While Australia Burns: What Psychiatrists Can Learn From Each Other

It would be hard for any American psychiatrist not to have noticed the unprecedented crisis in this Australian summer of fire, attributed at least in part to climate change. Australia appears to have surfaced as the proverbial canary in the coal mine regarding future catastrophic consequences. Not coincidentally, 2019 recorded the highest temperatures worldwide since temperatures were first recorded.

The toll is staggering: decimated forests, air pollution, people being evacuated, and approximately a billion animals dead so far. The accumulating tragedies have shaken us. If you have any love of animals, and of course we humans are animals too, who cannot be heartbroken by the images of wildlife loss; attempts to rescue the koalas, kangaroos, and wallabies are heroic yet heartbreaking.

Whose heart would not be racing when fire tornadoes are in sight? If you saw the old movie On the Beach, how can you not be reminded of the Australian beach where the world as we know it was ending after a nuclear disaster? Perhaps that movie played a role in the world not having a nuclear disaster (yet). Will the images of refugees on the Australian coast contribute to reducing climate instability?

Solastalgia

At this point, Australia is Ground Zero for climate instability and its consequent mental health repercussions. More than a decade ago, Glenn Albrecht, an Australian philosopher coined the word, solastalgia, a new psychiatric syndrome-distress caused by environmental change.¹ At that time Albrecht was not referring to fires, but to the despoiling of beloved environments by coal mines. Solastalgia will likely increase globally, as well as posttraumatic stress disorder, depression, and ecological grief, necessitating the availability of more therapeutic services.

Australia can seem a world away from America. As such, it is easier to ignore and deny what is happening there, while we are in the cold of winter. Australian psychiatrists, however, are actively engaged in confronting climate change and its impact on mental health.

In his keynote address at the Royal Australia and New Zealand College of Psychiatrists (RANZCP) Congress this past May, Professor Ernest Hunter called for psychiatrists to speak out on climate change.² In December of 2019, the RANZCP published their concerns in “Statement on Climate Change and Mental Health.” This statement was soon followed by another for 2020, “Position Statement 35: Addressing the Mental Health Impacts of National Disasters and Climate-Related Weather Events.” The organization emphasized the important role psychiatrists play in disaster planning and responsiveness, not only acutely but as an ongoing endeavour.

Professor Helen Berry at the University of Sydney School of Public Health is an expert in climate change and mental illness. In an article written in 2018, Berry and colleagues³ discuss the limitations of current thinking about climate change and mental health. They conclude that a systems approach and a new style of research leadership is essential: “Systems thinking, which describes the big picture as well as the detail, can be used to help drive ideas towards the radical action needed.”

The US-Australia connection

The US and Australia were connected to Great Britain in our mutual early development. During colonization, native populations, who lived as stewards of the land, were displaced and discriminated against. Both countries are large and have vast natural resources, but many of them have been mismanaged through the ages, resulting in the release of too much carbon. Now both the US and Australia are confronted with fierce fires exacerbated by rampant drought that is only one of the consequences of climate change.

Australia’s current political environment is similar to that of the US. Australia’s leader continually emphasizes that coal is king, even as the carbon released from coal contributes to Australia burning.⁴

Since summer has just begun in Australia, more fires are expected. American firefighters have joined the fight; they received a standing ovation at the airport. (Previously, Australian firefighters helped in California.)

Millions of animals have been lost to the fires. Many more are hurt, lost, abandoned. Worldwide, people are sending aid to help the animals-crafting guilds are sewing pouches and nests and the American Veterinary Medical Association (AMVA) is donating funds to Australian veterinarians.

Psychiatric burnout

Australia and America share another social problem: psychiatric burnout. When I was asked to join the newly formed American Psychiatric Association Workgroup on Psychiatrist Wellness and Burnout a few years ago, I looked into what Australia was doing about psychiatrist burnout. I found the “Top 5 Self-Care Tips for Psychiatrists,” produced by RANZCP. Akin to problems psychiatrists in the US face, the article, “Overburdened Psychiatrists Abandon ‘Broken’ Public System” published in The Sydney Morning Herald by Kate Aubusson discusses the reasons Australian psychiatrists are leaving for private practice in droves.

As I wrote in a January 24, 2017 article (“What Do Climate Change and Physician Burnout Have in Common?”) for Psychiatric Times, I believe the underlying cause of many problems in both countries appears to be related to capitalism run amok. Some corporations dominate health care, others are leading contributors to environmental pollution-resulting in burnout and environmental cirses. Now, we can add the destruction of animal habitats to the climate and burnout crises.⁵

Recommendations

What, then, is important for Australian and American psychiatrists to learn from each other?

We must continue to understand and define the numerous psychiatric consequences of both physician burnout and the psychological scars that result from the many tragic consequences of climate change.

1) We need to institutionalize climate and psychiatry in our guild organizations and ideally recognize climate psychiatry as a formal entity in the psychiatric nomenclature.

2) We need knowledgeable faculty in the departments of psychiatry who are able to teach climate psychiatry.

3) We need to collaborate with veterinarians because the dangers of climate instability and burnout apply to all animals, not just humans.

4) We need to lobby for increased attention and funding to educate all countries about the human, animal, plant, ecological, political, cultural, and global effects of continued climate change that is leading to the point of no return, at which point our efforts to stop and reverse the progression of climate trends will be ineffective.

5) We need to learn more from our indigenous populations, including the small numbers of aboriginal or native American psychiatrists and their traditions of being stewards for the land.

6) We need to consider ways American psychiatrists can help Australian psychiatrists in the current crisis.

7) American psychiatrists need to understand what Australian psychiatry regrets not doing so that we can avoid making the same mistakes.

8) We need a unique Australian/American psychiatric working coalition that focuses on the intersecting triad of climate, burnout, and animals that conducts virtually meetings to minimize the carbon effects of long flights!⁶

Because climate instability is a global challenge, America and Australia, on different sides of the world, can model how global partnerships can work. As the poet Warsan Shire wrote at the end of the poem What They Did Yesterday Afternoon7:

. . . later that night
I held an atlas in my lap
ran my fingers across the whole
world
and whispered
where does it hurt?
it answered
everywhere
everywhere
everywhere

Disclosures:

Dr Moffic is an editorial board member and regular contributor to Psychiatric Times. He was a tenured Professor at the Medical College of Wisconsin until he retired in 2012. Since then he has functioned as a private community psychiatrist providing pro bono services locally, nationally, and internationally. Currently, he is focused on four major advocacy initiatives: physician burnout, climate instability, Islamophobia, and anti-Semitism. He is co-editor of Combating Physician Burnout: A Guide for Psychiatrists, with Richard F. Summers and Sheila Loboprabhu.

References:

1. Albrecht GA. Earth Emotions. New York: Cornell University Press; 2019.

2. Hunter E. Vicarious Dreaming: With Jack Idriess on Madman’s Island. Sydney, Australia: ETT Imprint; 2019.

3. Berry H, Waite TD, Dear KBG, et al. The case for systems thinking about climate change and mental health. Nature Climate Change. 2018;8:282-290.

4. Morton A. Revealed: northern Australia’s fossil fuel plans push climate goals beyond reach. The Guardian. October 9, 2019.

5. Moffic S. A psychiatrist, a veterinarian, and an emergency physician resolve to improve mental health. Psychiatric Times. January 23, 2019; Epub ahead of print.

6. Louv R. Our Wild Calling. Chapel Hill, NC: Algonquin; 2019.

7. Shire W. What They Did Yesterday Afternoon. November 2016.