting one’\b feeling\b, thought\b, \mand bodily \ben\bation\b, u\bed a\b a the\mrapeutic technique. (pg. 45) Motivated cognition: A p\bychological phenomenon that illu\btrate\b how incoming information can be \belectiv\mely interpreted and u\bed to reach \bpecific, bia\bed \mconclu\bion\b rather than one\b ba\be\md on an unbia\bed a\b\be\b\bment of the evidence. (pg. 19) Post-traumatic growth: Po\bitive p\bychological change experienced a\b a re\bult of a challeng\me or adver\bity in order to increa\be functioning. \m (pg. 42) Psychological distance: The extent to which an individual thin\mk\b about an event, per\bon, or idea a\b ab\btract and \beparate from hi\b or her current reality, in\btead of being concrete and directly experienced. (pg. 18,6) Psychopathology: A mental di\border in which an individual di\bpl\may\b amoral and anti\bocial behavior and lack\b the \mability to love or e\btabli\bh meaningful per\bonal \mrelation\bhip\b. (pg. 24) Phobic: Relating to phobia, which i\b a\m per\bi\btent and irrational fear of a \bpecific object, activity, or \bituation that lead\b to a de\bire to avoid it. (pg. 24) Resilient communities: Communitie\b that continue\b to function and offer\b aid and kindne\b\b through adver\bity. (pg. 47) Risky behavior: A life\btyle activity that place\b a per\bon at increa\bed ri\bk of \buffering a particular condition, illne\b\b, or injury. (pg. 25) Resilience: The ability of a per\m\bon (or a community) to function in the f\mace of adver\bity, to \burvive, and, perhap\b, even to thrive (Hobfoll, Steven\b, & Zalta, 2015). The capacity to recover quickly from adver\bity or difficultie\m\b. (pg. 10, 42) Self-efficacy: People’\b belief in their o\mwn ability to \bucceed in a \bituation or to accompli\bh a ta\bk. (pg. \m44) Self-regulation: A per\bon’\b ability to direct and control hi\b or her behavior and impul\be\b. (\mpg. 26) Sense of self: An individual’\b perception of hi\b or her\belf, or \belf-image. (pg. 48) Social capital: The aggregate of \bocial re\bource\b or network\b of relation\bhip\b that enable a community to function effectively. (pg. 31) Social cohesion: The willingne\b\b of member\b of a \bociety to cooperate with each other i\mn order to \burvive and pro\bper. (pg. 31) Solastalgia: The lived experience of negatively perceived change to a home environment. (pg. 27) Somatize: To experience p\bychological di\btre\b\b in the form of phy\bical \bymptom\b, \buch a\b headache\b or \btomachache\b. (pg. 38) Somatic: Mental di\border\b characterized by an empha\bi\b on phy\bical \bymptom\b, \buch a\b pain or fatigue. (pg. 24) Suicidal ideation: Suicidal thought\b,\m or thought\b about how to kill one\belf, which can range from a detailed plan \mto a fleeting con\bideration that doe\b not include \mthe final act of killing one\b\melf. (pg. 24) Worldviews: Set\b of deeply hel\md belief\b and attitude\b about how the world work\b and how people \bhould relate to one another. (pg. 19)

68 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance American P\bychological A\b\bociation | ecoAmerica 69 GLOSSARY Acute: A condition that i\b \bevere and \budden-on\bet. (pg. 2\m4) Adaptation: Modification to fit a changed environment or adju\bt to cultural \burrounding\b. (pg. 25) Agency: The feeling of being th\me agent exerting power over a given action. (pg. 38)\m Aggression: Ho\btile or violent be\mhavior or attitude\b toward another; readine\b\b to attack or confront. (pg. 26) Anxiety: A negative emotional \btate occurring in \bome form\b of mental di\bor\mder that cau\be nervou\bne\b\b, fear, apprehen\bion, and worry. (pg. 24) Arousal: Heightened phy\biological activity \m cau\bed by reaction to \btimuli. (pg. 26) \fassandras: With origin\b in Greek mythology, the Ca\b\bandra \byndrome occur\b when valid warning\b or concern\b are di\bmi\b\bed or di\bbelieved. (pg. 59) \fausality: The mental experience that one event follow\b another becau\be on\me cau\bed the other. (pg. 38) \fhronic: A condition that i\b a long-developing \byndrome. Note that a chronic condition may cau\be an acute condition. (pg. 24, 29) \fommunity efficacy: The \ben\be within a \m community that member\b have the re\bource\b and the ability to u\be them to achieve common goal\b. (pg. 48\m) \fritical incident s\ltress management: An adaptive, \bhort-term p\bychological helping proce\b\b that focu\be\b \bolely on an \mimmediate and identifiable problem. It can range from pre-incident preparedne\b\b to acute cri\bi\b management to po\bt-cri\bi\b follow-up. (pg. 50) \birectly: An impact that occur\b through immediate interaction of an activi\mty. (pg. 24) \bysregulation: An abnormality or \mimpairment in the metabolic, ph\my\biological, or p\bychological regulation proce\b\be\b. (pg. 38) Ecoanxiety: A chronic fear of environmental doom. (pg. 29) Ecomigration: The migration of population\b for economic or ecological rea\bon\b; often occur\b a\b a re\bult of the deterioration of land. (pg. \m31) Environmental refugees: People who have been forced to permanently or temporarily leave their traditional habitat becau\be of a natural or triggered environmental di\bturbance that \beriou\bly jeopardize\b their quality of\m life or exi\btence. (pg. 31) Food insecurity: Being without reliable acce\b\b to food that i\b \bufficient in qua\mntity and quality. (pg. 10) Food safety: Handling, preparation, and \btorage of food in way\b that prevent food-borne illne\b\b. (pg. 13) Group identity: Sen\be of belonging \mto a group. (pg. 32) Healthy community: A community with a \btrong \bocial fabric and mutual \bup\mport, that encourage\b civic involvement, allow\b people to expre\b\b them\belve\b, and maintain\b \btructure and order (Moo\b, 2008). (\mpg. 47) Indirectly: An impact that i\b produced away from or a\b a re\bult of a complex impact pathway. Al\bo known a\b \becondary or even third-level. (pg. 24) Intergroup: A group that deal\b with two or more collection\b of different people; taking \m place or being between group\b. (pg. 23) Mental health: The ability to function cognitively and emotionally\m. Meta-analysis: A \btati\btical technique that look\b for \bignificant pattern\b of re\bult\b acro\b\b multiple \bcientific \btudie\b. (pg. 24)Mindfulness: A mental \btate achieved by focu\bing one’\b awarene\b\b on the pre\bent moment, while calmly\m acknowledging and accepting one’\b feeling\b, thought\b, \mand bodily \ben\bation\b, u\bed a\b a the\mrapeutic technique. (pg. 45) Motivated cognition: A p\bychological phenomenon that illu\btrate\b how incoming information can be \belectiv\mely interpreted and u\bed to reach \bpecific, bia\bed \mconclu\bion\b rather than one\b ba\be\md on an unbia\bed a\b\be\b\bment of the evidence. (pg. 19) Post-traumatic growth: Po\bitive p\bychological change experienced a\b a re\bult of a challeng\me or adver\bity in order to increa\be functioning. \m (pg. 42) Psychological distance: The extent to which an individual thin\mk\b about an event, per\bon, or idea a\b ab\btract and \beparate from hi\b or her current reality, in\btead of being concrete and directly experienced. (pg. 18,6) Psychopathology: A mental di\border in which an individual di\bpl\may\b amoral and anti\bocial behavior and lack\b the \mability to love or e\btabli\bh meaningful per\bonal \mrelation\bhip\b. (pg. 24) Phobic: Relating to phobia, which i\b a\m per\bi\btent and irrational fear of a \bpecific object, activity, or \bituation that lead\b to a de\bire to avoid it. (pg. 24) Resilient communities: Communitie\b that continue\b to function and offer\b aid and kindne\b\b through adver\bity. (pg. 47) Risky behavior: A life\btyle activity that place\b a per\bon at increa\bed ri\bk of \buffering a particular condition, illne\b\b, or injury. (pg. 25) Resilience: The ability of a per\m\bon (or a community) to function in the f\mace of adver\bity, to \burvive, and, perhap\b, even to thrive (Hobfoll, Steven\b, & Zalta, 2015). The capacity to recover quickly from adver\bity or difficultie\m\b. (pg. 10, 42) Self-efficacy: People’\b belief in their o\mwn ability to \bucceed in a \bituation or to accompli\bh a ta\bk. (pg. \m44) Self-regulation: A per\bon’\b ability to direct and control hi\b or her behavior and impul\be\b. (\mpg. 26) Sense of self: An individual’\b perception of hi\b or her\belf, or \belf-image. (pg. 48) Social capital: The aggregate of \bocial re\bource\b or network\b of relation\bhip\b that enable a community to function effectively. (pg. 31) Social cohesion: The willingne\b\b of member\b of a \bociety to cooperate with each other i\mn order to \burvive and pro\bper. (pg. 31) Solastalgia: The lived experience of negatively perceived change to a home environment. (pg. 27) Somatize: To experience p\bychological di\btre\b\b in the form of phy\bical \bymptom\b, \buch a\b headache\b or \btomachache\b. (pg. 38) Somatic: Mental di\border\b characterized by an empha\bi\b on phy\bical \bymptom\b, \buch a\b pain or fatigue. (pg. 24) Suicidal ideation: Suicidal thought\b,\m or thought\b about how to kill one\belf, which can range from a detailed plan \mto a fleeting con\bideration that doe\b not include \mthe final act of killing one\b\melf. (pg. 24) Worldviews: Set\b of deeply hel\md belief\b and attitude\b about how the world work\b and how people \bhould relate to one another. (pg. 19)

70 Mental Health and Our Changing Climate\f Impact\b, Implication\b, and Guidance 1730 Rhode I\bland Avenue NW, Suite 200 Wa\bhington, D.C. 20036 870 Market Street, Suite 428 San Franci\bco, CA 94102 2 0 2 . 4 5 7. 1 9 0 0 ecoAmerica.org ecoAmerica builds a critical mass of institutional leadership\f public support\f and political will for definitive climate solutions in the \bnited States. Thi\b wa\b printed with a Certified Green Partner, en\buring that the paper contain\b fiber\b from \bu\btainable and well–managed fore\bt\b, and the u\be of vegetable–ba\bed ink.

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