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

International and Cultural Psychology

Series Editor Anthony J. Marsella, Ph.D.

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

Inka Weissbecker Editor

Climate Change and Human Well-Being Global Challenges and Opportunities

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Editor Inka Weissbecker Washington, DC [email protected]

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

Preface

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

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

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

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

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

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

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

Acknowledgments

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

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Contents

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

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The Impact of Climate Change

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

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

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

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

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

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Specific Populations

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

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

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Part III

Guidance and Recommendations

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

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

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

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

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Contributors

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

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

Chapter 1

Introduction: Climate Change and Human Well-Being Inka Weissbecker

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Chapter 3

Chronic Environmental Change: Emerging ‘Psychoterratic’ Syndromes Glenn Albrecht

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

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

I. Weissbecker (ed.), Climate Change and Human Well-Being, International and Cultural Psychology, DOI 10.1007/978-1-4419-9742-5_3,  C Springer Science+Business Media, LLC 2011

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

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

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

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

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

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

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

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

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

Psychoterratic (Psyche-Earth)

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

Ecoanxiety Ecoparalysis Solastalgia Econostalgia/nostalgia

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Chapter 4

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

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

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

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

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

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

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

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

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

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

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

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

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

Onset

Scale

Duration

Warning period

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

Slower Rapid Slower Slower Rapid Rapid

Regional Local Regional Regional Local/regional Regional

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

Yes No Yes Yes No Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Laukkonen, J., Blanco, P. K., Lenhard, J. Keiner, M., Branko, C., & Kinuthia-Njenga, C. (2009). Combining climate change adaptation and mitigation measures at the local level. Habitat International, 33(3), 287–292. Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer. Lerner, E. B., & Moscati R. M. (2008). The golden hour: Scientific fact or medical “urban legend”? Academic Emergency Medicine, 8(7), 758–760. Lowder, D. (1995). The day the earth moved. Health Facilities Management, 8(8), 72, 74–75. Lubit, R., Rovine, D., DeFrancisci, L., & Eth, S. (2003). Impact of trauma on children. Journal of Psychiatric Practice, 9(2), 128–133. Madrid, P. A., Grant, R., Reilly, M. J., & Redlener, N. B. (2006). Challenges in meeting immediate emotional needs: Short-term impact of a major disaster on children’s mental health: Building resiliency in the aftermath of Hurricane Katrina. Pediatrics, 117(5 Pt 3), S448–453. Madrid, P. A., & Grant, R. (2008). Meeting mental health needs following a natural disaster: Lessons from Hurricane Katrina. Professional Psychology: Research and Practice, 39(1), 86–92. Manyena, S. B. (2006). Rural local authorities and disaster resilience in Zimbabwe. Disaster Prevention and Management, 15(5), 810–820. Marsella, A. J., & Christopher, M. A. (2004). Ethnocultural considerations in disasters: An overview of research, issues, and directions. Psychiatric Clinics of North America, 27(3), 521–539. Marshall, R. D. et al. (2007). The psychology of ongoing threat – Relative risk appraisal, the September 11 attacks, and terrorism-related fears. American Psychologist, 62, 304–316. Masten, A. S., Best, K. M., & Garmezy, N. (1990). Resilience and development: Contributions from the study of children who overcome adversity. Development and Psychopathology, 2, 425–444. McEwen, B. S. (2008). Central effects of stress hormones in health and disease: Understanding the protective and damaging effects of stress and stress mediators. European Journal of Pharmocology, 583(2–3), 174–185. Miller, T. W. (2007). Trauma, change, and psychological health in the 21st century. American Psychologist, 62(8), 889–898. Nachmias, M., Gunnar, M., Mangelsdorf, S., Parritz, R., & Buss, K. (1996). Behavioral inhibition and stress reactivity: The moderating role of attachment security. Child Development, 67(2), 508–522. Norris, F. H., Friedman, M. J., Watson, P. J., Byrne, C. M., Diaz, E., & Kaniasty, K. (2002). 60,000 disaster victims speak: Part I. An empirical review of the empirical literature, 1981–2001. Psychiatry, 65(3), 207–39. Oliver-Smith, A. (1998). Global changes and the definition of disaster. In E. L. Quarantelli (Ed.), What is a disaster (pp. 177–194). London: Routledge. Osofsky, J., & Osofsky, O. H. (2006). Children and adolescents displaced by Katrina: In the eye of the storm – resilience in Katrina’s wake. Paper presented at the 19th U.S. Psychiatric and Mental Health Congress, New Orleans, LA. Palakudiyil, T., & Todd, M. (2003). Facing up to the storm: How local communities can cope with disasters: Lessons from Orissa and Gujarat. London: Christian Aid. Peduzzi, P. (2005). Is climate change increasing the frequency of hazardous events? The Environment and Poverty Times, No. 3. Published as part of special edition for the world conference on disaster reduction January 18–22, 2005, Kobe, Japan. GRID-Arendal. Available at: http://www.grida.no/publications/et/ep3/page/2598.aspx Quarantelli, E. L. (1981). An Agent Specific or an All Disaster Spectrum Approach to SocioBehavioral Aspects of Earthquakes? University of Delaware: Disaster Research Center. http:// dspace.udel.edu:8080/dspace/handle/19716/441. Last accessed 5/4/2011. Quarantelli, E. L. (Ed.). (1998). What is a disaster?: Perspectives on the question. London: Routledge. Reacher, M., McKenzie, K., Lane, C., Nichols, T., Kedge, I., Iversen, A., et al. (2004). Lewes flood action recovery team. Health impacts of flooding in Lewes: A comparison of reported

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

Chapter 5

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

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

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

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

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

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Map 13:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Chapter 6

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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particularly vulnerable. The net aggregate effects of climate change are expected to be overwhelmingly negative, whether measured in terms of ecosystem health, excess morbidity and mortality of human populations, mental health impacts, economic damages, or political and social measures of stability. Availability of vital resources such as land, food, and water may threaten the sustainability of communities unable to adapt, and vulnerable nodes in key systems may fail, spreading impacts far beyond the local and visible. Several authors have warned of impeding resource wars and environmental conflicts fueled by resource scarcity and increased migration. However, we have argued that an escalation of violent conflicts that might be regarded as genuinely ‘environmental conflicts’ is not currently likely to occur. Security cannot focus on issues of violence as in the past, nor will visible issues such as resource scarcity and mass migration suffice. These are likely symptoms of deeper issues in the area, which must be more comprehensively addressed and understood. Researchers and practitioners must also remain aware that impacts may be second- or third-order effects of earlier changes, and that these relationships may be far removed in space and time. Care should be taken to increase the ability of states and communities to adapt to new situations, to decrease key vulnerabilities and risks prioritize policies to mitigate effects and prevent systemic failure of fragile systems. Means of decreasing vulnerabilities and reducing the risk of conflict include foresight and early warning, promoting community adaptation and access to resources, reducing inequalities, and promoting cooperation and shared goals in the development of disaster mitigation and response. However, more research is needed to shed light on key factors and their interrelationships. Research on environment and conflict has been dominated largely by political science. The social sciences and natural sciences need to cooperate more closely for the purpose of investigating the societal implications of climate change. This can be achieved with greater cooperation among the associated disciplines and by developing common metrics and conceptual frameworks that can integrate data and information from various sources.

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Part II

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

Introduction Though some skeptics remain, increasingly climate change is recognized as the crisis of the 21st century, affecting not only the lives of the present generation but reaching far into the future to dramatically change the environmental space of generations to come. It is also agreed that while everyone will suffer the consequences of climate change regardless of race, caste, ethnicity, sex, and level of income (e.g., Dunkelman, 2008; Mitchell, Tanner, & Lussier, 2007), the world’s poor, of whom 70% are women, are the most vulnerable (Aguilar, 2009; American Psychological Association [APA] 2009; Brody, Demetriades, & Esplen, 2008; United Nations Development Program [UNDP], 2007; Women’s Environment and Development Organization [WEDO], 2007; Genanet/LIFE e.V. [gen] & Women in Europe for a Common Future [WECF], 2006). Climate change is not gender neutral (Dunkelman, Alam, Ahmed, Gueye, Fatema, & Mensah-Kutin, 2008). This relationship between women and climate change has been implicitly recognized in gender equality policies and agreements, which include provisions linking women with environment and sustainable development dating back to the late 1970s. For example in 1979, The Convention on the Elimination of Violence against Women (CEDAW) called for integrating a gender perspective into environmental policies, obliging parties to take necessary measures to ensure that women participate in and benefit from rural development. Similarly, Strategic Objective K of the Beijing Platform for Action (1995) committed to securing the active involvement of women in environmental decision making and integrating gender concerns and perspectives in policies and programs for sustainable development. More recently, in 2008, the Manila Declaration for Global Action on Gender, Climate Change and Disaster argued for a gender-sensitive approach to climate change adaptation and disaster risk reduction, and the 52nd Commission on the A.L. Wenden (B) Earth and Peace Education International (EPE), Rego Park, NY, USA; NGO/CSW Subcommittee on Women and Climate Change, New York, NY, USA e-mail: [email protected]

I. Weissbecker (ed.), Climate Change and Human Well-Being, International and Cultural Psychology, DOI 10.1007/978-1-4419-9742-5_7,  C Springer Science+Business Media, LLC 2011

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Status of Women identified gender perspectives on climate change as its key emerging issue. In Resolution 21(jj), Financing for Gender Equality and the Empowerment of Women, the commission urged governments “to integrate a gender perspective in . . . . national environmental policies . . . . [and] . . . . to ensure women’s full and equal participation in decision-making at all levels on environmental issues, in particular on strategies related to climate change and the lives of women and girls” (E/CN.6/2008/L).This notion reappears in the Statement of the CEDAW Committee on Gender and Climate Change (2009), adopted at its 44th session. It calls for “State Parties to include gender equality as an overarching guiding principle in the UNFCCC agreement expected at the 15th Conference of Parties in Copenhagen”. However, despite this documentary foundation on the link between women, environment, and climate change, which has inspired an increasing number of women NGOs to advocate for the inclusion of a gender perspective in climate change policies and programs (e.g., Global Gender & Climate Alliance [GGCA], WEDO, WECF) thus far, according to Aguilar (2009), most of the debate on climate change “has been gender blind” (p. 59), and, as stated in the Statement of the CEDAW Committee (2009), a gender perspective remains absent in the UNFCCC and other global national policies on climate change.1 Unsurprisingly, this also applies to climate change research. The integration of a gender-sensitive perspective in this body of literature is recent, and for this reason little of it focuses on the linkages between climate change and gender (Brody et al., 2008). In response to this lack of recognition of women’s vulnerability to climate change and the leadership they can offer in mitigation and adaptation, this chapter intends to demonstrate that it presents a severe threat to the dignity, livelihood, and, in some cases, even to the very survival of women, primarily those who constitute 70% of the world’s poor but, at the same time, have the capacity to respond to these threats. To that end, insights from a selected review of the literature on women and climate change will be drawn upon to provide an overview of (1) how sociocultural factors contribute to women’s vulnerability to climate change and (2) how the need to adapt to climate change can challenge women to become agents of change in their communities and, in doing so, to reshape their roles and realign relationships of inequality.

Vulnerability of Women to Climate Change According to O’Brien (2007 cited in Dunkelman et al., 2008), the consequences of global warming are closely determined by the context in which they are experienced, and so a vulnerability approach to analyzing and prescribing for the impact of climate change is advocated (also cf. Lambrou & Piana, 2006; Wisner, Blaikie, Cannon, & Davis, 2004). As suggested by a contextual approach, vulnerability refers to the conditions determined by physical, social, economic, and environmental factors or processes that influence a group’s capacity to anticipate, cope with, resist, and recover from not only the impact of natural disasters of a catastrophic

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nature but also other less dramatic manifestations of global warming (based on United Nations International Strategy for Disaster Reduction [UNISDR], 2004; Wisner et al., 2004). However, while appreciating the range of factors that determine vulnerability, the focus of this discussion, as noted above, will be mainly limited to the social-cultural factors contributing to women’s vulnerability as, for the greater part, these apply whatever the specific context of a group.

SocioCultural Factors Contributing to Women’s Vulnerability to Climate Change As noted in the literature (e.g. Pan American Health Organization, n.d.; Enarson, 2000; Genanet et al., 2006; Mitchell et al., 2007; Neumayer & Plümper, 2007; Javate de Dios, 2008), the cultural norms built into every day socioeconomic relations and legal frameworks determine the gendered division of labor and the access women have to a community’s assets. Institutionalizing gender inequality in terms of rights, resources, and voice, these socially ascribed roles and responsibilities make women especially vulnerable to the direct and indirect threats to human security, which come in the wake of climate change, that is, threats to security of survival, livelihood, and human dignity. (For an elaboration of this framework, see Dunkelman et al., 2008.) Gendered Division of Labor Resource degradation and scarcity, natural disasters and disease, displacement, civil war, and conflict, all direct or indirect consequences of climate change, contribute to threatening the human security of women through the roles and responsibilities a society assigns to them, examples of which are given below. Women as Food Providers In rural societies, which depend on local natural resources for daily sustenance, it is the task of women and girls to provide food for their families (Smyth, 2008). In fact, rural women, in particular, are responsible for half of the world’s food production and produce 60–80% of the food in most developing countries (Aguilar, 2009; Mitchell et al., 2007). They are primarily responsible for collecting, using, and managing water and the energy sources necessary to prepare the food (Dunkelman et al., 2008). The scarcity of these basic resources and the difficulty of access to and the cost of what is available increase women’s workload and, in the case of girls, put at risk their opportunities to attend school (WEDO, 2007; Mitchell et al., 2007; Thanh, 2008). In addition, faced with the burden of caring for dependents while being obliged to travel farther for water or firewood, women and girls are prone to stress-related illnesses and at risk for attack and violence in insecure environments (Canadian International Development Association [CIDA], 2002 cited

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in Brody et al., 2008), while the use of inferior energy sources and exposure to contaminated water resources lead to health risks (Enarson, 2000; Patt et al., 2007 cited in Dunkelman et al., 2008; Aguilar, 2009). Women as guardians of health and caregivers. It is also the responsibility of women to watch over the health of their families and communities. They are the primary caregivers when illness strikes (Smyth, 2008; Genanet/LIFEe.V.& WECF, 2006). Global warming adds to the burden of these tasks (Mitchell et al., 2007). Rising sea levels resulting from natural disasters bring vector and waterborne diseases, such as malaria, in their aftermath; increasing temperatures result in heatrelated illness and mortality, with older people and children at the highest risk. The declining quantity and quality of drinking water and calorie deficiency due to food scarcity increase vulnerability to disease and malnutrition. The physical and mental stress of environmental refugees, displaced by food and water scarcity or civil conflict, due to a variety of socioeconomic factors but ignited by scarce resources (Wallace, 2009; CNA, 2007; WEDO, 2007), adds to the responsibilities and challenges of health care as does the limitation of health care options open to women due to the loss of traditional medicines resulting from the decrease in biodiversity brought on by permanent temperature change (Aguilar, 2009). Women as economic actors. Women not only produce food for their families but also contribute to the economy of the community (Dunkelman et al., 2008). However, because they are overrepresented in agricultural and informal sectors (Smyth, 2008; Thanh, 2008; WEDO, 2007), the diminishing availability of arable land, due to weather extremes, and the reduction in agro-biodiversity upon which women rely to diversify their crops to accommodate to climatic variability, is a threat to their livelihood (Enarson, 2000). Increased epidemics resulting from climate variability have also made it harder, especially for female-headed households to adopt new strategies for crop production or to mobilize livestock (Mitchell et al., 2007). In addition, because of their responsibilities as food providers and caregivers, women, unlike men, are often prevented from migrating to look for better employment and/or from availing themselves of opportunities to acquire new skills that would add to their options as economic actors. Women as heads of households. Resource shortage and unreliable job markets, due in part to the impact of climate change on agricultural livelihoods, have led men to leave their homes in search of employment, leading to an increase in femaleheaded households. Civil conflict in which men participate at higher rates has also taken men from their familial responsibilities. As a result, there is an increasing number of female-headed households (Genanet et al., 2006). Women must assume the burden of men’s responsibilities as well as their own without access to the needed resources and, as noted above, in the face of climate variability which threatens their sources of livelihood (Aguilar, 2008, 2009).

Limited or Lack of Access to Community Assets A group’s vulnerability to risks will depend to a great extent on the assets they have available to deal with them (Aguilar, 2009). Because of the gender inequality built

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into cultural norms, women have limited access to or, in some cases, a total lack of access to community resources – physical, financial, human, social, and natural capital – which would enhance their capacity to cope with climatic changes (Brody et al., 2008; Lambrou & Piana, 2006; Aguilar, 2008). In many societies, opportunities to benefit from services for education, training, health, and legal matters are not easily accessible to women and, sometimes, not accessible at all (e.g., see the case studies on Ghana and Senegal in Dunkelman et al., 2008). Additionally, women are, often, not a part of the communication network that provides information regarding forecasted natural disasters and other hazards from climate change. Nor are they informed of related relief programs and technologies for dealing with its impact. They are absent from or have minimal input in the decision-making bodies that plan for natural disaster preparedness and rehabilitation and other climate change mitigation and adaptation activities. As a result, their priorities are neglected. They do not have access to a fair share of financial (e.g., credit), technological, and social resources (e.g. health care services and nutritional resources). These include the distribution of natural disaster immune and arable land and resources for land use (Dunkelman et al., 2008; Brody et al., 2008; Kalyanimitra Foundation, 2008; Smyth, 2008; Thanh, 2008; WEDO, 2007).

How Vulnerability to Climate Change Affects Women As outlined above, due to climate change, the responsibilities assigned to women as food providers, guardians of health, and caregivers have increased their workload. There is more to do, and the difficulty of access and availability adds to the burden of these added tasks. The magnified need for caregiving during periods of environmental stress makes women less mobile and less able to deal with effects of climate change. Moreover, women, like those for whom they must care, find themselves vulnerable to the health risks brought on by improper nutrition and contaminated water resources (Thanh, 2008). As economic actors, they find their options reduced while, at the same time, they are faced with taking on the additional responsibilities of men, fulfilling the tasks of the head of a household. All this is with limited or total lack of access to the needed resources that are available in a community. Additionally, the threats to their human security outlined above are compounded by (1) the mortality and injury they suffer in the face of natural disaster and (2) the feminization of poverty and the violation of their human rights both exacerbated by climate change.

Mortality, Morbidity, and Injuries due to Natural Disasters Research has shown that increased extreme weather events, such as cyclones, hurricanes, floods and heat waves, place a higher toll on the lives of women than that of men (Genanet et al., 2006; Smyth, 2008). For example, findings from Neumayer and Plümper’s (2007) much quoted study of 141 countries that had experienced natural disasters between 1981 and 2002 found that natural disasters lower the life

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expectancy of women more than that of men; the stronger the disaster, the stronger this effect on the gender gap in life expectancy, though the effect was weaker among women from a higher socioeconomic status. Neumayer and Plümper conclude that it is the socially constructed gender-specific vulnerability of women built into everyday socioeconomic patterns that leads to relatively higher female mortality rates compared to those of men in times of natural disasters. Indeed, in the face of natural disasters, women’s caregiving responsibilities can prevent them from fleeing the home (Beinin, 1981 & Oxfam Int’l, 2005 cited in Neumayer & Plümper, 2007). And even if caregiving did not prevent them from doing so, some cultural norms require that they not leave the home in search of safety without a male relative, nor may they relocate after a natural disaster without the relative’s consent. These same norms have prevented them from acquiring lifesaving skills, such as swimming (Genanet et al., 2006; Cannon, 2000 cited in Neumayer & Plümper, 2007; Aguilar, 2008; Thanh, 2008). Moreover, not only does mortality come in the wake of natural disasters, such catastrophic environmental events are also accompanied by increased numbers of injuries and disease morbidity among survivors. In the case of women, they are at higher risk for suffering from PTSD and the domestic violence that has been shown to result from natural disasters and the conflict it may engender (Galea, Nandi, & Vlahov, 2005).

Feminization of Poverty As noted earlier, the world’s poor, of whom 70% are women, are on the front lines when the manifestations of climate change strike. Thus, together with the sociocultural norms that determine the gendered division of labor, poverty is an economic factor that must be recognized as contributing to the vulnerability of women to climatic disasters (Pan American Health Organization, n.d.; Genanet et al., 2006; Mitchell et al., 2007; Neumayer & Plümper, 2007) and other less dramatic but also harmful impacts of global warming. While, on the one hand, poverty makes women more vulnerable to climate change, on the other hand, the impact of climate change on their lives exacerbates these conditions of poverty under which they live. As already noted, poor women are overrepresented in agricultural and informal sectors and so more likely to lose their sources of livelihood in the face of natural disasters, such as hurricanes. Women farmers are often allocated the nonarable land in a community, which will be rendered useless in the event of a drought, thus making rehabilitation more difficult if at all possible. As a result poor women “slip deeper into poverty and the inequality and marginalization they suffer from because of their gender, increases” (Dunkelman et al., 2008, p. 10). Thus climate change contributes to a cycle of poverty, inequality, and vulnerability: it exacerbates the feminization of poverty and, as a result, magnifies existing inequalities between women and men, which in turn make them more vulnerable to and less capable of coping with climate change (Masika, 2002; UNDP, 2007; WEDO, 2007; Mitchell et al., 2007; Dunkelman et al., 2008; Aguilar, 2009; Brody et al., 2008).

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Violation of Human Rights Thus far the impact of women’s vulnerabilities to climate change has been considered from the perspective of human security, analysed by the WEDO framework as (1) security of survival, (2) security of livelihood, and (3) dignity (Dunkelman et al., 2008). In contrast, in their briefing paper, Climate wrongs and human rights, OXFAM (2008) views the impact of climate change from the perspective of human rights. They list four basic human rights acknowledged in the Universal Declaration of Human Rights (UDHR) and the International Covenant of Economic, Social and Cultural Rights (ICESCR), similar to the first two dimensions of human security, outlined in the WEDO framework: the Right to Life and Security (UDHR, article 3), the Right to Food (ICESCR, Article 11), the Right to Subsistence (ICESCR, Article 1.2), and the Right to Health (ICESCR). The report maintains that climate change is set to undermine these human rights on a massive scale and that as documented by the Intergovernmental Panel on Climate Change (IPCC), the continued and excessive emissions of greenhouse gases by countries with highly industrialized economies continues to deprive millions of people of the water, soil, and land they need to survive. Moreover, they note that the rights of vulnerable and marginalized groups, such as women, are particularly at risk. Indeed, climate change as a human rights issue is a notion that has been recently affirmed in the January 15, 2009 Report of the Office of the United Nations High Commissioner for Human Rights, which highlights the observed and projected impacts of climate change and their implication for the enjoyment of human rights and the responsibilities of states under international human rights law (A/HRC/10/61). The Statement of the CEDAW Committee on Gender and Climate Change (2009) addressed to the UNFCCC also demands that climate change and disaster risk reduction “respect human rights”. From this perspective, the impact of climate change on the human security of women is, in effect, a violation of their human rights and a direct threat to the implementation of CEDAW and the Beijing Platform for Action (BPfA). These sources of human security, that is, survival, livelihood, and dignity, are at one and the same time inviolable rights listed not only in the UDHR and the ICESCR but also in the CEDAW, the women’s bill of rights, and the Beijing Platform for Action (BPfA), which aims to implement CEDAW. This is illustrated in Fig. 7.1, which lists some of the vulnerabilities to climate change discussed in preceding sections as examples of human rights violations.

Adaptive Capacities of Women in Responding to Climate Change Climate change presents women with one of the greatest opportunities in history for addressing inequities and enhancing human security (O’Brien, 2007 cited in Dunkelman et al., 2008). It presents them with the opportunity to challenge the relationships of gender inequality written into the norms of social institutions and

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Right to life – survival, security and health • Inferior energy sources and contaminated water lead to health risks. • During natural disasters, more women die than men because they are not warned, cannot swim, or cannot leave the house alone. • Mental health problems also come in the wake of natural disasters. UDHR 3; CEDAW 12,14-2b; BPfA 1,C.2 Right to sources of livelihood—food, water, energy, shelter, economic security • Climate change (CC) increases the difficulty of accessing food, water, and sources of energy, typically the responsibility of women. • Sociocultural norms and increased caregiving responsibilities due to CC prevent women from migrating to look for shelter and work when a disaster hits. UDHR 25 CEDAW 13, 14-2g,h; BPfA F.1 Right to participation— decision-making opportunities and information • Increased responsibilities due to climate change (CC) limit women’s participation in planning and decision making about CC adaptation activities. • Women’s lack of access to local communication networks denies their right to information regarding forecasted natural disasters and related relief services. UDHR 21, 27; CEDAW 7, 8, 14-2 a, f, 15 BPfA G.1, K.1. Right to capacity development—education and income generation opportunities • Increased responsibilities resulting from CC deprive women of opportunities to train for alternative sources of income generation. • During or after disasters, more girls drop out of school to reduce household expenses or to assist with household tasks, or because of early marriage. UDHR 23, 26; CEDAW 10, 11, 14 1, 2 d, e; BPfA A.2, B.1, L.4

Fig. 7.1 Climate change as a violation of women’s human rights. Adapted from Information Sheet, Climate change and the CEDAW, prepared by the NGO/CSW Subcommittee on Women and Climate Change www.ngocsw.org

the perceptions with which they are viewed by society and by which they often view themselves.

Women as Agents of Change in Their Communities After 150 years of industrialization, global warming has gained momentum and will continue to affect the Earth’s natural system for hundreds of years. Nonetheless, measures can and must be taken to reduce the rate of warming by curbing the emission of greenhouse gases (GHG) by human activities. Societies must learn how to reduce the size of their carbon footprint if GHG concentrations are to be kept at a safe level. Efforts must also be made to help people adapt to the consequences of climate change, that is, to be less vulnerable and more resilient.

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It is in this endeavor that women can and must step forward to take leadership as equal partners with men. A view of women and climate change that focuses only on their vulnerabilities is ‘misleading’ (Lambrou & Piana, 2006). It is only one half of the picture; as suggested in Dunkelman et al. (2008), “Too often women are primarily perceived as the main victims of climate change and not as positive agents of change and contributors to livelihood adaptation strategies” (p. 11), and in the Statement of the CEDAW committee (2009), “. . . . women are not just victims of climate change – they are powerful agents of change and their leadership is critical.” Aguilar (2009) agrees that women’s leadership is ‘critical,’ adding that they have the potential to either “help or hinder strategies for energy use, deforestation, population, economic growth and science and technology . . .” (p. 59). In fact, women are already more engaged in climate change–related activities than what is recognized and valued in their community (Escobar-Darvahal, Quintero-Angel, & Vargas-Garcia, 2008). Worldwide, they are taking the initiative in adapting to a changing climate and articulating what they need to secure and sustain their livelihoods more effectively (Mitchell et al., 2007; Aguilar, 2009), thus challenging the perception of victimhood that results when the focus is only on their vulnerabilities and taking on the role of change agents in their communities.

Promoting Women as Leaders in Adapting to Climate Change Community projects aimed at developing resilience to the manifestations of climate change have enabled women to assume roles of leadership by using one or more of the following strategies. Providing for Equal Participation of Both Women and Men in Planning and Decision Making In the municipality of La Masica, a project of community preparedness for disaster, launched by the Central American disaster prevention agency, included both men and women in the establishment of local organizations in charge of risk and disaster management, training in geographical mapping of hazards and development of an early warning system. Women took on the task of monitoring the warning system, and therefore when the hurricane struck, the municipality was prepared and evacuated the area promptly, thus avoiding deaths (Women in Development Program Unit, 1999). Using Women’s Traditional Knowledge and Expertise During a drought in the Federated States of Micronesia, local women knowledgeable about island hydrology found potable water by digging a new well that reached the freshwater lens. While Pacific island men know more about fishing in deep waters, women know about the shoreline, because they often collect shellfish close to the waters’ edge. Thus, their knowledge could add significant value to programs designed to protect against coastal erosion (AusAID, 2008).

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Providing Women with Opportunities to take Leadership and Solve Problems Creatively In Tamil Nadu, water is a very precious commodity due to an arid climate exacerbated by global warming. To adapt, women have organized self-help groups to protect the areas around hand pumps. The groups have canalized the wastewater and used it to water vegetable and fruit gardens, collecting a water users’ fee from every household for maintenance of the hand pumps. Already trained in rainwater harvesting, the women have learned how to repair hand pumps. Having thus responded to their community’s need for water, the women now feel empowered to raise their voices with Panchayati officials from the forest conservation departments regarding environmental issues (Experiences in Tamil Nadu, n.d.). Providing Skills Training and Access to Agricultural Technology Mali, a Sahelian country, is two thirds desert, and 90% of the country’s energy needs are met by burning wood and charcoal. The Sinsibere project works to reduce desertification by developing sustainable sources of income for rural women as an alternative to their commerce in wood. Besides environmental literacy and financial education, rural women are trained to grow vegetable gardens, make soap, and use energy-efficient stoves, thus diversifying their income sources. After six years, 80% of the participating women no longer cut wood for commercial purposes and, in this way, mitigate the future threat of climate change (UNISDR, 2008). Redefining Women’s Roles and Realigning Relationships of Inequality While not an exhaustive list of strategies, the above projects illustrate how women can take leadership to anticipate, cope with, resist and/or recover from the impact of climate change (cf. Aguilar, 2009 and Dunkelman et al., 2008 for other examples). Such involvement brings with it the potential of redefining their roles and realigning culturally determined relationships of inequality, a notion affirmed by Enarson (2000) and O’Brien (2007), who note, referring to how women respond to natural disasters, that this could give women a singular opportunity to challenge and change their gendered status in society (cited in Dunkelman et al., 2008, p. 11). How such change may happen is suggested by the examples in the preceding section. In La Masica, women work as partners with men in a project for community preparedness for disaster, a task typically allocated to men. As food providers, Micronesian women collect shellfish close to the waters’ edge, acquiring knowledge of the shoreline and the island hydrology. This knowledge, which men, who fish in deep waters, do not have, places women in a position of power when it comes to decision making and planning for programs to protect against coastal erosion and to dig wells to find potable water. It provides them with the capacity to take initiatives in tasks outside the home, which would traditionally fall within the scope of men’s responsibilities.

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In Tamil Nadu, as providers of food and water for their families, women organized to deal creatively with the village’s scarce water supply. These creative efforts empowered them not only to take on leadership within the village but to move beyond the village to provide input to forest conservation departments regarding environmental issues. In this case we see an ever-widening scope of responsibilities for women – moving from the home and local community, the traditional venue of their involvement, to governmental departments, the public sphere beyond the local community. (See the case studies in Dunkelman et al., 2008, for a similar expansion of roles). The Sinsibere project demonstrates the critical role education plays if women are to be change agents within their communities. New knowledge provided by the training project and the behavior change that followed resulted in better control of the adverse effects of climate change. Such an outcome has the potential of bringing about a feeling of empowerment basic to challenging relationships of inequality. That involvement in projects to adapt to climate change has the potential to lead women to challenge their gendered status is a notion that derives some support from the American Psychological Association [APA] (2009) discussion of the psychological benefits associated with responding to climate change, though the research referred to is not of women as a subgroup. Noting that “actions to deal with the challenges of climate change may transform and strengthen the resilience of . . . . a community and individuals (my italics) (p. 93),” they refer to research findings that found competence, enhanced personal meaning, a sense of self-efficacy that resulted from effective efforts at climate change adaptation and mitigation. All these factors could contribute to the empowerment of women necessary to challenge relationships of inequality. Cupples’s (2007) insights derived from her research on the reworking of gender identity and subjectivities as women respond to natural disasters offer conflicting support to the notion that empowerment flows from involvement. She reports that while some women perceived themselves as victims, others felt a new sense of freedom. However, the focus of her research is the impact of Hurricane Mitch and not adaptation projects aiming at resiliency as described above. In other words, more research is necessary to determine definitively whether new tasks and responsibilities will lead to a change in self-identification and a stable redefinition of gender roles.

Research on the Gendered Dimensions of Climate Change The integration of a gender-sensitive perspective in climate change research is relatively new (Brody et al., 2008), and as noted earlier, there is little existing research considering the linkages between climate change and gender, although the need for such research is a theme that recurs in the literature reviewed (e.g. Brody et al., 2008; Smyth, 2008; Neumayer & Plümper 2007; Aguilar, 2008; Thanh, 2008; Genanet et al., 2006). In this concluding section, therefore, I will take up this theme and

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briefly suggest what could contribute to a better understanding of the vulnerabilities of women to climate change and their adaptive capacities.

Research on Vulnerability Except for research on gender and natural disasters, for the greater part, insights on the vulnerability of women to climate change is derived from descriptive reports of the impact of climate change in various world regions. There is a need for systematic research on gender differences as these apply to the impact of climate change, adaptation, and resource use. The following examples of questions that should be explored are based on Brody et al. (2008); Neumayer and Plümper (2007), Lambrou and Piana (2006), and Genanet et al. (2006). Gender-Specific Effects of Climate Change How and why do natural disasters affect women differentially from men? How has the health of women and men been differentially affected by climate change? How, specifically, does climate change lead to violence against women and girls? How does natural resource depletion and limited access lead to gender-related conflict within households? Gender and Decision Making on Climate Change Have programs aimed at mitigating environmental impacts or at improving resource management included women? What are the current levels of female participation in decision making on climate change at local, regional, national, and international levels – both in terms of the numbers of women participating as well as the quality of that participation? What are the barriers to participation and to being heard and taken seriously? Gender-Specific Resource Use Patterns What are the different energy consumption patterns of men and women? For example, in transport, household management, agriculture? Who is causing most emissions and for what purpose? How do socioeconomic status and education affect resource use by women? By men? Gender-Specific Accessibility to Technology and Community Resources Are new technologies for dealing with the impact of climate change equally accessible to women and men? Extension services? Credit facilities? If not, what are the barriers to women’s access?

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Research on Adaptive Capacities As regards women’s adaptive capacities, as examples in the preceding section indicate, there is an emerging body of research on best practices, that is, women’s capacity to adapt to climate change (e.g. Dunkelman et al., 2008; UNDP, 2008; FAO, 2003). This needs to be expanded (Brody et al., 2008). New research in this area should also aim to specify gender-based aspects of mitigation and adaptation. The notion that involvement in adaptation projects has the potential to redefine the roles of women would also benefit from systematic subjectivity research of women as a subgroup, using the approach described in Cupples (2007). Longitudinal case studies are also needed to determine whether women’s participation in adaptation and mitigation activities actually results in stable change in role definition and gender identity perception.

Note 1. It must be recognized, however, that since Fall 2009 when this paper was submitted for publication, due to the efforts of the GGCA, WEDO and other women’s advocacy groups, gender equality has become more prominent in the outcomes of the UNFCCC’s annual Conference of the Parties, most recently the Cancun Accords (2010), which recognize women as integral to effective actions to mitigate and adapt to climate change, including eight references to gender across seven sections of the text.

References Aguilar, L. (2008, October 18–22). Is there a connection between gender and climate change? Paper presented at the third global congress of women in politics and governance, Manila, PI. Available at http://www.capwip.org/resources/resources.html Aguilar, L. (2009). Women and climate change; Vulnerabilities and adaptive capacities. In L. Starke (Ed.), State of the world: Into a warming world. A Worldwatch institute report on progress towards a sustainable society (pp. 59–62). New York: W.W. Norton & Company. American Psychological Association. (2009). Psychology and climate change: Addressing a multifaceted phenomenon and set of challenges. Report by the American Psychological Association Task Force for the Interface between Psychology and Global Climate Change. Available at http://www.apa.org/science/climate-change/ AusAID. (2008). Gender and climate change [Electronic version]. Focus, 23(1), 28. Beijing Platform for Action. (1995, September 15). 4th World Conference on Women A/CONF. 177/20, 1995. Brody, A., Demetriades, J., & Esplen, E. (2008). Gender and climate change: Mapping the linkages. A scoping study on knowledge and gaps. Prepared for the UK Department for Social Development. Retrieved April 4, 2009, from www.bridge.ids.ac.uk CNA Corporation. (2007). National security and the threat of climate change. Alexandria, VA: Military Advisory Board. Retrieved October 3, 2009, from www.securityandclimate.cna.org Convention on the elimination of all forms of violence against women. (1979). UN resolution A/RES/34/180. Cupples, J. (2007). Gender and Hurricane Mitch: Reconstructing subjectivities after disaster. Disasters, 31(2), 155–171.

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Dunkelman, I. (2008, October 18–22). Mainstreaming gender in climate change policies: Urgencies, challenges, and perspectives. Paper presented at the Third Global Congress of Women in Politics and Governance, Manila, PI. Available at http://www.capwip.org/resources/ resources.html Dunkelman, I., Alam, K., Ahmed, W. B. Gueye, Y. D., Fatema, N., & Mensah-Kutin, R. (2008). Gender, climate change and human security: Lessons from Bangladesh, Ghana, Senegal. Report prepared by WEDO, ABANTU for development in Ghana, ActionAid, Bangladesh and ENDA in Senegal. Available at www.wedo.org/library Enarson, E. (2000). Gender and natural disasters. IPCRR Working Paper no. 1. Geneva: International Labour Organization. Escobar-Darvahal, Y., Quintero-Angel, M., & Vargas-Garcia, M. (2008). Women’s role in adapting to climate change and variability. Advances in Geoscience, 14, 277–280. Experiences in Tamil Nadu: Empowering women as conservators of water and the environment. (n.d.). Gendered adaptations to water shortages and climate change. Retrieved October 15, 2009, from http://waterwiki.net/ FAO. (2003). Gender and sustainable development in drylands: An analysis of field experiences. Document prepared by Marina Laudazi under the supervision of Yianna Lambrou. Retrieved October 21, 2009, from ftp://ftp.fao.org Financing for gender equality and the empowerment of women.(2008). Resolution 21(jj) (E/CN.6/2008/L.8). Galea, S., Nandi, A., & Vlahov, D. (2005). The epidemiology of post-traumatic stress disorders after disasters. Epidemiological Review, 27, 78–91. Genanet/LIFE e.V. and WECF. (2006). Fighting climate change. Input from women to government: a study on climate change and gender. Retrieved September 2009, from http://www.wecf.org/ Javate de Dios, A. (2008, October 18–22). Gender, migration and climate change: Understanding women’s vulnerabilities and response. Paper presented at the Third Global Congress of Women in Politics aaaand Governance, Manila, PI. Available at http://www.capwip.org/resources/ resources.html Kalyanimitra Foundation. (2008, October 18–22). Recovery in Aceh after the earthquake and tsunami: Looking at women’s participation in housing construction in Aceh Jaaya, Acheh, Indonesia. Paper presented at the Third Global Congress of Women in Politics and Governance, Manila, PI. Available at http://www.capwip.org/resources/resources.html Lambrou, Y., & Piana, G. (2006). Gender: The missing component of the response to climate change. Rome: Food and Agriculture Organization of the United Nations (FAO). Manila declaration for global action on gender, climate change and disaster risk reduction. (2008, October 18–22). Third Global Congress of Women in Politics and Governance, Manila, P.I. Masika, R. (Eds.). (2002). Editorial [Electronic version]. Gender and development. Special Issue on Climate Change, 10(2), 2–9. Mitchell, T., Tanner T., & Lussier, K. (2007). We know what we need: South Asian women speak out on climate change adaptation. ActionAid International. Institute of Development Studies, UK. Neumayer, E., & Plümper, T. (2007). The gendered nature of natural disasters: The impact of catastrophic events on the gender gap in life expectancy, 1981–2002. Annals of the Association of American Geographers, 97(3) 551–566. OXFAM, International. (2008). Climate wrongs and human rights: Putting people at the heart of climate change policy. OXFAM briefing paper, 117. Pan American Health Organization [PAHO]. (n.d.). Gender and Natural Disasters. Women, Health & Development Program. Fact Sheet. Retrieved October 27, 2009, from www.paho. org/genderandhealth Report of the Office of the United Nations High Commissioner for Human Rights on the relationship between climate change and human rights. (2009, January 15). A/HRC/10/61 Smyth, I. (2008, October 18–22). A perfect storm? Women, food security and climate change. Paper presented at the Third Global Congress of Women in Politics and Governance, Manila, PI. Available at http://www.capwip.org/resources/resources.html

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Statement of the CEDAW Committee on Gender and Climate Change. Adapted at the 44th Session of the CEDAW, July–August 2009. Subcommittee on Women and Climate Change. (2009). Climate change, human rights and CEDAW, Information Sheet 4. Available at www.ngocsw.org Thanh, Le Cong. (2008, October 18–22). Women’s vulnerability and policy framework for climate change adaptation: Vietnam. Paper presented at the third global congress of women in politics & governance, Manila, PI. Available at http://www.capwip.org/resources/resources. html UNDP. (2007). Fighting climate change: Human solidarity in a divided world. Human Development Report 2007–2008. New York: Palgrave Macmillan. UNDP. (2008). A primer on climate change adaptation in the drylands of Africa. Background paper for the 3rd African Drought Adaptation Forum of the African Drought Risk & Development Network, Addis Ababa, Ethiopia. United Nations International Strategy for Disaster Reduction [UNISDR] Inter-Agency Secretariat. (2004). Living with risk: A global review of disaster reduction initiatives. UNISDR publications. Available at www.unisdr.org/publications UNISDR Secretariat. (2008). Gender perspective: Integrating disaster risk reduction into climate change adaptation (pp. 3–4). UNISDR publications. Wallace, J. (2009). The security dimension of climate change. In L. Starke (Ed.), State of the world: Into a warming world. A Worldwatch institute report on progress towards a sustainable society (pp. 63–66). New York: W/W/Norton & Company. Wisner, B., Blaikie, P., Cannon, T., & Davis, I. (2004). At risk: Natural hazards, people’s vulnerability and disasters (2nd ed.). London: Routledge. Women’s Environment and Development Organization. (2007). Changing the Climate: Why women’s perspectives matter. New York: Fact sheet. Women in Development Program Unit. (1999). Hurricane Mitch: Women’s needs and contributions. Inter-American Development Bank. Washington, DC: Sustainable Development Department Technical Papers Series.

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Chapter 8

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

Overview Because the term “environmental refugees” has been used broadly and inconsistently in the literature, Lonergan suggested five types of causal environmental stressors for evaluative purposes: natural disasters, cumulative or slow-onset environmental changes, natural or industrial accidents, development projects, and conflict and warfare. Events associated with climate change that may create refugees include shoreline erosion, coastal flooding, and agricultural disruption (Lonergan, 1998). Shifting global temperatures and consequent alterations in regional ocean acidity and flow patterns threaten coral reefs, marine biodiversity, and thus habitats for humans and other animals. One to three degree increases in global temperatures exacerbate droughts, dustbowls, and perhaps tornados in some regions. If temperatures rise three to six degrees, ocean plankton will be threatened by further ocean acidity, there will be more heat waves such as the one in 2003 that killed 30,000 people in Europe, the Amazon basin will grow increasingly dry, and melted snowpacks will threaten major cities due to more severe storms and increasing tides. The evidence for disruption and displacement due to these specific climate change events is not yet as robust as for other types of environmental stressors such as political conflict, warfare, and natural disasters. However, it is estimated that up to 200 million people could be overtaken by sea level rise, coastal flooding, and droughts once the full effects of global warming take hold (Myers, 2002). The general effects of climate change on human health and well-being are detailed in other chapters. These effects include nutritional insufficiency due to drought, heat stress from heat waves, injuries due to extreme weather events and their sequelae, infectious disease outbreaks due to changing patterns of insect and

M. Hollifield (B) The Behavioral Health Research Center of the Southwest, Pacific Institute for Research and Evaluation, Albuquerque, NM, USA; University of New Mexico, Albuquerque, NM, USA; University of Louisville, Louisville, KY, USA; Program for Traumatic Stress, The VA Long Beach Healthcare System, Long Beach, CA, USA e-mail: [email protected]

I. Weissbecker (ed.), Climate Change and Human Well-Being, International and Cultural Psychology, DOI 10.1007/978-1-4419-9742-5_8,  C Springer Science+Business Media, LLC 2011

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waterborne diseases, and poor nutrition from reduced access to food (Blashki, McMichael, & Karoly, 2007). Mental health effects of climate change events are less well understood (Fritze, Blashki, Burke, & Wiseman, 2008). It is known that mental health outcomes differ by the type and severity of events experienced and the social, cultural, and historical contexts in which they occur (Ozer, Best, Lipsey, & Weiss, 2003). It has been theorized that climate change will affect mental health by direct and indirect pathways (Berry, Bowen, & Kjellstrom, 2009). Types of climate change events are discussed in part I of this book. In this chapter we focus on the psychological and psychosocial effects of such events, particularly when climate change creates refugees. While the definition of “refugee” varies by different international organizations, all include aspects of displacement (Williams & Westermeyer, 1986). However, because of the slower nature of the events, climate change will also create a new kind of refugee who will be either nondisplaced or minimally displaced geographically, but who instead will be distressed by a new environment that has been displaced onto them. In fact, the term “solastalgia” has already been coined to indicate the “distress that is produced by environmental change impacting on people while they are directly connected to their home environment,” which is described in more detail in Chapter 2 (Albrecht et al., 2007). These climate change refugees will be defined less by displacement and more by resources that are lost or redistributed in their environment. Whether displaced or not, the primary resources that will be at risk and that have a powerful impact on mental well-being will be stability of place, identity, and belonging, as well as internal physiological homeostasis. Mental health outcomes will be determined by individual and group capacity to adapt to new conditions. After discussing theoretical and applied concepts of the resources at risk and adverse mental health outcomes, we provide a framework for how the global community might prevent and treat psychosocial problems associated with climate change.

A Broad View: Resource Conservation Versus Loss The relative loss, gain, and redistribution of resources over time are important variables in predicting individual and collective adaptive capacity after traumatic experiences. For example, a task force on war-related stress concluded that the risk for developing a stress-related illness is best predicted by the degree of objective stressors and actual resources at the individual’s disposal (Hobfoll et al., 1991). Other studies have shown that the loss of resources is also a predictor of psychological distress in survivors of war, natural disasters, and terrorist attacks (Hall et al., 2008; Hobfoll et al., 2009; Norris, Friedman, & Watson, 2002; Palmieri, CanettiNisim, Galea, Johnson, & Hobfoll, 2008; Silver, Holman, McIntosh, Poulin, & Gil-Rivas, 2002; Smith, Veenhuis, & MacCormack, 2000). Well-being depends on the availability and successful management of both internal and external resources (Hobfoll & Jackson, 1991), which operate in a social context where there is sharing and exchange between individuals and their community. In the wake of the chronic

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stress and trauma associated with climate change, some people are so injured – so resource depleted – that it is difficult for them to take advantage of resources that might be offered. For those displaced to new countries with new languages to learn, they almost always have a new, less-powered sociopolitical status such that their capacity to reestablish place, restructure identity, and regain a sense of belonging is just that much more difficult. This scenario promotes a cycle of loss, termed a “loss spiral” (Benotsch et al., 2000). When resources diminish, symptoms increase, and there is a bidirectional relationship between resources and symptoms over time (Benotsch et al., 2000). The Conservation of Resources (COR) theory bridges the gap between environmental and cognitive/perceptual viewpoints by conceptualizing stress as “a reaction to the environment in which there is the threat of a net loss of resources, the actual net loss of resources, or the lack of resource gain following the investment of resources” (Hobfoll, 1989). This view is highly relevant to climate change and the refugee experience in which specificity of experience is overwhelmed by “world loss” that confronts those faced with chronic stress, extreme trauma, and displacement. It is also an appropriate model to capture the nature of the stress associated with slower changes, such as a slowly rising tide that has caused minimal displacement yet significant redistribution of resources. In this model, there are four general categories of resources – objects, personal characteristics, conditions, and energies – that are at risk of being lost, are lost, and may be gained in the healing process. Climate change refugees may have many types of resources placed at risk due to shifting environments. However, common to all types of stressful events are those that threaten the physical and psychological integrity of the self: one’s place, identity, and sense of belonging and physiological homeostasis.

Resources in and Around the Self The risks to core external (i.e., place) and internal (psychological and physiological homeostasis) resources for climate change refugees can be more fully understood from developmental and biopsychosocial perspectives. In his synthetic work, Attachment and Loss (1969–1982), John Bowlby had as a premise that the reciprocated attachment between infants and their principal attachment figure provides an evolutionary survival benefit. The innate attachment behavioral system serves to achieve and maintain close proximity to the principal figure, which provides safety, security, protection, and ultimately confers genetic replication. With age, adaptive attachment behaviors are transactional and grow in number and scope of figures as the child gains capacity to venture out from the primary figure to the world around. By developing an internal working model of social relationships, the person develops a unique set of thoughts, memories, beliefs, expectations, emotions, and behaviors to form identity. By late adolescence, the primary attachment figures begin to recede as the larger community gains predominance for identity formation. Bowlby argued that each person occupies a unique personal environment that

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serves as an “outer ring of life-sustaining systems complementary to the ‘inner-ring’ of systems that maintain physiological homeostasis” (Bowlby, 1973, p. 50). George Engel coined and developed the biopsychosocial model on the premise that “nature is ordered as a hierarchically arranged continuum, with its more complex, larger units superordinate to the less complex, smaller units” (Engel, 1981). Engel’s depiction, adapted below as Fig. 8.1, shows how the nesting of these units implies the orchestration between molecules, cells, persons, dyads, communities, and the larger biosphere. While each unit is an “organized dynamic whole” and has its unique properties and rules of functioning, each smaller unit is necessarily a component of larger units. In his classic article “The Clinical Application of the Biopsychosocial Model” (Engel, 1981), Engel describes how one unit (e.g., person) is a part of the larger units in a stable configuration in time and space. For example, a cell has no identity separate from person who is necessarily identified and influenced by external environment. In this article, Engel continues to demonstrate the clinically relevant interactions between the units both internal and external to the person in the specific case of a man having a heart attack. In this case, the immediate event begins within the person, yet over time internal physiological adaptation is also dependent on external resources (e.g., effective versus noneffective interventions by

Biosphere Society - Nation Culture - Subculture Community Family Two Person Nervous System Organ – Organ System Tissue Cell Organelle Molecule

Fig. 8.1 Pictoral depiction of Engel’s Biopsychosocial Model

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others, goodness of the care system) and features of personal identity (e.g., confidence, pain, anxiety, anger, help-seeking versus withdrawal). The value of Engel’s work was that he pictoralized and applied a model of health that was real and that captured how social and psychosomatic medicine worked. It allowed for the relevance of social and psychological factors on biological health, not requiring them to be reduced into biochemical and cellular terms in order to have meaning. For the climate change refugee, the immediate event begins outside of the self, yet health outcomes will also depend on internal and person-level resources. A sudden disaster or a slowly rising tide threatens individual and collective resources. Whether displaced or not, place will be disrupted, and there will be shifts in boundaries of identity and belonging and, along with them, internal homeostasis.

Disruptions of Place, Identity, and Belonging Place In detailing the psychology of place, Fullilove describes different dimensions of place as a way of defining the immediate and intimate portion of the environmental unit outside of the person and the psychiatric implications of displacement (M. Fullilove, 1996). Place and home can be thought of as the “geographic center,” which facilitates attachment, development and identity, and survival and is optimally healthy when it also has nondiscriminatory structures that promote the human search for meaning, creativity, and generativity. Place can also be understood as “standing for the human interactions occurring in a given location,” and represents the “nodes of the life biography,” important in providing the “sum of resources and human relationships in a given location,” which sets the conditions for human identity. A stable and optimal place offers the best chance for a homeostatic environment. Disruptions to place threaten biopsychosocial homeostasis by altering attachments, familiarity, and place identity and may result in psychological problems of nostalgia, disorientation, and alienation. Place loss not only affects people’s sense of identity and belonging but is also an identified risk factor for poor mental health. Places that are and will be most affected by climate change are more likely to be less than optimal and at more risk for ongoing disruption. One example of this is Sri Lanka, a country that is highly susceptible to rising tides from global warming or catastrophic events such as the 2004 tsunami. Chronic stress because of social and cultural divisions was the backdrop for the collective trauma of one of the worst floods in history. In 1948, the island of Ceylon gained independence from Britain. In spite of decades of British imprinting, the island held two other identified groups: the Sinhalese, who comprise 74% of the island and are said to be descendants of Prince Vijaya after being exiled from the Sinahapura kingdom in northwest India, and the Tamils, whose origins appear to be the current area of southern India and Northern Sri Lanka before the land mass separated. In 1956, the government named the majority Sinhala the official language of the state, immediately establishing the Sinhalese

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as the identified owners of Ceylon and the Tamils as the “other.” These man-made demarcations resulted in the ensuing feelings of marginalization by the Tamils, and reactive anti-Tamil riots in 1958 were an almost predictable response that marked the overt beginning of ethnic distrust. Growing conflict continued after Ceylon was named Sri Lanka in 1972, fueling the formation of the Liberation Tigers of Tamil Eelam in 1976 and the beginning of the civil war by 1983. Over the next 21 years this internal struggle would surge and regress in spite of international interventions and prophesied truces and cease-fires. It was in this chaotic social and physical ecology that the Asian tsunami hit on December 26, 2004. Sri Lanka reported 31,187 deaths and 545,715 displaced. The Southern province with a population of 2.3 million was severely affected by the tsunami. A third of the people live below the poverty level, and the public health care system was resource-poor, partly due to the ongoing civil strife. The Peraliya area is adjacent to the main coastal road, and its people primarily support themselves by fishing. Over 95% of Peraliya’s structures were destroyed, 450 families became homeless, and approximately 296 inhabitants and 1,500 people on a train that was traveling through the area perished when the tsunami struck. Because of the devastation and the new government-imposed rule prohibiting new building within 100 meters of the sea, villagers had to relocate, rebuild, and shift their places and with it part of their identities. People in Peraliya noted that the power relationships that governed how funds were distributed shifted, sometimes reinforcing the hold over the community by some families and power brokers while at other times creating new power alliances. Resettlement and rebuilding within Sri Lanka after the tsunami was negotiated in the backdrop of inequalities that have formed in the fault lines of war and ethnic inequality (Ruwanpura, 2009). These post-disaster processes have only strengthened what had been going on for decades. Splitting identities along ethnic, familial, and social status lines mimicked the ongoing battle between Sinhalese and Tamils. Forty percent of people in Peralia had clinically significant symptoms of posttraumatic stress disorder (PTSD), depression, and anxiety 21 months after the tsunami (Hollifield et al., 2008). Another study showed even higher levels of distress in Sri Lankans living in temporary shelters 6 months after the storm: 64% of women and 42% of men had significant PTSD symptoms (Ranasinghe & Levy, 2007). This symptom prevalence was fourfold higher than what was predicted by the World Health Organization soon after the disaster (Miller, 2005) and was most certainly an interaction between the effects of the tsunami and decades-long disruption of place and ongoing stress of poverty and war, which has been identified as “trauma on trauma” (Ozgediz, Adams, & Dicker, 2007). Loss of place has been identified in many other studies as a significant predictor of poor mental health, although this loss is inevitably confounded by many other stressors. In Sri Lanka, prolonged displacement was one factor contributing to depressive and PTSD symptoms in adolescents in addition to psychosocial and family losses and poor maternal mental health (Nikapota, 2006; Wickrama & Kaspar, 2007). On the Andaman and Nicobar islands following the tsunami, Port Blair had 12 camps that provided shelter for 4,684 survivors, and there were 62 camps

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that sheltered people who stayed in their habitat despite needing temporary shelter. Overall psychiatric morbidity was 5.2% in the displaced group – more commonly, panic disorder, anxiety disorders, and somatic complaints – and 2.8% in those who could remain near their home, a preponderance being adjustment reactions (Math et al., 2008). Interestingly, PTSD and depression were distributed equally among the two groups. Whether from displacement or disruption of place, other studies have revealed the negative effects of place loss due to hurricanes (Acierno, Ruggiero, Kilpatrick, Resnick, & Galea, 2006), socioeconomic problems (Mogollon Perez & Vazquez Navarrete, 2006), demolition and urban development (Bowie, Farfel, & Moran, 2005), and war (Desjarlais, 1995; Sikic, Javornik, Stracenski, Bunjevac, & Buljan-Flander, 1997; Steel, Silove, Bird, McGorry, & Mohan, 1999).

Identity and Belonging The disruption caused by climate change will necessarily alter boundaries of identity and belonging for individuals and communities. Many deteriorating environments present the option to stay or to go. For example, some disaster survivors decide to remain at home, promising to rebuild and make a better life for themselves. Others find it intolerable to remain, haunted day and night with memories provoked by ongoing stress and nightmarish reminders. For such individuals, where place disruption has provoked shifts in identity and a sense of belonging, removing oneself and one’s family from the now-alien place may be seen as the best option to move forward. This emerging refugee, like his counterpart who has maintained a sense of identity and belonging in the stressed environment, often feels there is no choice but to flee from an increasingly dangerous world. The potential for this dual response is illustrated by movement patterns after the 1999 earthquake in Turkey. Among those whose homes were rendered uninhabitable, 88% relocated to shelters. Loss of psychosocial resources was the primary axis predicting relocation. Specifically, relocation was predicted by the loss of loved ones, the degree of material loss, and behavioral avoidance of situations that were reminders of the earthquake (Salcoglu, Basoglu, & Livanou, 2008). Those who could no longer identify the destroyed place as their place were more likely to relocate where there was hope for self- and family reconstruction. In her essay Postcoloniality and the Aftermath of Revolution among Vietnamese Refugees, Jenkins details the long history of altered identity in Vietnam, which served as the backdrop for mental health effects in externally displaced refugees (Jenkins & Hollifield, 2008). After years of Chinese occupation, long-standing national identity confusion was intensified by the French takeover in 1882–1883 when the new ruling elite began to incorporate elements of the cultural West because they considered it superior to Sino-Vietnamese civilization. Over the next three decades, the internal structure of what had been “Vietnam” was as much disintegrated as clarified. Older scholars and social leaders could no longer lead because Chinese characters were replaced with the Roman alphabet and Confucian teachings

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were at odds with the new culture. Only about 10% of children received promised European-based education, leaving the majority at cultural odds with their own political structure. Even the rise of the Indochinese Communist Party in 1935, led by Ho Chi Minh, did not consolidate split identities and loyalties. Years of political struggle resulted in postponement of an identified nation-state and created further internal conflict about what it meant to be Vietnamese. The Geneva convention of 1954 further served to formalize the problem of Vietnamese identity that had been going on for centuries, providing for two-zone split at the 17th parallel, with the north dominated by the Vietminh and the south by the puppet government of the French. Subsequent population shifts were fueled by persistent confusion about the boundaries of identity, which provided the backdrop for both Vietnamese and US leaders to be uncertain of who were friends and who were foes during the 1968 to 1975 US-Vietnam war. At war’s end in 1975, hundreds of thousands of former South Vietnamese government and military officials, as well as intellectuals and private citizens, were subjected to retribution through systematic imprisonment within now-infamous “reeducation” camps. These once-proud leaders suddenly became outcasts – “nonVietnamese” – because of an acute-on-chronic environmental change. Identity confusion was thus both a result and a subsequent cause of trauma and displacement. For the survivors, their release from prison only extended their struggle to find a sense of identity and belonging in the face of continued oppression. Emigration to other countries was a choice for some and not for others. Even so, relocation did not always help individuals regain what was already a tenuous sense of identity, as stated by a Vietnamese man who had been a high-ranking military leader and imprisoned for years. After being released from camp, he recalls remaining alienated in a Vietnam that was now controlled by less-educated Vietminh: I got so used to that, I mean you know, to always be an outsider. I mean whatever you do. . .you might make the people (Vietminh) comfortable and happy but again, (they do) not always appreciate what you are doing, and feel just like you are too superior, that (they) should not keep (me) here. You have the paperwork to qualify to leave the country but you choose not to. And the communists say what are you doing here? You can go to another country like the others, then why are you choosing not to?

Identity conflict and further oppression eventually pressed this man to leave his country for the USA, where he has found security but continues to suffer from many symptoms and be nostalgic for his home country: Yes, here I enjoy the freedom, liberty and I’m enjoying my life. And now I am living with my wife and getting social security. But I realize that the Vietnamese are under communism, so I expect and I never throw away my expectation to come back to my country and to liberate my country from communist dictatorship. I live here and say I am American, but mentally I am Vietnamese.” Then with a low voice and slow cadence: “To be truthful, I am always Vietnamese.”

Another Vietnamese ex-military leader expressed the problem of alienation in Vietnam during and after his release from prison, but more successfully negotiated attachment to the USA as his country:

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(In prison) we could not say something belonging to our conscience. We had to stay in the scope of a re-educationer. I met a very close friend but we could not say anything to each other. We knew the communists would maybe keep us until we were old or until we died so I didn’t have any feeling of belonging or being possessed by anything or anyone. The feelings of belonging when I came to the United States were much different than the time in prison or out of prison in Vietnam. Here in the United States I actually feel belonging and like I’m being taken care of and good feelings and help from the whole society and friends who are here. When I took the citizenship test they asked me which country I belonged to and I said my country is the United States.”

The loss of the sense of identity and belonging is associated with poor mental health in refugees, whether due to war or to natural processes that may be from climate change. In a study of 76 Somali adolescents displaced to the USA, a greater sense of belonging at school was associated with less depression and higher self-efficacy regardless of the severity of previous exposure to traumatic events (Kia-Keating & Ellis, 2007). Five years after their immigration to Israel from the former Soviet Union, and in spite of a positive change in absorption and functioning in their new surroundings, immigrants still had the same level of perceived stress and psychological symptoms as when they first arrived. Among other factors associated with continued distress were perceived lack of social support and nonidentification with the host society (Lerner, Kertes, & Zilber, 2005). In Palestinians who were facing forced removal from Gaza, distress and demoralization were predicted by higher-risk perception and greater alienation from the government in addition to a handful of other factors, while life satisfaction was associated with greater place attachment, less risk perception, less feeling of alienation from the government, and a more positive outlook about returning to Gaza (Billig, Kohn, & Levav, 2006). The association of acute and chronic weather-related environment change on one’s sense of identity and belonging has also been described (Carroll, Morbey, Balogh, & Araoz, 2009; Dugan, 2007).

Betrayed by the World: The Environment Personified In her work on the development of attachment to place during childhood, Louise Chawla expounds on seminal works of Bowlby by describing how children expand safe areas by exploring away from and returning to the shelter of the caretaker in ever-larger spatial and psychic diameters (Chawla, 1992). As this process unfolds, needs for dependency and protection are moved into the larger world, which, if safe, is seen in the dimension of interdependency. The known external environment is part of individuals’ identity and increasingly becomes the de facto caretaker. In this light, environmental change that is stressful or traumatic may be seen as a betrayal by the world and a sharp threat to identity. The felt betrayal by the natural world was evident after the tsunami. The havoc wreaked from the water is one kind of calamity that will be expected over ensuing decades in the face of climate change. The tsunami had altered the collective identity of those left in its wake. Most felt the loss of the sea as a protector and provider.

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Always a source of peace and sustenance, the ocean had become a mnemic of the devil’s actions in the world. In many of the coastal areas, children were no longer allowed to go to the sea, and many children were insisting they were too frightened to do so. A whole generation of children are expected to internalize adult fears as they move forward in their development, as adults communicate their fears and that they do not want anything to do with the beach or the ocean. In their work with survivors, Nikopota and colleagues noted that coastal areas remain a source of grief and loss, heard from one man: I always went down to the beach whenever I wanted consolation. Now I have lost that too (Nikapota, 2006).

Host Responses: Adaptation Versus Symptoms and Illness The response of individuals or communities to stressful events may be a determinant of health outcome as much as the event itself. The majority of refugees from any cause do not develop stress-related disorders (Fazel, Wheeler, & Danesh, 2005). For example, in the context of mass casualties after weather-related events, most are highly adaptive and do not report psychological distress (Hobfoll et al., 2009). Yet, a significant minority of refugees do experience distressing symptoms. The presence of or lack of an adaptive response is a complicated process with many relevant biological, psychological, and social factors involved. In our framework, capacity for an adaptive response can be thought of as a product of the total resources that people have at the onset of the challenge and the extent of resources that they are able to foster and protect through the period of challenge. As our discussion reveals, personal, social, and material resources are interwoven and challenged in concert by climate change to threaten one’s place and sense of identity and belonging. The response to these challenges and threats will be one determinant of relative adaptation or relative failure of adaptation that leads to disintegration and illness.

Adaptation: Resistance and Resilience “I have crossed so many rivers, I no longer get wet” is a Kurdish saying that identifies the prolonged exposure to traumatic experiences and the resistance or resilience of many refugees. “Resistance” is a term that has been used to describe that majority of persons who experience transient but not enduring psychological distress after severe stressful experiences (Bonanno et al., 2006, 2007). Bonanno and colleagues have defined resilience as the “ability to maintain relatively stable, healthy levels of psychological. . .functioning” (Bonanno, 2005) in the face of highly threatening events. Olsson and colleagues highlight the lack of consensus about how resilience is best defined and measured (Olsson et al., 2003). When resilience is defined as an internal property of an individual, there is disagreement about how to best assess it. When resilience is conceptualized as a

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process, variables that moderate the interaction between risk and protective factors are higher cognitive ability, positive self-esteem, hopefulness, problem solving repertoire, and flexibility (Richardson, 2002). In contrast, defining resilience by positive outcomes requires specifying constructs indicative of positive adaptation in response to adverse experiences. Measures of functionality, mental health, social competence, life satisfaction, and somatic health have all been included in various combinations as resilience-as-outcome constructs (Olsson et al., 2003). As part of the New Mexico Refugee Project (Hollifield et al., 2005), in-depth interviews were conducted to better understand factors that were adaptive and protective to health. Extant literature was used to identify key domains of resilience. Review of participants’ narratives facilitated locating words and statements that were reflective of resilience domains. Participants’ stories illustrated how potential losses (i.e., to agency or physical well-being) had either been averted or how actual losses (i.e., vitality, freedom) had been regained or recreated over time. Refugees were saying that it was the interaction between who they are and what they have, who and what they have lost, and who and what they have regained that either helped them survive and thrive or caused further pain and suffering. Internal resiliency and external protective factors were reconceptualized to illustrate distinctions between innate characteristics, resilient actions, and protective factors associated with context. Categories of innate characteristics included strength, adaptability, belonging, and purpose. Categories of action paralleled innate characteristics (i.e., actions of strength, actions of adaptability, etc.). Protective factors associated with context included personal resources, social networks, place, social institutions, community stability, and relationship with social institutions. Hobfoll and colleagues have built on theoretical work by outlining four symptom trajectories over time during an ongoing threat of mass casualty, in this case, the latter period of the Second Intifada (Hobfoll et al., 2009). Two adaptive trajectories were identified. The resistance trajectory was defined by individuals who never develop significant symptoms of clinical distress. The resilience trajectory was defined by initial distressing symptoms followed by recovery. In contrast, two other trajectories identify less-adaptive capacity: chronic distress was characterized by individuals who are initially symptomatic and remain so over time, and delayed distress was defined by those who appear to be initially resistant but later develop significant distress. In their sample of Arabs and Jews living in Israel, 157 (22%) were resistant, 96 (14%) were resilient, and 383 (54%) and 73 (10%) had chronic and delayed distress, respectively. It should be noted that the resistant and resilient definitions required no more than one traumatic stress-related symptom on the 17item PSTD symptom Scale (Foa & Riggs, 1993) and no more than one depressive symptom on the 5-item Patient Health Questionnaire (Grabe et al., 1999), which is a relatively high standard for lack of distress. Predictors of resistance were male gender, Jewish background, being secular, higher income and education, and less psychosocial and economic loss. When demographic variables were controlled, less resource loss was the best predictor of psychological adaptation to this chronic environmental stress.

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Failure of Adaptation: Distress, Disorder, and Disruption When adaptation is not fully successful, distress and illness may ensue. Environmental disruptions and traumatic exposure alone are significant risk factors for distressing emotional and somatic symptoms, psychiatric disorders, psychosocial problems, and poor health habits, and these effects are clearly linked to longer-term illness and decreased life expectancy. For example, nonrefugees who have experienced more than three traumatic childhood events (compared to none) have a 4- to 12-fold increased risk for mental disorders, a 2- to 4-fold increased risk for smoking and poor self-rated health, and an increased risk for physical inactivity, obesity, and the presence of many adult diseases (Felitti et al., 1998). For refugees, problems with loss of place and identity/belonging may also result in various forms of psychological distress, such as alienation, demoralization, and solastalgia in addition to psychiatric and medical illness, somatic symptoms, and psychosocial problems. Alienation, Demoralization, and Solastalgia Place, identity, and belonging are intertwined and understood according to symbolic constructions by those within the intimate place and the surrounding community. Identity depends on having and belonging in a place where one is valued. When identity is betrayed by place loss or devaluation of a person in relation to place, alienation may result (M. Fullilove, 1996). In their qualitative work with Bosnian refugees in the USA, Keyes and Kane identified elements that affected feelings of belonging and adapting. Belonging was promoted by the protection of cultural memory, a sense of identity and respect for difference, demonstrations of empathy and reciprocity, and perfection of speech. Adapting depended on coping with transitions and memories of past and ongoing losses, coping with the tensions of having to accept and fit into a new cultural space while holding on to their own, and learning the new language (Keyes & Kane, 2004). The authors identified the concurrent alienation and hope of displaced refugees: Implicit in the refugees’ experiences were states of culture shock, loneliness, psychic numbness, grief, nostalgia, and feelings of dejection, humiliation, inferiority, and as if they belonged nowhere. Simultaneously, the refugees reported feelings of relief and safety after leaving behind the threat of death in their old homes, feelings of gratefulness for their new freedom to hope for a better life, and their restored ability to notice beauty, as well as a sense of normalcy in their new lives.

Demoralization is a parsimonious phenomenon across emotional disturbances and is often related to a sense of alienation. A term that was coined by Jerome Frank, demoralization “. . . results from persistent failure to cope with internally or externally induced stresses that the person and those close to him expect him to handle. Its characteristic features, not all of which need to be present in any one person, are feelings of impotence, isolation, and despair. . .Insofar as the meaning and significance of life derives from the individual’s ties with persons whose values he shares, alienation may contribute to a sense of the meaninglessness of life” (Frank, 1974).

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With alienation and a lack of belonging, refugees are prone to demoralization with or without psychiatric disturbances. One study showed that refugees and migrants are often diagnosed with major depression, yet on the average do not benefit from a normal course of treatment. However, data analyses suggested that demoralization was a preferable concept for many of the subjects rather than depression (Briggs & Macleod, 2006). Albrecht coined and defined the term “solastalgia” (detailed in another chapter of this book) as a separate and related phenomenon to nostalgia (G. Albrecht et al., 2007; G. A. Albrecht, 2005), which has long been recognized as a potentially lethal condition associated with melancholia in people who have an enduring desire to return to their homes after displacement. First reported in 1688 briefly as ‘philopatridomania’ (Sanchez et al., 1994), nostalgia has been minimized in modern writings as a minor and relatively harmless emotion. Fullilove alternatively points to an environmental perspective, in which psychological disturbances such as nostalgia associated with loss of place cannot be considered as separate from the loss of objects and its effects on communities and individual lives (M. Fullilove, 1996). Albrecht and colleagues posit that solastalgia is a form of ‘psychoterric’ illness (earth-related mental illness caused by threats of severing healthy links between people and their homes) that refers to the “pain caused by the loss of, or inability to derive, solace connected to the negatively perceived state of one’s home environment” (G. Albrecht et al., 2007). As evidence, they point to work in eastern Australia where coal mining and droughts have had a serious impact on lived spaces. The unwelcomed transformation of the landscape and the change in soil chemistry by pollutants have altered the sense of place, identity, physical and mental health, and general well-being of the residents who feel powerless over the environment change. Psychiatric Disorders A broad range of psychiatric disorders are seen in refugees, the most common being PTSD, depression, and anxiety (Fazel et al., 2005; Hollifield et al., 2002). The best evidence of this comes from the literature on severe environments resulting from natural disasters and war, since there is as of yet little data about climate change refugees. In the months and years after weather-related disasters, the prevalence of PTSD and depression range from 15 to 67% (Hollifield et al., 2008). In the year after the event, PTSD symptoms will abate for approximately half of those who were acutely symptomatic. Those who have symptoms for one year or more are likely to stay disabled for years (Shalev, Tuval-Mashiach, & Hadar, 2004). It also appears that rates of PTSD longer than one year after disasters are strikingly similar between events at about 22–28%, although another review suggests that between 7 and 67% of people exposed to mass trauma will develop PTSD at some time (Norris et al., 2002). The relevant epidemiological evidence for psychiatric disorders in war refugees is conflicting because of the use of different sampling and assessment methods. This

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is instructive regarding assessment of refugees in general. For example, estimates of the prevalence of PTSD in adult refugees have ranged from 3 to 86% and those for major depression have ranged from 3 to 80% (Hollifield et al., 2002). Mina Fazel and colleagues conducted a meta-analysis of 20 studies that comprised 6,743 adults from seven countries that had been forcibly displaced to other countries. Ten percent of adult refugees displaced to western countries had PTSD, 5% had major depression, and about 4% had generalized anxiety disorder with comorbidity being common. Specific study methods had a significant impact on prevalence rates. For example, studies with larger and more rigorous surveys reported lower prevalence rates than studies with less optimal designs. In addition, sampling methods and primary language of the interpreter affected prevalence rates. In her work with Chinese-American immigrants, Hicks showed that diagnostic accuracy using structured interviews by lay interviewers was poor because the interview questions were about individual symptoms, whereas Chinese immigrants tend to view symptoms in a collective manner based on cultural determinants (Hicks, 2002). Somatic Symptoms Refugees tend to experience multiple somatic symptoms with or without psychological symptoms. Such symptoms are often not characteristic of PTSD, depression, or other defined psychiatric disorders. Somatic symptoms are common in refugees who have experienced traumatic events, and, in medical settings, somatic symptoms are more commonly presented than psychological symptoms when a psychiatric disorder is subsequently found to be present (Gilgen et al., 2005). As recently reviewed, the cause and meaning of somatic symptoms is complicated (Hollifield, Warner, Krakow, Jenkins, & Westermeyer, 2009). Most studies have not conducted complete psychiatric and medical evaluations of somatic symptoms to determine their cause. They have, however, shown that unexplained somatic complaints are associated with low acculturation, high treatment seeking, the presence of psychiatric disorders, and self-identified medical problems (Cervantes et al., 1989; Cheung, 1993; Hauff & Vaglum, 1993; Westermeyer, Bouafuely, Neider, & Callies, 1989). Ta and colleagues utilized history, review of medical records, physical examination, and laboratory assessment in 266 Southeast Asian refugees from a psychiatric outpatient clinic and concluded that 146 patients had at least one medical condition and that their psychiatric disorder may have been caused or exacerbated by the medical disorder in 48 of the cases (18% of the total) (Ta, Westermeyer, & Neider, 1996). The New Mexico Refugee Symptom Checklist–121 (NMRSCL-121) was developed to assess a broader range of symptoms than was previously available. Years after their forced migration, refugees of war experienced on average 48 persistent and bothersome somatic and psychological symptoms (Hollifield et al., 2009). These symptoms were strongly associated with their war-related experiences and moderately with current impairment. Nine somatic and three psychological scales were identified during development of the NMRSCL-121. Compared with

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the somatic scales, the psychological scales correlated better with other standard psychological measures that were concurrently administered. This may suggest that some of the variance of somatic symptoms on the NMRSCL-121 is due to nonpsychiatric factors, consistent with data from Ta and colleagues. However, correlations between the NMRSCL-121 somatic scales and the HSCL-25 and the psychological scales were not insignificant. Overall, the data imply that somatic symptoms may have a significant contribution from psychophysiological processes, yet other medical illness may be present and should be assessed.

Psychosocial Problems The approximately 500 incidents worldwide that meet the Red Cross’ definition of disaster are most likely to occur in developing countries, which have fewer resources than more developed countries (Norris & Alegria, 2005). It is predicted that disasters from climate change will continue to predominantly affect developing countries. One commonality between weather-related events is that there is an imbalance between demands and resources and between damage and the ability to provide repair, such that adaptive mechanisms fail and vulnerabilities emerge. Norris and other investigators have reported on how social structures and support deteriorate after disasters in developing countries and how this is associated with both individual and collective distress (Norris & Alegria, 2005). A needs assessment after the 2004 tsunami provides an example of the psychosocial needs that may exist after weather-related events (Vijaykumar, Thara, John, & Chellappa, 2006). Table 8.1 shows the range of harms and subsequent needs in a Sri Lankan community in the few months after the tsunami.

Table 8.1 Needs assessment in Sri Lanka after 2004 tsunami Rank

Needs

Required by (%)

1 2 3 4 5 6 7 8 9 10 11 12 13 14

Household items Shelter Assistance in getting financial compensation/relief vouchers Clothing Psychological support/counseling/medication Any other specific needs of children/elderly disabled Vocational/occupational needs Religious/spiritual needs Educational needs Others Legal assistance Physical health Food Assistance in locating missing family members/friends

78.4 64.7 55.0 54.9 52.9 41.2 39.2 33.3 31.4 27.4 21.6 15.1 13.7 2.0

From Vijaykumar (2006)

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There is also evidence that psychosocial problems after weather-related events may be long lasting. In Sri Lanka, 20 months after the storm, 60%, 25%, and 25% of the cases were experiencing mild, moderate, and severe impairments, respectively, on the Sheehan global disability scale, and similar rates of impairment were seen in specific work, family, and social functioning. Psychological and somatic symptoms were highly correlated with these psychosocial problems (Hollifield et al., 2008). Interpersonal and domestic violence appear to worsen in displaced and nondisplaced survivors of environmental disasters. The post-Katrina context in 2006 is instructive. Interpersonal violence increased dramatically in the months and even years after the hurricane. Gender-based violence increased fourfold among internally displaced persons and was associated with poor mental health (Anastario, Shehab, & Lawry, 2009). The risk of suicide attempts and completions after displacement were 78 and 14 times baseline rates prior to the disaster (Larrance, Anastario, & Lawry, 2007). Psychobiology and Long-Term Health Consequences Information about how psychological distress and psychiatric disturbances are associated with body functions is rapidly expanding. Given this vast literature, it is instructive to focus on the complex effects of PTSD on physiological homeostasis, with the caveat that PTSD is only one of many adverse outcomes in refugees. PTSD is associated with dysfunctions of the hypothalamic–pituitary–adrenal (HPA) axis, autonomic nervous system (ANS), central nervous system (CNS), immune and inflammatory systems, and even the way genes express themselves in making proteins. All of these systems regulate psychological and physical processes, and disturbances in these processes confer a higher risk for distress, psychiatric disorders, comorbid psychiatric and medical illness, and later medical disease (reviewed in a number of recent works (Koenen et al., 2009; Lanius, Bluhm, Lanius, & Pain, 2006; Rohleder & Karl, 2006; Yehuda et al., 2009; Yehuda & LeDoux, 2007)). Together, these data point to a failure of adaptation to the stress response, which causes significant disruption in physiological homeostasis within and between multiple body systems. The most likely primary dysfunction in PTSD is in communication between the medial prefrontal cortex (mPFC) and the anterior cingulate cortex (ACC) with the amygdala. The failure of mPFC/ACC activation to moderate amygdala functioning during traumatic reexperiencing is a neural correlate of the failure of recovery of the stress response. This alteration is implicated in emotional and cognitive interactions involved in fear conditioning, habituation, and endocrine responses via regulation of the HPA axis and the ANS. This integrated disruption is responsible for symptoms that occur during reexperiencing events such as nightmares, sweats, tremors, and palpitations (Bremner, Elzinga, Schmahl, & Vermetten, 2007; Prins, Kaloupek, & Keane, 1995; Shin, Wright, Cannistraro, & Wedig, 2005) and also promotes the higher risk for cardiovascular and inflammatory disease seen in PTSD (Boscarino, 2004, 2006; Boscarino & Chang, 1999; Cwikel, Abdelgani, Goldsmith, Quastel, & Yevelson, 1997; Dobie et al., 2004; Gander & von Kanel,

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2006; Kadojic, Demarin, Kadojic, Mihaljevic, & Barac, 1999; Schnurr, Spiro, & Paris, 2000; Shemesh et al., 2004). PTSD symptoms and later risk of medical illness may be mediated by a low-level chronic pro-inflammatory response (Spivak et al., 1997; von Kanel et al., 2007). The relevance of this body of knowledge to climate change refugees is of theoretical and practical importance. The psychological effects of environment change on place, identity, and belonging are transmitted into physiological disruption and medical illness for a significant minority of those exposed. Consistent with Engel’s biopsychosocial paradigm, smaller units are necessarily components of larger units, inexorably tied to and affected by them. The outside world makes its way into organs, cells, and molecules of the individual. This means that environment matters, not only because of the seen effects but also because of the unseen, the delayed, and the potentially disastrous effects on human health. Pre- and Post-Displacement Impact on Psychosocial Disturbances Poor mental health of refugees is most commonly attributed to the traumatic events that lead to displacement. However, post-migration stressors such as poor access to health care and jobs, communication difficulties, obstructions to social integration, poverty, and worries about family back home also contribute to mental health problems in this population (Porter & Haslam, 2005; Silove et al., 1997). Furthermore, clinical investigators have opined that problems for refugees in the resettled country are significant and sometimes overwhelm available services (Silove, 2002). The studies that have evaluated the relative contribution of both pre- and post-migration events to the mental health of refugees have found that post-migration stress provides a risk similar to premigration war trauma (Fenta, Hyman, & Noh, 2004; Marshall, Schell, Elliott, Berthold, & Chun, 2005; Momartin, Steel, Coello, Aroche, Silove, & Brooks, 2006; Steel, Silove, Bird, McGorry, & Mohan, 1999).

Global Responsibilities for Promoting Adaptation to Climate Change Whether people become displaced or have new environments displaced onto them, the psychological health related to climate change is a global problem and a global public health responsibility. There are no consensus guidelines about promoting psychological health during climate change since the field is relatively new. We suggest guidelines based on work from other environmental change conditions. One challenge to this task is that the effects of climate change on environments are likely to be heterogeneous, for example, ranging from slow losses of shores to rapid flooding from catastrophic events. These various events will call for various interventions. Furthermore, empirical data about psychological and social interventions for either slow or rapid environment changes are lacking (Hobfoll et al., 2007).

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Our recommendations are thus mostly broad principles to address the ongoing risk of resource loss and particular risks to place, identity, and belonging, and individual physiological homeostasis. Information about specific interventions is also provided.

Primary and Secondary Prevention Assessing and Encouraging Resource Conservation The fact that actual and perceived resource losses are important predictors of developing stress-related symptoms suggests that classical psychological interventions have limitations in a context where objective stress and loss are real, difficult, complex, and ongoing as they are with environment change and displacement (Hobfoll et al., 1991). Since the Conservation of Resources theory is a broad model with defined items in resource categories, it can be used to assess risk of loss as well as help establish intervention needs. Furthermore, education about what is at risk and how it might be stabilized in the various situations related to climate change could mitigate against psychological distress. The COR assessment is flexible: there are 74 items in eight scales from which to choose dependent on the purpose (Hobfoll & Lilly, 1993). For example, one study utilized seven COR items to assess psychosocial loss related to a terrorist attack (Palmieri et al., 2008). Another ongoing study has selected 31 items that assess interpersonal, personal, material, work, and health losses and gains in refugees displaced to the USA. A shorter instrument that might be used to assess economic and psychosocial resources is a 10-item scale developed by Norris and colleagues (Closs, Stead, Arshad, & Norris, 2001) that was recommended by the National Institute of Mental Health for all terrorism-related research following the events of September 11, 2001. Preventing Displacement, Encouraging Stability of Place Displacement is associated with reduced access to health care and humanitarian assistance, strained health systems that impact both locals and the displaced, and worse health outcomes. For these reasons, it has been proposed that, from a health perspective, the best option is to avoid human displacement if possible (Leus, Wallace, & Loretti, 2001). This is a complex task relative to climate change events that destroy place. The most obvious preventive measure is to keep environments intact by reducing carbon emissions and other human-caused sources of climate change. Another option is to continue to develop more powerful tools to understand the effects of climate change on various locales and provide support to communities at risk to encourage stability of place. This will mean dedicating global resources to assess the decay in areas affected by climate change, to model global and local interventions to stabilize decay, and to provide resources that are culturally relevant to implement interventions. An example of doing this in the context of structural social decay in US cities has been provided. Assessing the physical integrity of an area can be used to develop projects that enhance social cohesion, which is

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one indicator of overall health (Fullilove, 1998). Another example is the guidelines suggested by partners of the World Health Organization for humanitarian emergencies, which are designed to stabilize the health of individuals by working with communities to bolster assets and capacities of beneficiaries (Leus et al., 2001).

Assistance with Resettlement When displacement does occur, it is critical to structure resettlement in a way that helps those displaced regain a sense of place and encourage stability of identity and belonging. This is of course no easy task, given the disparate settings to which refugees are displaced. Agencies around the world are already doing great work to assist displaced refugees with the resettlement process. Components that need further work include conducting timely health assessments, particularly for mental health, establishing longer-term capacity for access to health care, being more aggressive in enhancing language capacity and the ability to work, and providing for community participation to develop places and activities that help refugees retain their culture while also acculturating to the new environment.

Tertiary Prevention: Interventions Screening Efficient and targeted screening of refugees for all types of adaptive failures are rarely conducted in a systematic way due to perceived time constraints and the lack of valid and efficient models for screening for psychological health in a public health setting. One program in the US state of Colorado was implemented to screen 1,580 refugees using a rationally developed 25-item instrument designed to assess for PTSD, depression, and anxiety (Savin, Seymour, Littleford, Bettridge, & Giese, 2005). Nine percent screened positive for one of the disorders, and 37% of those who were provided a treatment referral went for treatment. Factors that predicted treatment seeking were co-location of “physical” and “mental” health services, clinic staff experienced in working with culturally diverse people, frequent contact between refugee case managers and clinical staff, and a good relationship between case managers, clinical staff, and public health officials (Savin et al., 2005). Limitations to current screening practices are the lack of valid screening measures, the exclusive focus on diagnostic categories, and the lack of instruments in many languages. In addition to being assessed for resource loss and gain, refugees should be assessed for the following: (1) psychological and somatic symptoms of distress, (2) alienation, demoralization, and solastalgia, (3) psychiatric disorders, (4) psychosocial dysfunction, (5) capacity for coping and resilience, (6) risks for future psychological and medical illness, (7) trauma exposure, and (8) impairment due

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to assessed problems. Ideally, screening assessments would occur on two occasions – early after arrival and 8–12 months later – because of the fact that some refugees have chronic and some have delayed onset of distress (Hobfoll et al., 2009). Identification of chronic mental illness not related to the stress of environmental change should also be identified. It is important to include a cultural formulation in the screening, assessment, and treatment planning for culturally diverse groups (Baarnhielm & Scarpinati Rosso, 2009; Watters, 2001). Principles for Intervention A group of scholars convened to develop essential elements of intervention for the immediate and mid-term period after mass trauma. The proposed elements were not specific interventions, but rather principles to guide clinicians, policy makers, and investigators in planning subsequent interventions and trials. One focus was to identify principles that are best supported by the extant literature as promoting resistant and resilient outcomes, and as such are highly relevant to climate change refugees. The five principles identified were to promote: (1) a sense of safety, (2) calming, (3) a sense of self- and collective efficacy, (4) connectedness, and (5) hope (Hobfoll et al., 2007). The authors emphasized that there are many ways to operationalize these principles, that they should be applied in carefully designed interventions that are responsive to the ecology of the culture and type of trauma, and that there are no empirical data on the effectiveness of applying these principles. However, this approach may be highly relevant for the climate change refugee who has suffered losses and threats to place, identity, and belonging and internal homeostasis. Counseling As opposed to specific treatment, refugees may benefit from counseling about the risks of psychological disturbances, the risk of medical illness associated with ongoing stress, and ways to mitigate these risks. To reduce stigma while concurrently reinforcing the fact that psychological and physical illnesses are related, counseling may be best conducted as part of routine medical assessment. Refugees should be counseled about the benefits of conserving and regaining lost resources, which might include ways to both acculturate and retain cultural pride and behaviors in the new environment. It is critical to honor their experience and help them reidentify and find meaning and belonging in their new domicile. Experimental evidence for the benefit of this approach is lacking and needs to be addressed in future research. Specific Treatments Medications and various forms of culturally adapted psychotherapy have been shown to be helpful for refugees with PSTD, depression, and anxiety (Boynton, Bentley, Strachan, Barbato, & Raskind, 2009; Hinton, Hofmann, Pollack, & Otto, 2009; Hinton & Otto, 2006; Otto & Hinton, 2006; Paunovic & Ost, 2001; Renner,

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2009; Smajkic et al., 2001). To the degree possible, attention should be paid to potential ethnopharmacological differences when medications are used and sociocultural variables when psychotherapies are employed. Whatever approach is used, it is critical to help the refugee understand the most salient clinical problem and to provide a reparative relationship while providing specific treatment (Kinzie, 2001). Classic cognitive and behavioral interventions effectively target ongoing stress, avoidance behavior, and cognitive dysfunction. However, refugees have many physical and safety needs and a fluctuating sense of identity in addition to classic distressing psychological symptoms. In this context, cognitive and behavioral exercises may be difficult and may not necessarily make sense. It is not uncommon for displaced refugees to describe the confusion associated with betrayal, loss, and injection into a foreign place with the implied expectation of seamless integration within months. For most, these transitions are difficult but negotiated successfully. For others, this does not happen as well. It is critical to target resources that are lost or at risk and most likely to cause a loss spiral. For some, psychiatric disorders are most prominent and medication may be the best primary option. For others, the losses are external, and a social- and community-based approach may be best. And yet for others, taking a social and health rights advocacy approach might be most helpful. Examples of such approaches that have evidence for effectiveness in refugees include psychological first aid (Brymer, Steinberg, Sornborger, Layne, & Pynoos, 2008), school-based educational and trauma healing exercises for children (M. Fazel, Doll, & Stein, 2009; Gupta & Zimmer, 2008), multifamily disclosure, education, and support (Weine, Kulauzovic, 2008; Weine, Raina, 2003), and trauma disclosure and testimony approaches for adults and children (Lustig & Tennakoon, 2008; Neuner, Schauer, Klaschik, Karunakara, & Elbert, 2004; Onyut et al., 2005; Weine, Kulenovic, Pavkovic, & Gibbons, 1998). Other successful approaches in refugees include the use of lay counselors to administer therapy for larger populations (Neuner et al., 2008; Stepakoff et al., 2006) and the use of body-based therapies such as qigong and tai’chi (Grodin, Piwowarczyk, Fulker, Bazazi, & Saper, 2008) and dance and movement therapies (Harris, 2007).

Helping Host Communities Prepare It would be ideal if politicians, local policy makers, and the general public were more aware of the events, responses, and potential adaptive capacities as well as problems of refugees. If there were support for community centers that assisted refugees in maintaining their personal and cultural identity, and in so doing educated a generation of children about climate change and other real-world issues in a multicultural space, benefits to refugees and host communities might be profound. If refugees were provided the ability to belong and reidentify themselves as part of the new community because the host was more prepared for helping them on arrival, prevention of adaptive failure may be maximized. In this scenario, the refugee and the host community would gain a better appreciation of the interconnectedness of cells, organs, individuals, and larger communities.

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Future Directions There are several gaps in knowledge about climate change refugees that point to future directions for understanding the phenomena and the needed policies and interventions in this field. The kinds of climate change events are variable and will provide different challenges and problems for refugees. Research on the short- and long-term effects on psychological health of these disparate events is needed in order to make policy and plan appropriate interventions. Ways to effectively keep communities together with strong social cohesion in the face of ongoing environmental threats may be one of the best preventive measures that could be employed. Effective and efficient screening of communities at risk will be essential for the global community to have an impact on prevention and intervention. Currently, screenings exist for psychiatric disorders and some psychosocial problems, but those lack validity for various contexts. There are no screening tools for the other adaptive failures that are seen in refugees and that will emerge with climate-related environment change. Screening must be developed to detect both strengths and weaknesses in individuals and communities (Betancourt & Khan, 2008) and must demonstrate effectiveness to health outcomes in order to be viable. More research is needed to understand how to best promote resistance and resilience in the face of ongoing stress. Specifically, identifying ways to solidify identity in a new social context is critical. The interactions between climate change stress, the capacity for adaptation versus distress and illness, and longer-term somatic health need to be identified and understood in order to plan more effective intervention strategies. Comparative effectiveness trials will identify culturally relevant, effective, and efficient ways to best provide for the vast number of people that will be affected by weather-related events. Finally, improving knowledge about how to enhance understanding of and sensitivity for refugees in host communities will allow us to work toward optimally healthy environments.

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

Changing Perspectives of Climate Change We live in a time of enhanced vulnerability at many levels, indicated through an increase in reported environmental and human disasters – extreme weather events, civil disruption and war, drought and famine, global economic crisis, institutional hardship and individual and social suffering. In recent years, there has been increased reporting and arguably increased prevalence of environmental disasters strongly tied to climate change, as an outcome of deforestation, the use of polluting chemicals, the increased use of fossil fuel, and production and consumption patterns resulting in inordinate amounts of waste. The United Nations Climate Change Conference in Copenhagen, held in December 2009, revealed how inequalities and disaster compound, and the arguments that ensued over this period and subsequently highlight how political, economic and social schisms intertwine with and complicate action in relation to the environment. Regular media accounts of climate change and associated poverty and hardship are routine reminders of the local affects of this global problem. Our purpose in this chapter is not to address these difficulties but to consider how individuals, families and communities find meaning in their face. Faith-based communities are among the first on the ground at times of sudden disaster, as usually occurs with extreme weather events. In this chapter, we focus not on their short-term pastoral and practical roles, however, but on the role of spirituality and belief systems in managing suffering and supporting resilience. After contextualizing the traditional role of religious communities in providing care and current humanitarian guidelines on religion in disaster, we discuss the principles of positive psychology, drawing on Frankl’s work on logotherapy and the more recent work of psychologists Tedeschi, Calhoun and Janoff-Bulman, in

At the time of writing, Dr Ramsay was a PhD candidate at Monash University. Dr Ramsay is now NGO representative to the United Nations for the Brahma Kumaris. This chapter was made possible with the support of a Monash University Postgraduate Publishing Scholarship. T. Ramsay (B) Social Sciences and Health Research Unit, Faculty of Medicine, Nursing and Health Sciences, School of Psychology and Psychiatry, Monash University, Caulfied East, VIC 3145, Australia e-mail: [email protected] I. Weissbecker (ed.), Climate Change and Human Well-Being, International and Cultural Psychology, DOI 10.1007/978-1-4419-9742-5_9,  C Springer Science+Business Media, LLC 2011

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posttraumatic growth, meaning making and resilience. For many people, faith and spiritual practice are powerful contributors to support resilience and deal with the personal effects of climate change and associated catastrophe. Although contemporary scholars are often unwilling to speak and write about spirituality, it plays a significant role in caregiving, support and meaning making in local cultural contexts, in the everyday practices of faith communities, and in the psychology of resilience and posttraumatic growth. We understand this best in terms of the beliefs and practices of major religions. But in this chapter, we use as an example a relatively small (in global terms) new religion, the Brahma Kumaris World Spiritual University (Brahma Kumaris), within which environmental and anthropogenic disasters are normalized through spiritual philosophy. Drawing on ethnographic data collected by Ramsay between 2007 and 2009, we illustrate how daily scriptures, delivered in morning services, provide Brahma Kumaris (BKs) with lessons of the significance of disaster and trauma and about how to manage the mind’s internal state during calamitous or difficult times. Through spiritual praxis and philosophy, BKs find meaning in disaster for themselves and adopt spiritual ways to manage their suffering. BKs also find unique ways to be of service to others, despite the physical constraints that disaster brings. Because extreme events and sustained hardship associated with climate change affect all aspects of personhood and community life, we argue the importance of drawing on multiple methods and eclectic approaches to enhance resilience and, in doing so, to acknowledge the value of diversity in belief systems and responses. Our argument is one that supports spiritual, as well as physical, mental and emotional, dimensions to health and well-being. This is one that could be made in relation to any disaster, but the theology of the Brahma Kumaris provides a particular frame to comprehend the complex multifaceted problems of climate change (see also Eco Buddhism, 2009).

Faith-Based Response to Disaster Meteorological and other environmental disasters have been a recurrent feature of world history, an area in which colonial missionaries played an active role in providing physical aid while proselytizing (Padel, 1995; Stipe, 1999). The undisguised opportunism of the occasion for conversion – disaster linked to divine displeasure, recurrence averted through conversion – is no longer common, yet there is residual scepticism and caution about the role of faith-based organizations in disasters, and suspicion that disaster presents unethical opportunities to proselytize (Jayasinghe, 2007). However, religious organizational responses to disaster have changed substantially. Bergman (2008) documents the 1930s as a time when progressively, faith-based organizations provided disaster relief within a neutral framework, and since then, large established religions and new religious movements have become less championing of particular philosophies and more concerned with ‘service’ to the community at large (Olson, 2003; Leong, 2008; Southern Baptist Disaster Relief, 2004). In times of crisis, as occurs in environmental disasters due to climate

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change, responses to suffering, pain and loss are shaped by the urgency to save lives, provide physical care, and offer immediate pastoral and practical support. Following disaster, there is commonly an influx of emergency service personnel, health professionals and community volunteers. Fuelled by the desire to help, faith communities are among the first to respond in the aftermath of disaster, according to the directives of their faith, offering practical and spiritual contributions while considering the need to balance congregational needs with the needs of the broad communities that they serve (Yetman, 2006). Within different religious communities, there has been growing consideration of faith-based solutions to those who have experienced trauma (Leong, 2008). Religion can help to offer meaning in a way that does not threaten or challenge one’s worldview, but offers tools that are empowering. With non-proselytizing support, the ‘experiencer’ designs a new narrative that enables him or her to move through the situation with greater ease. This is an important step for individuals and communities who must come to terms with loss, including – as illustrated by Hurricane Katrina of individuals, pets, personal possessions and houses, as well as community infrastructure. Religious congregations, local search and rescue groups, and other community-based organizations have unique knowledge of local risks and resources, and attachment to place and population that allows for sustained support (NVOAD, 2009, Smale, 1998). In consequence, there has been a call for the greater collaboration of participants in disaster response and the better utilization of faith-based organizations, because they provide and support existing social networks and strong trust-based community relationships (Koenig, 2005) and so can help build trust between governments, various NGOs (including faith based) and their populations at times of crisis (Hall, 2006). Faith-based organizations from all theological standpoints now form a significant body of the United Nations (UN) community of non-governmental organizations (NGOs) (Ferris, 2005). Many affiliated with the UN also belong to the United States umbrella organization of relief organizations – National Voluntary Organizations Active in Disaster (NVOAD, 2009), which includes diverse Christian (Pentecostal, Episcopalian, Catholic, Mennonite, Baptist, Lutheran, Latter Day Saints, Presbyterian, Methodist), Jewish (National Association of Jewish Chaplains), Hindu (Ananda Marga Universal Relief) and Buddhist (Tzu Chi) groups. Although not with NVOAD at time of writing, the Brahma Kumaris is a new religious movement that affiliated with the UN in 1980. Founded in northwest India in the mid-1930s, Brahma Kumaris holds general consultative status with the Economic and Social Council (ECOSOC), consultative status with the Children’s Fund (UNICEF), and is affiliated with the Department of Public Information (DPI). Various caucuses and agencies within the UN regularly consult Brahma Kumaris representatives to the UN, like other faith representatives, on matters to do with the human spirit, in different fields, including climate change (BKWSU, 2007, 2009b) and sustainable development (BKWSU, 1992, 1995, 2000, 2002, 2006). Such advice is made without prosyletization, by reaffirming core spiritual principles that inform the foundational UN Charter (UN, 1945).

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All disasters are multifactorial, the consequence of a complex interplay of social, environmental and political factors, and affect all aspects of human life and threaten all facets of well-being. Climate-related disasters are no exception, although the capacity of people and their governments to head off further disaster and take appropriate longer-term action for a sustainable future is complicated by debates about causality and the timelines for effective change. The effort in climate-related disaster therefore is concentrated in the short term, and beyond this point, in general, co-operation between governments and civil society both in social and physical reconstruction and in addressing the spiritual and cultural needs of people is limited (Aguirre, 2006, see also Fjord and Manderson, 2009). This is despite IASC guidelines for mental health and psychosocial support in emergency settings, published in 2007 through the Inter-Agency Standing Committee (IASC) and reiterated in the Sphere Project, a key manual for humanitarian aid workers in disasters. IASC and Sphere argue unequivocally for sensitivity to and awareness of community, spiritual and religious practices to ensure the best possible outcome for people affected by environmental disasters. The guidelines suggest that humanitarian aid workers approach local religious and spiritual leaders and other cultural guides to establish the wide impact of the event and to ensure sensitivity in working with affected communities. The guidelines highlight the need for ethical practice and cultural sensitivity, including communicating respectfully with religious and spiritual leaders to provide the best support. The guidelines emphasize that humanitarian aid workers are supplementary to local resources. While ensuring adherence to the international standards of human rights, proper care must consider local cultural, religious and spiritual forms of support and coping, and proper acknowledgement of local knowledge, customs and beliefs including in relation to the physical as well as social environment.

Resilience, Meaning and Logotherapy Like other states and responses, resilience is developed and shaped by social, economic, political, familial and institutional factors. Societal and cultural continuity relies on resilience, including in response to colonization and industrialization as well as the more acute experiences of disaster. People use and incorporate local knowledge and understanding to mitigate and adapt to geophysical, meteorological and hydrological, as well as political and economic, events. Archeological evidence of the Andes, for instance, demonstrates that the pre-Colombian Andean people lived with a high risk of earthquakes, with traditional housing and infrastructure designed to limit consequent disaster (Cook, 1981), and in extreme environments and regions of regular vulnerability everywhere, living conditions are adapted to minimize loss. In these instances, resilience follows from and builds on institutional and structural factors. In this chapter, however, we use the term “resilience” to refer to individual responses to disaster, trauma and distress – a kind of internal elasticity that, like a stick of bamboo, may bend with the wind. We refer to the capacity for individuals and communities to adapt to stress and to make sense of events of

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stress. For many people affected by disaster, including increasingly extreme weather events, modernization, industrialization and urbanization have undermined conventional coping mechanisms such as cultural practices and rituals, which helped people to find meaning, to make sense of the events, and so rebuild their lives. Below, we explore the role of faith-based community practice and ideology in responding to disaster and finding meaning in its wake. Creating meaning is fundamental to building resilience and ensuring personal growth following traumatic events. In theorizing these relationships, Viktor Frankl founded logotherapy, a highly influential school of psychotherapy and a precursor to positive psychology. Building on his own experience, his survival of internment in Nazi Germany, Frankl first elaborated his theory in Man’s Search for Meaning (1962 [1946]). Logotherapy has three fundamental philosophical and psychological precepts (Marshall, 2009). The first is that life has meaning, and the will to meaning is central to Frankl’s understanding of human adaptation and resilience even in the most tragic of circumstances. For those on a spiritual path such as that of Buddhism, Christianity or Brahma Kumaris, suffering is understood to be meaningful and never arbitrary. To experience growth through suffering in the context of traumatic experiences, psychologists suggest that “the stressor must be sufficiently disruptive to core beliefs to prompt a search for meaning” (Stanton, Bower, & Low, 2006, p. 165; Calhoun & Tedeschi, 2006a, 2006b; Janoff-Bulman, 2006; Tedeschi & Calhoun, 2006). For example, facing death can offer an enhanced appreciation for life to a degree that the individual may not have previously experienced; the loss of a home may highlight the distinction between material and social goods and values. Frankl explains that each person has the freedom to choose how he or she approaches and responds to life circumstances and tragedies; his “tragic optimism” (1984, pp. 161–179) posits that whatever happens in life, whatever is experienced, taken away or destroyed, each person retains the “ultimate freedom” to choose his or her attitude to these circumstances. Human freedom is not freedom from particular circumstances, Frankl argues, but the freedom to take a stand and to face conditions as presented. These two tenets – the will to meaning and the autonomy of an individual to act in a particular way – are echoed in various religious precepts. BKs, for example, take a similar approach to meaning, as developed through their theology and meditation, and endeavour to transform their own attitudes, when based on division and fear, to attitudes based on higher spiritual principles of inclusion and tolerance. Buddhists call for similar attention to meditation, which, for individuals, “develops mental clarity, (allows) insight into conditioned reality (and) freedom from negative states” (Trainor, 2004, p. 74) to construct a positive narrative, a key contributor to resilience. Buddhist and Christian philosophies emphasise that people have a choice in how they understand life experiences – what BKs may call ‘the power to face’ or Christians the capacity to ‘turn the other cheek’. The Sikh scripture says, “Those who beat you with fists, Do not pay them in the same coin, But go to their house and kiss their feet” (Guru Granth Sahib, 1604). Brahma Kumaris philosophy understands the self as master and maintains that each person can be self-sovereign by understanding his or her original virtuous state.

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BKs explain that each person has an eclectic inner box from which to choose their response to a given situation. This inner framework may include genetic predispositions, learned behaviours and aspirational values. However, BKs and other spiritual practitioners endeavour to strengthen values that are both attainable and desirable. Buddhists and Jains explain similarly that one must draw on the inherent capacities of the mind to facilitate change in the world around them (Dundas, 2002; Wallace, 1996). Beyond the body and mind, the spirit equips people with the will to explore, to decide, to choose and to change. Thus, religious philosophy provides what anthropologists characterize as an ‘explanatory model’ to make sense of changes, disasters and disruptions that occur beyond their own capacity to control or intervene. Frankl wrote in secular terms of the human spirit as dynamic and did not include a religious perspective in his description of logotherapy as a therapeutic tool. His philosophy of spirit, however, is akin to various religious tenets, and logotherapy provides a framework that can contain multiple theologies and experiences. Frankl explains that the spirit or the self is energy, not substance (Seidner, 2009). It cannot be destroyed, divided, reduced or duplicated. Spirit is the essence of a person, beyond biology and all forms of learned behaviour. A person is a spirit. A person has a body and a mind. The person (spirit) is expressed through the body and mind, but it is distinct from them. The spirit is, therefore, the ultimate form of freedom for each person in the way they live their lives, with meaning, and an identity not confused by the burden or restraint of physical consciousness (Frankl, 1962 [1946]; Marshall, 2009). As the third tenet of logotherapy, Frankl argues that meaning is a form of healing. He suggests that one can tolerate suffering and failure if there is meaning in either; without meaning, one will be led to despair. Searching for meaning offers a pathway in traumatic circumstances. In some cases, as with Frankl’s own experience in concentration camps, the losses are the very catalysts that reinvigorate the search for meaning. Herman (2004) and Frank (2000) suggest that finding meaning and constructing a coherent life story are an important part of recovery from trauma, disasters associated with climate change, and disruptions in social, economic and everyday life. Logotherapy is fundamentally holistic (Rice et al., 2009). Wong’s development of the idea of people as spiritual as well as psychological, social and biological beings is relevant in its capacity to consider spiritual and existential issues as central to healing, well-being and growth, as well as holding transformative power to help people re-author narratives (Wong, 1998). Calhoun and Tedeschi (2006b) have also augmented Frankl’s theories, and they suggest that the experience of trauma, either personal or large-scale disaster, can be instrumental for positive change (Tedeschi & Calhoun, 1996). Calhoun and Tedeschi’s work systematically recognizes the value of spirituality as a framework for people to experience and manifest positive change in the context of disaster and in connection with resilience. In so doing, their research and writings supplement and moderate theories of posttraumatic stress disorder (PTSD) and provide a way forward for people who might be so diagnosed (Asmundson, Carleton, Wright, & Taylor, 2004; Asmundson, Stapleton, & Taylor, 2004; Fontana & Rosenheck, 2004; Napoleon, 1991; Perera, 2002). Wong too sees that every crisis is an opportunity and every

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transition is a transformation (see also Janoff-Bulman, 1992, 2006). These theories recognize spirituality and existential questions as an intrinsic part of meaning making and may be applied to acute and chronic manifestations of climate change. Extreme weather events such as cyclones and floods, and geological disasters such as earthquakes and volcano eruption, in particular, require survivors to draw on all resources – psychological, spiritual and community – to be able to rebuild their social as well as the physical structures of place.

Posttraumatic Growth Posttraumatic growth is concerned with potential positive physical and psychological consequences of trauma (Calhoun & Tedeschi, 2006c). Although the term was devised only recently, the idea is not new; heroic myths are often founded on tales of exponential personal growth and fulfilment in the face of trauma and suffering, and within religious canons, such stories provide templates for the response of congregations to moments of personal or community distress. The posttraumatic growth inventory (PTGI) was developed in 1996, enabling scholars of psychology and the social sciences to better understand the phenomenon. Tedeschi and Calhoun (1996) include five components of growth in the PTGI: relating to others; new possibilities; personal strength; spiritual change; and appreciation of life. In this therapeutic approach, posttraumatic growth is considered both a process and an outcome, part of a continuum and a life narrative. Personality characteristics contribute to people’s capacity to experience growth, as does a cohesive and supportive social network. This is significant for those involved in environmental disaster as social networks are often substantially disrupted through death and forced relocation. The five components above, determined to be psychological capacities, coincide with what BKs understand of what it means to be spiritual. Tedeschi and Calhoun contend that serious disruption is a necessary condition for posttraumatic growth. This does not imply that traumatic experiences are desired, but if they occur, then it is important that the events are challenging enough to the assumptive world to activate the cognitive processing necessary for growth. Spirituality can be a key component of posttraumatic growth, again giving us license to centralize matters of the spirit. The overlap between psychological and spiritual understandings of these terms is elaborated below. While recognizing the benefits of studies into PTG, further studies are required to be able to apply theories of PTG more broadly (Jackson, 2007). Also, in terms of scholarly understanding of resilience, meaning and human response to trauma, PTG is a relatively new school. Studies into PTG and other studies on psychological resilience indicate that spirituality contributes powerfully to meaning and resilience in the face of trauma (Basit, 2007; Chester, 2005; Chester, Duncan, & Dibben, 2008; Chhean, 2007; Hoffman & Oliver-Smith, 1999; Koenig, 2007; Leong, 2008; Levy, Slade, & Ranasinghe, 2009; Pollock, 2007; Ramsay, Manderson, & Smith, 2010). Although there is little empirical data exploring the role of PTG in the specific context of climate change, one can make certain inferences in relation to

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extreme weather events and environmental disruptions based on our knowledge of psychological responses to certain stressors. Intentional disasters like the WTC collapse result in a particular trauma because of the associated malice, consequently eroding trust in groups of people and associated communities. Intentional disasters from acts of terrorism are thought to be more devastating than other disasters because of the purposeful intent to cause harm, and the lack of a clear end point, making it difficult to move into stages of recovery and grieving. The very aim, with terrorism, is to create significant secondary and ongoing psychological casualties (Bongar, Brown, Beutler, Breckenridge, & Zimbardo, 2007). In war and terror, there are often greater expressions of anger and feelings of worthlessness after the fact, although these also occur with disasters caused by climate change or other environmental disruption. In the rapidly changing and highly politicized landscape of climate change, there have been significant shifts from belief in ‘natural disasters’ and ‘acts of God’ beyond human volition, to a growing understanding of the human contribution to climate change. However, shifts in understandings of risk, causality and responsibility to include governments, individuals, industry and coalitions, make it difficult to apportion blame and so understand the logic, (in)justice, and consequent restoration, reparations and preventive action. This lack of clear understanding adds a new layer of trauma to disasters caused by climate change.

Brahma Kumaris The Brahma Kumaris began in northwest India in the mid-1930s as a small exclusive ascetic community of 300. The organization was established by a middle-aged jeweller, Dada Lekhraj (later known, with respect, as Brahma Baba), and entrusted by him to a group of young women, then in their teens and early twenties. Almost 80 years on, a few original members are still alive and remain the spiritual and administrative leaders of the Brahma Kumaris. The Brahma Kumaris is millenarian, believing in forthcoming cataclysmic events preceding a paradisiacal world. Broad patterns of climate change, environmental instability and economic unpredictability, and distinct events such as war, extreme weather events and political crises, all indicate ‘the age of confluence,’ a critical point of a 5000-year cycle of life when the world is moving towards a critical junction between the worst and the best times of human existence. Further economic, political, social and environmental crises are expected and portentous. Like lay members of other ascetic communities such as Jain (Vallely, 2002) and Buddhist (Rahula, 1974), BKs live lives of service and spiritual discipline. While the founder and original members lived in seclusion until the 1950s, since then, members have retained their commitment to social asceticism, but have increasingly supported humanitarian service and outreach (Ramsay and Smith 2008; Ramsay 2009). Consequently, the organization has steadily expanded and today has spiritual centres in 128 nations and, as noted, affiliation with the UN (BKWSU, 2009a; Walliss, 2002; Walsh, Ramsay, & Smith, 2007). Consistent with this shift

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in emphasis, members are increasingly called upon and motivated to provide social and spiritual responses to traumatic events. And, like many faith-based organizations, the Brahma Kumaris is faced with challenges related to its role in providing pastoral care and practical assistance in response to extreme weather events, disaster and suffering (Cain & Barthelemy, 2008; Jayasinghe, 2007).

The Super Cyclone In recent work drawing on ethnographic research in New York and Orissa, India, Ramsay (2009) has examined the role of spiritual practice in shaping BKs’ experience of traumatic events, and we turn to this now. We identify five interconnected areas that form the soft boundaries of ‘spirituality:’ reflective practices, knowledge, a moral code, service to others and good behaviour. These five domains are common to a number of studies of spirituality (Brome et al., 2000; Bouma, 2003; Chiu et al., 2004; Cunningham, 2003; Koenig, 2001; Martsolf & Mickley, 1998; Piedmont and Leach, 2002; Tacey, 2004). Below, we draw on the accounts of BK participants from Orissa, India, and their experiences of the Super Cyclone, to better elucidate the meaning of these domains as they apply to resilience, posttraumatic growth and spirituality. These BKs live either in small ashrams or with families in villages, abiding by the rules of purity and devotion while undertaking subsistence activities. Orissa, located on the eastern coast of the Bay of Bengal, India, is well known for its heavy tropical storms, high humidity, chronic drought and regular coastal flooding. Climate change and the destruction of mangrove forests for industry make the state especially vulnerable to disasters. Orissa is also one of the poorest states of India (UNDP, 2008). The majority of the population live at near-subsistence levels, and climate-related disasters cause extreme hardship and, recurrently, loss of life as well as property. Although BKs living in the state have extended their roles to outreach and community service, as noted above, such activities are localized, unorganized, and rarely systematic. Few people in Orissa are aware of or are able to comprehend the international community and its humanitarian work; rather, their lives are defined by the everyday hardships of their own environment. Although cyclones and floods are endemic in Orissa, the Super Cyclone of October 1999 remains one of the most devastating environmental disasters of the subcontinent. Two cyclones occurred in rapid succession: the first cyclone, with winds reaching 200 kph, devastated the Orissa coast on the evening of 17 October; eleven days later, while communities were still recovering, a second cyclone hit the same area, with unprecedented winds of 300 kph. These cyclones affected the lives and livelihoods of almost 16 million people, including BKs living in small villages throughout the state: Ten members of our family, we all went to the roof and just a few days earlier my father had cut the branch of a (sacred and indigenous) banyan tree that was very near to our hut. It was raining so heavily that we could not see anything outside. We were not even able to see face to face. Water was also spinning. It was rushing at such a high speed that it was spinning. The wind and the water took away some of the house, and that banyan branch acted as a

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boat for us. We could see animals and people dying in front of us. Lifeless. All our crops were washed away. Other family members started crying, “What are we going to eat?” My father said, “Just hold onto that branch of the banyan tree.” Our entire house was washed away and we were just holding onto that branch. (Aahlaad) (all names are pseudonyms)

At least ten thousand people were killed during these cyclones; millions of houses were destroyed (Palakudiyil and Todd, 2003). Orissa BKs argue, however, that the mortality statistics underestimate their impact; many people were unregistered and so were not included in the official toll: When we found our grandmother, she was all white. She was white on white and had become bloated. She still had her arms wrapped around her legs. She was floating along with so many other things in the water. (Jaishree)

The cyclones damaged almost two million hectares of crops. Ten years on, families are still displaced from their villages and are unable to earn a livelihood through regular cultivation: Since then, sometimes the seed grows very well but sometimes it won’t grow at all. The water brought so many things with it that the soil is different now, so we never know if we are going to be able to eat properly or not. (Ravi) From our tiny village a total of seven people were dead. And the river water washed away the entire village. All the houses, all the crops. Everything was gone. There was nothing to eat. (Urvashi)

Meaning, as noted above and as used by Frankl (1978), refers to the ways in which people make sense out of, and find significance in, life events. This is connected with overall life purpose, articulated in cultural terms but shaped by individual experiences, capacity and context. BKs made sense of the tragedy through theology, as we discuss below. In the context of spirituality, meaning may either reaffirm or challenge a faith in universal principles, a supreme benevolent being, and/or a big picture perspective that takes the absolute importance out of the here and now. In determining PTG, it is in the realm of existential, spiritual and religious matters that the greatest growth may be experienced. For BKs in Orissa, scenes of devastation witnessed at the time of the Super Cyclone and countless smaller local disasters as a result of floods, storms, drought, and high winds provide meaning because the events are affirmed and reflected in their theology. Whatever is happening will happen. We have learned from our teachings that whatever is written in destiny will happen for sure anyway. Whatever happens do not worry. Remember God. It is destined. After these calamitous events everyone will be liberated, so there is peace ahead for everyone. (Hemlata)

Values lead one to reconsider the ethics and morals that form the foundation of one’s life, character and relationships (Kleinman, 2006). This relates to the PTG determinants of ‘changed philosophy of life’ where people have a renewed and heightened appreciation of the more simple aspects of life, in the face of significant loss. Placing a value on their elementary spiritual capacities contributed to BKs’ sense making after the cyclone, as well as feeling constructive at a time when many feel helpless:

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I was feeling that (the job of) my thoughts were to order nature. I was speaking to the water and saying, “You must stop now. You cannot increase anymore.” And it happened that it didn’t rise anymore. It stopped. So I was feeling that yes, we are the ones who can work with nature. (Devi)

While Devi’s practice was to give to the elements, Jagdish’s practice was to remain beyond their influence. He placed value on his personal spiritual practice: I felt it was. . . an examination to make our internal stage strong. It gave me the feeling that even if you don’t get water and food for many days even just with the remembrance of God you can survive. I felt it very strongly.

Reflective practice refers to establishing and maintaining an inner conversation with the self on the basis of faith in something of great personal significance. When determining PTG, the character traits of optimism are significant in growth. Therefore, reflective practices are generally positive: meditation and prayer may help the sufferer moving beyond patterns of thinking that have previously brought experiences of sorrow, limitation and suffering. Reflective practice may also bring an experience of transcendence through meaningful fulfilment or loving encounters (Frankl, 1978), such as a relationship with God, a guru or a higher power experienced through meditation. For BKs, meditation served as a form of personal transcendence that lifted them out of what they see as a chronic over-identification with the body and the material world. The power derived through meditation allowed BKs in Orissa to offer ‘subtle’ (unexpressed) support to others through the vibrations they create with their mind. After the cyclone, we helped to distribute relief. We did that, but the most important service was to treat everyone with goodwill, good thoughts and have good wishes for all. As we have been taught, wherever destruction has happened, remain there in spiritual consciousness and give good vibrations. No other service is beyond that. (Ramesh) Constantly I was in remembrance of God, got power and peace from God and distributed it among other people who were there. (Roshan)

Service to others is a form of negotiation in which one establishes and deepens an alliance of the self, God, others and nature. Helping in the aftermath of disaster is associated with experiences of well-being, self-esteem and positivity, enhancing people’s psychological resources (Musick & Wilson, 2003). While acting on the basis of physical and spiritual forms of humanitarian aid (distributing food and clothing, and meditating and projecting good wishes respectively), participants used their teachings to establish a coherent narrative in the context of ‘service’: (It felt like) everyone was going to die and everything was going to finish, so I thought we should spread the vibration of peace and happiness. We too had lost everything in water. But we didn’t have even a little bit of unhappiness . . . I was also feeling that this is a very tough time when people need to be able to tolerate whatever is happening. They need real power, so through mental power I was trying to spread the atmosphere that they will have the power to face, they will have internal happiness and peace. (Devi) Physically we can do whatever we can for them. And together with that we can spread the vibration of peace . . . (Manju) Mental peace. People require mental peace. We can help bring this about through our practice of meditation. (Nagraj)

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Good action involves bringing the results of personal meaning finding and constructive reflection into the physical world in a way that reaffirms and anchors internal change. One then draws understanding from the past into the present, in order to practically construct one’s future. It must be grounded in daily life through action and may involve renewal and reconfiguration of attitude: There was a younger brother I was with who started crying, seeing the situation and then I said, “You don’t worry. God is with us. (Through spiritual teachings) we have been told in advance what will happen. So don’t worry, let’s see what happens. (Adesh)

Maintaining a fluid perspective (Halemba, 2008) and being prepared to alter the way in which life is viewed (Agrimson & Taft, 2009) and enacted are spiritual methods that assist in the restoration of meaning (Ai et al., 2005): We saw in front of our eyes what would happen in the future. (Our teachings said) we would see that. So inside we had even more faith. (Gulab)

Meaning, values, service, reflection and good action, therefore, are part of the psychological frame for BKs, demonstrating the overlap between spirituality and psychology – certainly as articulated in logotherapy – in the process of sense making contributing to resilience (Levy, Slade, and Ranasinghe, 2009; Leavey, 2008). Psychologists have called for more specific detail on effective faith factors that sit between the scholarly disciplines of positive psychology and faith-related research (Ai et al., 2005). This reconfiguring of outlook captures much of what is at the heart of re-authoring and the growth that can result.

Re-authoring as an Explanatory Tool Re-authoring, as suggested by Janoff-Bulman (1992, 2006), is a form of deeper and more complex reframing, central to posttraumatic growth; it involves writing a new life narrative rather than just seeing things in a new light. “Self narratives are the very substance that is disrupted by trauma and loss, and that public and private narration of tragedy and transition is heavily implicated in posttraumatic resilience, repair and transcendence” (Neimeyer, 2006, p. 78). Re-authoring begins with the premise that each person has an interwoven tapestry of memories, thoughts and behaviours that have been affected by and impact on the lives of others. This tapestry goes towards creating the person’s assumptive world, forming attitudes that become the filter through which life is experienced. It is a fluid world open to external influences, particularly in times of heightened awareness, as occurs with disaster. Overarching schemas offer a sense of certainty and control and are formed through a process of action, response and feedback that takes place between individuals and the social worlds they inhabit. Once this assumptive world is challenged and the old filter through which life was viewed is displaced, a new identity and perspective must somehow be woven, so that a coherent meaning can be gleaned from what has occurred (Frank, 2000).

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The assumptive filter then acts as a frame of reference through which life is understood and is considered to be standard and unremarkable, however it may seem to others. The filter is an osmotic one, with information constantly being revised and adjusted by new experiences throughout life, either gradually or abruptly. This rewriting of one’s life narrative in light of new understanding may result in growth. Re-authoring occurs on a continual basis and reflects the endeavours of individuals to find an existential logic and coherent identity to carry forward as they move through their lives. In some respects, one could argue that BKs’ theology is a conservative one, allowing the inevitability of climate change and associated disasters as instantiation of the confluence age, with no notion of the capacity of adherents to change this sequence and so avert disaster. The spiritual perspective used by BKs brings their attention back to the self, but, in doing so, it offers individuals alternative solutions for resilience in face of personal or environmental disaster. Hence while BKs have no authority for activism, in this regard, any disaster is a call to serve and, because it affirms their theology and faith, it can provide spiritual practitioners with a sense of purpose and framework through which to make sense of the disastrous events. At the same time, the growing concern with outreach of this organization, and other faith-based communities, suggests increase in concern among practitioners about the extent of suffering and the need for action both locally and globally.

Spiritual Practitioners A central component of spiritual practice is being self-reflective and analytic of motivation. The key to intervening in the unfolding events of the biological system is to create a change in the inner system of thought. First, we must make thought aware of its role in creating the world – or to put it another way – we must make the thinkers of thoughts aware that we are not neutral observers of a sequence of events: our inner beliefs affect our process of observing and the choices we make as a result, affecting the very world we are observing. (BKWSU, 2009b, p. 3)

BKs purposely view this assumptive filter and reflect on it daily; worldwide most BKs attend daily morning services with readings (murli) (Ramsay, 2009). Spiritual practitioners adapt their behaviour and thinking accordingly, aiming to remain authentic to daily demands and responsibilities while repeatedly and continually endeavouring to transcend materialistic attitudes, consciousness and limitations of the physical world. Because of the existential and questioning nature of spiritual paths, spiritual practitioners frequently explore and seek to explain the reason for suffering and the nature of change, including global environmental change. To understand, accept and manage the mind is deemed the key to enlightenment, and so the mastery of one’s own mind is the tool to release the self from suffering. The method of release from suffering for BKs is systematic, with a strong focus on internal reflective practice and private ruminations, reinforced by virtuous action

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and disciplined rituals designed to promote and sustain strong spiritual awareness. Although this type of positive rumination is not exclusive to spiritual practitioners, it is a more purposeful part of their existence as all forms of theology call their adherents to engage in self-reflection to a substantial degree, mostly on a daily basis. Spiritual practitioners are often encouraged to deal with suffering and difficulties mindfully, managing necessary change and associated tensions thoughtfully and peacefully. Furthermore, they may often hold beliefs contradictory with those of others in the communities in which they reside, moving them to rewrite a new identity on a regular basis in order to live authentic spiritual lives within their home community. This daily rewriting may contribute to their resilience in the occasion of a calamitous event. As noted above, this suggests the role of members of faith-based communities in ministration at times of disaster, rather than providing them with a mandate to support action to head off disaster. Ministering to those who are suffering cannot be underestimated, however. Spirituality provides important elements to the process of re-authoring: understanding universal laws and tenets of good living, a feeling of connection with others and with nature, and a sense of meaning, all contribute to purposeful suffering that plays a part in the process of moving through the experience and re-authoring one’s life narrative, key to PTG. The dying of old ways of being pushes individuals into negotiating a new relationship with the self and the external world. It helps people manage, and not resolve, grief. In many cases, according to Calhoun and Tedeschi (2006b), people who have lived through disaster report personal growth as the relationship of the self with the external world is reconfigured. Depending on the form of the disaster, this arbitration may create further levels of peeling away and rebuilding. With spiritual practitioners who are Buddhists, BKs or Jains, this occurs through reaffirming identity as a spiritual being (Cousins, 1997), performing daily meditation (Whaling, 1995), and shaping their understanding through spiritual philosophy to acknowledge the connection between human consciousness and the physical world (Vallely, 2002). By providing a practical way to restructure individual, physical and social worlds, re-authoring can become a powerful method of recovery and healing (Todeschini, 2001). Faith-based reasoning and the spiritual technology of meditation may support and offer additional tools for the re-authoring process. Including spirituality in discussions about the way in which we care for others during disasters broadens the places that we look for ways that we may help people to manage their experience of suffering. Humanitarian agencies, governments and non-governmental agencies must all become increasingly aware of and sensitive to the diverse systems of belief that are important to different populations.

Concluding Thoughts In Orissa, BKs indicated three forms of understanding that contributed to their ability to moderate their experience of the Super Cyclone: a belief that they have a capacity to serve themselves and others through the mind; a capacity to find purpose

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and meaning in life’s difficulties through their theology; and the practice of meditation that offers a sense of transcendence that can lift them out of the tragedy of the moment. Just as one stockpiles utensils and food, and rehearses behaviour appropriate to safety and physical resilience in disaster, BKs stockpile the practice of meditation and positive thinking, coupled with thoughtful good action, as a method to develop inner resilience using local resources. In tandem with growing political pressure to avoid catastrophe, developing awareness of and concern about climate change has provoked individual concern about responsibility and call to action. The call is to engage positively with the challenge of climate change by considering the ways in which people think, feel, believe and behave, rather than looking solely to physical answers. As the responses of BKs to extreme weather events in Orissa illustrate, spiritual community understandings and practices enrich our understanding of social and cultural dimensions of disaster, the role that spirituality has in the interplay between the lived experience of people and the vulnerable environment around them, and in meaning making. Conversations about climate change and its medium- to long-term impact have favored objective information over subjective experience, and the scientific, rational and logical, over the spiritual, intuitive and complex. In this context, religious leaders and spiritual practitioners have little say in policy, but increasingly, their voices are important as people’s social and psycho-religious needs post-disaster are left to the community (Doughty, 1999). The increases in relative poverty, disasters, political unrest and mass suffering caused by climate change have revealed the privilege of particular scientific standpoints to be problematic. Policy science allows little room for indigenous understandings of disaster and local faith-based forms of resilience, but in doing so, it hampers international efforts to respond appropriately to current environmental crises, and the long-term threats and effects of climate change. One way to integrate these better is to include spiritual advisors in high-level international discussions that contribute to policy, as well as adhering to international standards of human rights and consulting with local spiritual leaders in the aftermath of environmental disasters. Our approach to climate change must be multipronged, otherwise repeated calls by those most affected by climate change may remain ineffective. The World Health Organization (WHO) has emphasized the need for greater psychosocial care post-disaster (Gist, 1999; Roberts and Ashley, 2008). In Australia, spiritually sensitive social care is now being integrated in the curriculum of highlevel disaster training (Gray, 2008; Spencer and Archer, 2008) and forms part of the government’s response to disaster (EMA, 2002). The IASC guidelines and the Sphere handbook, the humanitarian charter that documents minimum standards in disaster response, both call for consideration of religious and spiritual factors, in creating resilient communities, and in proper care in the relief and recovery stages of disaster. Yet in general, there has been limited use by governments of formal and informal networks with the capacity to aid in social reconstruction after disaster (Aguirre, 2006, see also Fjord and Manderson, 2009). Studies that centralize the discussion of spirituality and its potential to contribute to our understanding of and management of climate change, we suggest, work as

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a bridge between scientific policy and social need, based on local understanding, capacity and resources. To adequately equip people to respond to disaster, we must broaden our understanding of the ways in which people, individually and collectively, manage and respond to traumatic circumstances and social suffering. While acknowledging all forms of faith and non-faith, religion and secularism, there may be inherent capacities in faith-based organizations that are, as yet, under-utilized in the disaster context. Suffering is manifold; so too are its solutions. The experiences of disasters of BKs, and certain other spiritual communities, may enrich the methods people use to bring solace to those who are suffering, in ways that may be practical, non-proselytizing and cost-effective. We need to explore more deeply the relationship between the human spirit and the physical world if we are to maintain the well-being of both.

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Chapter 10

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

While climate change is clearly a global emergency requiring global solutions, there is also increasing understanding of the diverse challenges and opportunities that local communities face in strengthening resilience to the impacts and implications of climate change. Evidence is also growing about the crucial contribution that local actions and networks can make in strengthening community resilience – and in driving the broader social and political transformations needed to prevent catastrophic climate change in ways that are ecologically healthy, just and democratic. This chapter therefore has two aims. The first aim is to bring together recent evidence and learning about the characteristics that strengthen community resilience to the threats and challenges of climate change. The second aim is to explore the links between the theory and practice of resilience and the actions needed for communities to adapt to climate change already being experienced and enable pathways to reduce the risks of catastrophic climate change – locally and globally. The core argument of the chapter can be summarised in the following way. Community resilience to climate change requires strengthening the overall foundations of resilient communities, augmented by locally relevant, locally tailored actions to improve local climate change adaptation capabilities and outcomes. However, given that the capacity of any local community to adapt to climate change is limited, strengthening community resilience to climate change will also require transformative action leading to the rapid and equitable reduction of carbon emissions and the drawing down of carbon dioxide from the atmosphere. This crucial journey from paralysis and fear to hope and transformation requires a wellinformed understanding of the perilous path we are on; compelling visions of an alternative, desirable future; a shared belief that transformation is possible; and

J. Wiseman (B) Melbourne Sustainable Society Institute, University of Melbourne, Victoria 3010, Australia e-mail: [email protected]

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clear plans and pathways – all critical components of truly resilient communities and societies.

Understanding Resilience The concept of resilience has become increasingly important to theorists, policy makers and activists from a wide range of disciplines and perspectives (Cork, Walker and Buckley, 2008; Norris et al., 2008). Here we briefly review the variety of ways in which the concept is understood before turning to the more specific goal of building ‘resilient communities’. The common starting point for diverse understandings of resilience is the capacity of a system to ‘bounce back’ and maintain its essential functions in the face of stress and disturbance. From an engineering perspective, resilience is understood as the length of time required for a system to return to a steady state equilibrium (Holling, 1996). Ecologists conceptualise resilience slightly differently as the ‘capacity of a system to absorb disturbance and reorganize while undergoing change so as to still retain essentially the same function, structure, identity, and feedbacks’ (Walker et al., 2004, p. 5). A resilient ecosystem is therefore one which can withstand shocks, reinvent and rebuild itself when necessary. Key characteristics of resilient eco-systems include diversity, openness and modularity (Olsson and Folke, 2004). The capacity of human beings to anticipate and plan for the future adds a second, important dimension to the concept of resilience. For psychologists, resilience involves the capacity of individuals to successfully adapt and cope well with negative experiences and unfamiliar situations, especially highly stressful or traumatic events (Bonnano, 2005). Key characteristics of psychological resilience include a strong sense of personal capacity and efficacy, well-informed awareness of changing conditions, strong problem-solving skills and strong social connections and support systems (Luthar, Cicchetti, & Becker, 2000). There is also increasing evidence that individual capacity to deal well with challenging events is significantly affected not only by the speed and flexibility of the response but also by the ability of individuals to anticipate and shape the pathways on which they are travelling. The business and management literature on resilience extends this analysis to an organizational level by highlighting the ability of organisations to anticipate crises and dynamically reinvent business models and strategies as circumstances change (Hamel and Valikangas, 2003). From this point of view, resilience is as much about organizational innovation and transformation as it is about adjustment and adaptation. Key properties of resilient organizations include a high capacity to be aware of and predict changing threats and opportunities combined with an organizational culture that rewards and promotes learning, flexibility, creativity and innovation (Lengnick-Hall and Beck, 2005). Although interpreted differently across different disciplines, there is broad consensus that resilience is better conceptualized as a process rather than an outcome and as evolution rather than stability (Norris et al., 2008).

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Community Resilience An increasing body of research and learning is focussing attention on the characteristics that build resilience in diverse communities of place, people and interest (Norris et al., 2008, Maguire and Cartwright, 2008). An important starting point for this work is the need to recognise the context-specific dynamics of resilience and vulnerability within diverse societies, cultures and communities. (Adger and Brown, 2009). Norris et al. (2008) draw on the experience of community responses to natural disasters to conceptualise community resilience as ‘a process linking a network of adaptive capacities (resources with dynamic attributes) to adaptation after a disturbance or adversity’ (Norris et al., 2008, pp. 127–128). Building on the experiences of resource-dependent, rural communities facing more gradual challenges caused by exposure to a range of political, economic and environmental stressors, the Canadian Centre for Community Enterprise proposes the following definition: ‘A resilient community is one that takes intentional action to enhance the personal and collective capacity of its citizens and institutions to respond to and influence the course of change’ (Community Resilience Project Team, 1999, p. 11). The importance of proactive or intentional action is also emphasised by Maguire and Cartwright (2008, p. 5) who define a resilient community as one that is ‘able to use the experience of change to continually develop and to reach a higher state of functioning’. Rather than simply surviving or coping with stress and change, a resilient community ‘may respond in creative ways that fundamentally transform the basis of the community.’ (ibid) Defined in this way, community resilience encompasses both the capacity of communities to ‘bounce back’ as well as their capacity to proactively and intentionally transform themselves in order to address or reduce the impacts of forthcoming shocks. This proactive, transformational quality is likely to be particularly important in understanding and building community resilience to climate change, given that the capacity of human beings to adapt to climate variability is not unlimited. Before turning to consider the specific characteristics of community resilience to climate change it is also important to take stock of the varied ways in which climate change impacts on the sources and determinants of community well-being.

Climate Change and Community Well-Being Climate change is an all encompassing threat, directly affecting the environment, the economy, health and safety. Many communities face multiple stresses with serious social, political and security implications, both domestically and abroad. Millions of people are uprooted or permanently on the move as a result. Many more millions will follow. Kofi Annan, Global Humanitarian Forum (2009, p. 5)

The term ‘community well-being’ encompasses the broad range of economic, social, environmental, cultural and governance goals and priorities identified as of greatest importance by a particular community, population group or society (Brasher

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& Wiseman, 2008). Implicit in this definition is a recognition that ‘community wellbeing’ priorities will vary across cultures and societies. As documented elsewhere in this book, the rapidly evolving impacts of climate change are already generating an unprecedented, diverse and complex range of environmental, social and economic threats and challenges to the well-being and sustainability of communities, regions and societies. Table 10.1 summarises a range of these impacts on key indicators and determinants of community health and well-being.

Table 10.1 Impacts of climate change on community health and well-being. Adapted from Edwards, Fritze and Wiseman (2009, pp. 83–85) Determinants of community well-being Physical health (see Costello et al., 2009; McMichael et al., 2003)

Mental health (Bourke, Blashki, Fritze and Wiseman, 2008)

Social and health inequalities

Work and unemployment

Access to insurance

Impacts of climate change Key health impacts of climate change include injury or death as a result of extreme weather events such as heatwaves, wind, storms, floods and fires; exposure to waterborne disease and toxins due to affected or unreliable water sources; malnutrition arising from food insecurity; exposure to food poisoning due to warmer temperatures; higher respiratory disease incidence linked to pollutants and increased rates of asthma and hay fever due to increased aeroallergens; increased exposure to vector-borne and other infectious diseases; increased exposure to ultraviolet radiation. Implications of climate change for mental health include direct mental health impacts due to extreme weather events (e.g. floods or bushfires), longer-term changes to the land (e.g. persistent drought or coastal inundation) and forced migration; impacts on key determinants of mental health such as social exclusion, economic insecurity, violence and discrimination; and emotional distress arising from awareness of climate change as a global environmental threat, which casts substantial uncertainty over the future. ‘Climate change will have its greatest effect on those who have the least access to the world’s resources and who have contributed least to its cause. Without mitigation and adaptation, it will increase health inequity especially through negative effects on the social determinants of health in the poorest communities’. (Costello et al., 2009, p. 1694) Industries such as agriculture and tourism are particularly vulnerable to climate change impacts. Carbon emission reduction policies will also affect employment prospects in the energy, transport, mining and heavy manufacturing sectors. On the other hand, the transition to a low-carbon economy also has the potential to create new ‘green’ economy industries and employment opportunities. Risks arising from climate change impacts (e.g. more frequent and intense extreme weather events) are already affecting the availability and affordability of insurance.

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Table 10.1 (continued) Determinants of community well-being Food

Water

Energy

Transport

Housing

Social cohesion and sense of home and belonging

Health, community and emergency services

Impacts of climate change Increased droughts and extreme weather events are impacting on local and imported food supply leading to price rises and scarcity. Increased food prices and food insecurity are a particular concern for people on low incomes. Climate change is reducing the quality and certainty of the water supply available for domestic, agricultural and industrial purposes. Infrastructure investment to increase water supply is raising water costs. Extreme weather events can damage crucial energy system infrastructure and disrupt transmission, causing power shortages and blackouts. Climate change and climate change policy responses are impacting on the price of energy-related services such as transport, heating, cooling and cooking. More extreme weather poses a risk to transport infrastructure. Higher costs of petrol and public transport due to increasing electricity costs and policies to reduce emissions are making mobility more expensive. As the climate changes, housing design and construction will need to be altered to provide adequate protection from heat and extreme weather events. In some areas, building or maintaining existing houses may not be viable, leading to the need for people, and potentially, whole communities to relocate. Climate change is likely to lead to temporary or permanent displacement of communities affected by extreme weather events, coastal erosion, sea level rise or loss of economic viability, which disrupts deep human connections and ties to ‘place’ – including location, relationships and traditions (Hess et al., 2008, p. 468). Rising temperatures and lack of water are also affecting a wide range of social and community infrastructure such as parks, recreational and sporting facilities. The range of impacts outlined above is placing increasing demands on emergency, health and community services. Extreme weather events, in particular, have the capacity to disrupt access to essential health and community services.

Vulnerable Places and Populations Vulnerability to the health and well-being impacts of climate change between geographical locations and population groups varies greatly. The IPCC (2007, p. 21) defines climate vulnerability as ‘the degree to which a system is susceptible to, and unable to cope with, adverse effects of climate change, including climate variability and extremes. Vulnerability is a function of the character, magnitude, and rate of climate change and variation to which a system is exposed, its sensitivity, and its

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Fig. 10.1 Vulnerability and its components

adaptive capacity’ (see also Fusel, 2007 for a useful analysis of the strengths and limitations of the IPCC definition of climate change vulnerability). Vulnerability to climate change consists of several components (Fig. 10.1) including the exposure of a given system or community to climate change impacts, the sensitivity, or extent to which changes will affect it in its current form, and the adaptive capacity¸ or capacity to change in a way that makes it better equipped to deal with external impacts (Allen Consulting Group, 2005, p. ix). Community vulnerability to climate change risks can therefore be defined in terms of a specific community’s susceptibility to, or inability to cope with, the adverse impacts of climate change. Whilst a community’s exposure to climate change is determined by local variability of changes in the physical environment, sensitivity and adaptive capacity reflect the variable attributes and capacities of specific local communities and populations. As Edwards et al. (2009) note, place-based communities likely to be particularly vulnerable to climate change include the following: • • • • • •

Rural, drought-affected communities Communities reliant on water from snow melt and glaciers Coastal communities likely to be affected by sea level rise Flood-prone areas Bushfire-prone areas Communities with a high dependence on fossil-fuel, mining and other heavy industries • Isolated or remote communities with poor access to transport • Inner urban areas (with low capacity for food production) Population groups likely to be particularly vulnerable to climate change impacts include the following: • People living in poverty and on low incomes (e.g. unemployed people, single parents)

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• People already experiencing significant challenges in accessing transport , health and community services (e.g. older people, people with physical and mental disabilities) • Indigenous communities (Green et al., 2009) • Recently arrived migrants and refugees (Edwards et al., 2009) As the 2009 Global Humanitarian Forum Report (p. 13) on the social impacts of climate change also notes, it is communities and societies in developing countries that face by far the greatest risks. It is a grave global justice concern that those who suffer most from climate change have done the least to cause it. Developing countries bear over nine-tenths of the climate change burden: 98% of the seriously affected and 99% of all deaths from weather-related disasters, along with over 90% of the total economic losses. The 50 Least Developed Countries contribute less than 1% of global carbon emissions.

While all three elements of vulnerability (exposure, sensitivity and adaptive capacity) are important foundations for understanding the extent of challenges facing diverse communities, resilience provides a broader and more all-encompassing conceptual framework in that it gives greater emphasis to the capacity of communities to identify emerging vulnerabilities and take action to prevent or reduce the impacts of these trends. (Adger & Brown, 2009).

Strengthening Community Resilience to Climate Change The resilience of communities to the impacts and implications of climate change will depend on actions that strengthen both general and specific resilience. A society’s general resilience comes from a range of factors, including the trust and cooperation among its people, their ability to ‘pull together’ through tough times, the capacity of the people and the social institutions to generate and use knowledge to find solutions to new challenges and to learn from experience, and the extent to which natural ecosystems are able to continue to support economic and social welfare while absorbing the influence of human activities on them. In addition, specific challenges will require specific resilience that can only be built if society is able to imagine what those challenges might be. (Cork et al., 2008, p. 1)

An extensive body of research has led to the identification of a range of general features of resilient communities (Canadian Centre for Community Renewal, 2008). Norris et al. (2008) have helpfully organised these characteristics into the following four primary sets of networked resources, which together provide an overarching picture of resilient communities. • Economic development, including diverse, sustainable sources of economic prosperity, high-quality economic infrastructure, secure livelihoods and employment opportunities, and the equitable distribution of income and assets.

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• Social capital, including broad and deep social networks within and beyond the community, experienced and widely respected community leadership, a strong sense of community pride and optimism, and high levels of citizen engagement. • Information and communications, including rapid access to accurate, relevant information and responsive, accessible and reliable communications infrastructure. • Community competence, including a tradition of self-reliance combined with the capacity to identify and secure external resources; the capacity to collaborate effectively in identifying and achieving shared visions for the future; a diversity of well-resourced, well-linked community organizations; governance systems that enable and facilitate rapid, flexible decisions and responses; and strong education and innovation systems. Action to strengthen these general characteristics of community resilience will help ensure communities are better equipped to respond to climate change. However, it is clearly critical that actions to strengthen the general characteristics of resilience are augmented by the actions necessary to address the specific challenges that climate change brings to different communities. This has led to a rapidly growing literature exploring, testing and documenting strategies likely to be most helpful in assisting communities adapt to climate change (Adger, Lorenzoni and O’Brien, 2009). Table 10.2 provides an indicative overview of the range of strategies being employed to address the diverse health and well-being challenges arising from climate change. Actions to strengthen both general community resilience and to address more specific climate change challenges need to be informed by local knowledge and be tailored to reflect and address the vulnerabilities and strengths of specific societies and cultures. As Adger et al. (2009) note, views and values about the most effective and appropriate responses to climate change vary greatly between diverse communities and cultures. This reinforces the case for significant investment in deliberative decision making processes, which can maximise the possibility of well-informed, respectful and creative strategies for improving the general and specific resilience of specific communities (see McKinney & Harmon, 2007). While a comprehensive overview of the rapidly expanding array of community level climate change resilience strategies is well beyond the scope of this chapter, the following initiatives provide some illustrations of the diverse approaches to community climate change resilience emerging from differing political and cultural contexts.

The ‘Transition Towns Movement’ Originating from the work of permaculture teacher Rob Hopkins in the Northern Ireland community of Kinsale in 2005, the ‘Transition Towns Movement’ encourages and promotes community-driven responses to the combined challenges of

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Table 10.2 Overview of adaptation strategies designed to address health and well-being impacts of climate change at the community level Climate change vulnerabilities Extreme weather eventss

Physical health Mental health

Social and health inequalities Work and unemployment Access to insurance Food Water

Energy Transport

Housing

Social cohesion and sense of home and belonging

Adaptation strategies and responses Improved prediction and early warning systems Relocation of households and communities away from areas of danger (e.g. areas prone to sea level rise, tidal surges, cyclones or bushfires) Coastal barriers and dykes; bushfire prevention measures Refuges designed to improve protection from extreme weather events such as storms, cyclones and bushfires Improved capacity to prevent and treat heatwaves, infectious diseases, insect-borne diseases Improved capacity to respond to and treat mental health impacts of natural disasters and extreme weather events and to protect and provide care for people with pre-existing mental illness Discrimination, social inclusion and economic participation Social inclusion and redistribution strategies including improving access to income, employment, housing and essential services Local and regional industry and employment development initiatives Labour market and structural adjustment programs Underwriting of household, community, local government and business insurance Improving food security Supporting local food production and distribution Building new dams and pipelines Investing in decentralised water collection and distribution systems at multiple scales including urban water harvesting, grey water recycling and tanks Water conservation Water desalination plants Investing in diversified energy production systems Improving energy distribution systems (e.g. through smart grids) Improving public transport networks and infrastructure Reducing distances between residential, work, community service, educational and recreational centres and activities Retrofitting of existing housing stock to improve energy efficiency and provide greater protection from extreme weather events Sustainable housing and urban design Community development strategies; strategies designed to strengthen social networks and build trust across cultural differences Investing in community infrastructure (e.g. meeting places, cultural, recreational and sporting facilities) Refugee resettlement policies’ programs designed to preserve and strengthen cultural identity in displaced and refugee populations

climate change and peak oil (Transition Network WIKI, 2010). ‘Transition Town’ initiatives’, arise when members of a local community get together, ask themselves what aspects of life are essential to sustaining and thriving as a community, and begin to work on strategies to increase local resilience.

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Hopkins (2008, 134) has outlined the following four key assumptions of the Transition Towns movement: 1. Life with a dramatically lower energy consumption is inevitable, and it is better to plan for it than to be taken by surprise 2. Our settlements and communities presently lack the resilience to enable them to weather the severe energy shocks that will accompany peak oil. 3. We have to act collectively, and we have to act now 4. By unleashing the collective genius of those around us to creatively and proactively plan for our energy descent, we can build ways of living that are more connected and more enriching and that recognise the biological limits of our planet. There are now several hundred Transition Town initiatives, primarily located in developed countries. The following overview of projects currently under way in the UK Transition Town of Totnes (summarised in Table 10.3) provides an indication of the range of strategies and initiatives being explored. The Transition Towns movement is creating a valuable testing ground for new approaches to social, technological and ecological resilience, innovation and transformation. However, as Haxeltine and Seyfang (2009) point out, the movement’s emphasis on the synergies between localisation, transition and resilience also runs Table 10.3 Transition Town Totnes: local community resilience projects (Transition Towns 2010) Name

Short description

Business resource exchange (Swapshop) Totnes healthy futures (Community garden) Energy descent pathways (EDP) Garden share Green energy for business Local food guide Measuring transition Solar thermal challenge

One company’s waste/spare resources used as input for another

The great re-skilling Totnes food hub Totnes pound Transition library Transition tales Transition together

Creating a Community Food and Well-being Garden within easy walking distance of Totnes Create vision of Totnes in 2030, and then define pathways to take us there Matching unused garden space with garden-less growers Helping businesses to switch to renewable energy tariffs Promotion of local produce and independent outlets How will we know we are making progress towards our goals? Bulk purchase and promotion of solar thermal kit for hot water on 50 homes Practical training programme to re-establish the skills we have lost An ‘online’ farmer’s market: local food ordered direct over the Internet Our own local currency, now accepted in over 70 shops in the town Wide selection of transition-related books and films available for free in Totnes Storytelling the future to educate and inspire Small social-based groups that take on their own practical-based transition agenda, based on a workbook

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the risk of underestimating and neglecting the need to address broader, larger-scale relationships of political and economic power.

‘People-Centred Resilience’: Working with Vulnerable Farming Communities As a result of its work with small-scale farmers living on marginal rural lands highly vulnerable to climate change Oxfam International (2009, p. 2) has noted the importance of ‘building up the resilience of vulnerable farmers by developing their skills, expertise and voice, while supporting their use of agro-ecological farming practices’. The following five core principles have been identified as central to the achievement of the goal of ‘people-centred resilience’: 1. 2. 3. 4. 5.

Restored and diversified natural resources for sustainability. Responsive institutions grounded in local context. Expanded and improved sustainable livelihood options. Sound gender dynamics and gender equality. Farmer-driven decisions.

A wide range of illustrative examples are provided. The Oxfam report on ‘People Centred Resilience’ (2009) points to a growing range of initiatives exploring these principles in a variety of settings. In Beni, in northeast Bolivia, where climate change–related droughts and flooding have become both more frequent and more intense, the revival of indigenous knowledge about the ancient ‘camellones’ farming systems has assisted local farming communities to protect crops from flooding while capturing and storing water through raised seedbeds surrounded by water channels. The multiple benefits associated with this system include the empowerment of local women and enhanced food security. In Khatlon Province, Tajikistan, the collective organic farms established by local women’s groups have helped drought-affected households and communities improve their incomes and avoid the cost of expensive chemical inputs. At the same time organic methods also help farmers withstand climate change by fostering more fertile soil with better water retention and by enabling the cultivation of more diverse crops with differing climate sensitivities. In Yasothorn Province, Thailand Oxfam is working with farmers to foster organic rice production, which copes better with erratic rains. Project activities include training farmers, small-scale water management; diversifying farm production; examining risks to and burdens on women; and farmer-to-farmer learning. Outcomes have been impressive, with participating farmers maintaining their rice yields – compared with 40% falls elsewhere – while also earning income from fruit and vegetables. (Oxfam International, 2009, p. 10)

Again it is important to note that, ‘while local-level success is possible using simple measures. . .scaling up such work will require major new investments’ (Oxfam International p. 10).

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Limits to the Adaptive Capacity of Local Communities to Climate Change Large-scale investment in innovative actions to strengthen the adaptive capacity of communities is clearly crucial, as is the ongoing task of strengthening the general resilience of communities. However the uncomfortable – and inconvenient – reality of climate change is that there are finite limits to the capacity of human societies and communities to adapt. Adger and Barnett (2009, p. 2804) have summarised a number of reasons for believing that adaptation to climate change is unlikely to be as ‘smooth, cheap and easy to implement’ as some have suggested. They begin by noting that the challenges of adapting to global mean warming of 2 degrees or more are significant. Some ecosystems (such as coral reefs) and some human societies (such as low-lying island nations) will be unlikely to survive mean warming of 2 degrees in anything resembling their current state. There are also very real risks that 2 degrees of warming may trigger a range of climate change ‘tipping points’ such as the melting of the polar ice caps, which may in turn reduce the solar radiation reflected back into space, further accelerating global warming trends. Combined with the fact that current emissions reduction paths provide little confidence that global temperature rises can be kept to under 2 degrees, this leads to the real possibility of crossing the threshold to a ‘four degree’ world in which rapid and unpredictable changes to ecological and human systems are highly likely. The track record of government decision making and action so far also raises important questions about the extent to which adaptive capacity will necessarily translate into sustainable action at the speed and scale required to prevent runaway climate change. The example of the reactions of the citizens of low-lying Pacific Island communities provides a powerful example of the final dilemma highlighted by Adger and Barnett. If adaptation means leaving the land on which these communities and all their ancestors have been born and raised and on which their entire culture and society have evolved – then adaptation alone may not be a sufficient or acceptable response. For all these reasons, it is becoming increasingly clear that resilient communities and societies will need to augment adaptation with ‘transformability’: the capacity to create a fundamentally new system when ecological, economic or social (including political) conditions make the existing system untenable (Walker et al., 2004).

Community Resilience as Adaptation and Transformation Nelson, Adger and Brown, (2007, p. 402) ‘distinguish between transformation as a directed, desirable process and transformation associated with the effects of inadvertently crossing thresholds. The former is a planned, deliberate process, whereas the latter is an uncontrolled process, which results from insufficient system resilience’. Attributes required for transformability include novelty, diversity, and organization in human capital; diversity in educational models, expertise, and

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occupations; trust, strengths, and variety in institutions; and speeds and kinds of cross-scale communication (Walker et al., 2009). While full awareness of the potentially catastrophic implications of runaway climate change is an essential foundation for transformative action, warnings of impending calamity are just as likely to create paralysis as they are to trigger creativity and action (Moser & Dilling, 2007). Looking to the lessons from great historical transformations such as the abolition of slavery, the end of apartheid or the fall of the Berlin Wall, we can see that the journey from fear and despair to hope and action requires a sense of an alternative and desirable alternative future; a shared belief that change is both essential and possible; and a working map of the pathways needed to achieve the change required. We need to begin this journey with a broadly shared understanding of the preconditions for a future in which the risks of runaway climate change are significantly reduced. While the political debate about what is ‘economically and political feasible’ drags on, the scientific evidence increasingly points to the need for emergency action leading to the return of atmospheric carbon to pre-industrial levels as soon as possible. As Professor Hans Joachim Schellnhuber (2008), director of the Potsdam Institute for Climate Impact Research, notes, ‘nobody can say for sure that 330 ppm is safe. Perhaps it will not matter whether we have 270 ppm or 320 ppm, but operating well outside the [historic] realm of carbon dioxide concentrations is risky as long as we have not fully understood the relevant feedback mechanisms’. The key components of the pathways and strategies needed to prevent catastrophic climate change are now broadly understood (see, e.g. Gore 2009, Dunlop et al., 2009). The first task is to significantly reduce net carbon emissions generated by human activity by designing and implementing carbon neutral technologies and ways of living. This will require dramatically improved energy efficiency; a rapid transition from fossil fuel to renewable and low-carbon emission energy production and the construction of an extensive network of smart grid energy distribution systems. The second key task is to draw down carbon now in the atmosphere with the aim of returning atmospheric carbon as rapidly as possible to pre-industrial levels. The means of achieving this include reforestation and new land management strategies designed to store carbon in vegetation and soils as well as the processing of some forms of biomass such as biochar into more stable forms of ground-based carbon for storage. Ensuring that the transition to a sustainable, low-carbon future is accomplished without social or ecological collapse will require extensive innovation and investment in the wide array of climate adaptation initiatives summarised above along with a comprehensive program of income and wealth redistribution to ensure the process is managed equitably. While the implementation of a comprehensive, emergency speed, low-carbon transition plan will clearly require a vast array of new technological innovations, the greatest challenges are likely to be cultural, political and organisational. How will the political support be generated and harnessed to drive this historically unprecedented program of social and economic transformation? How will the necessary renaissance in creativity and innovation be fostered and sustained? What

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kinds of new institutional and governance arrangements will be required? How will trust and co-operation be maintained and strengthened across diverse cultures and communities as ecological, social and economic stresses intensify? As the outcomes of the Copenhagen UN Climate Change Conference, COP15, demonstrated, reliance on international- and national-level governance institutions is unlikely to provide a sufficient basis for meeting these challenges. The creativity and energy of a vast array of local community projects, organisations and networks will also play crucial rules in exploring and testing new directions, sharing learning and setting examples.

Climate Change, Resilience and Transformation: Challenges and Opportunities for Local Communities This chapter has argued that resilience to the impacts of climate change is an essential precondition for the well-being of individuals, households and communities. This will require a wide range of actions to strengthen the overall foundations of resilient communities, augmented by locally relevant, locally tailored climate change adaptation strategies. Exploring and testing the effectiveness of such local actions and strategies will therefore form a crucial part of future community wellbeing research and policy development agendas. However, we have also argued that, in the end, the resilience of local communities to climate change will depend on the capacity of communities, societies and governments to invent, envisage and build pathways to an ecologically healthy, just and democratic, low-carbon future. This will require a transformational program of applied research, policy development and political mobiliisation at all levels of local, national and international governance.

References Adger, W., & Barnett, J. (2009). Four reasons for concern about adaptation to climate change. Environment and Planning A, 41(12), 2800–2805. Adger, W.N., & Brown. K. (2009). Vulnerability and resilience to environmental change: Ecological and social perspectives. In N. Castree, D. Demeritt, & D. Liverman (Eds.), A companion to environmental geography (pp. 109–122). London: Wiley Blackwell. Adger, W., Dessai, S., Goulden, M., Hulme, M., Lorenzoni, I., Nelson, D., et al. (2009). Are there social limits to adaptation to climate change? Climatic Change, 93(3–4), 335–354. Adger, W., Lorenzoni, I., & O’Brien, K. (Eds.). (2009). Adapting to climate change: Thresholds, values, governance. Cambridge: Cambridge University Press. Allen Consulting Group. (2005). Climate change risk and vulnerability: Promoting an efficient adaptation response in Australia (p. ix). Report to the Australian Greenhouse Office, Canberra: Australian Government. Australian Social Inclusion Board. (2009). Building Inclusive and resilient communities. Canberra: Australian Government. Ayers, J., & Forsyth, T. (2009). Community-based adaptation to climate change: Strengthening resilience through development. Environment, 51(4), 22–31. Bonnano, G. (2005). Resilience in the face of potential trauma. Current Directions in Psychological Science, 14(3), 135–138.

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Bourke, S., Blashki, G., Fritze, J., & Wiseman, J. (2008). Hope, despair and transformation: Climate change and the promotion of mental health and wellbeing. International Journal of Mental Health Systems, 2, 13. Brasher, K., & Wiseman, J. (2008). Community wellbeing in an unwell world. Journal of Public Health Policy, 29(3), 353–365. Canadian Centre for Community Renewal. (2008). Community resilience manual: A resource for rural recovery and renewal, Section 2. http://www.cedworks.com/files/pdf/free/P200_ Workbook.pdf Community Resilience Project Team. (1999). The community resilience manual: A new resource will link rural revitalization to CED Best Practice. Making Waves, 10(4, Winter 1999), 10–14. Cork, S., Walker B., & Buckley, R. (2008). How resilient is Australia? Australia21 Discussion Paper. http://www.australia21.org.au/pdf/Resilient08.pdf Costello, A., Abbas, M., Allen, A., Ball, S., Bell, S., Bellamy, R., et al. (2009). Managing the health effects of climate change, Lancet and University College London Institute for Global Health Commission. The Lancet, 373, 1693–1733. Dunlop, I., Herbetson, J., Suttton, P., & Wiseman, J. (2009). Strategic framework, Australian safe climate transition plan, safe climate Australia. www.safeclimateaustralia.org.au Edwards, T., Fritze, J., & Wiseman, J. (2009). Community wellbeing in a changing climate: Challenges and priorities for the Australian community sector. Just Policy, 50, 80–86. Fusel, H. (2007). Vulnerability: A generally applicable conceptual framework for climate change research. Global Environmental Change, 17, 155–167. Global Humanitarian Forum. (2009). Climate change: The anatomy of a silent crisis. Geneva, Switzerland: Global Humanitarian Forum. Gore, A. (2009). Our choice. New York: Rodale. Green, D., King, U., & Morrison, J. (2009). Disproportionate burdens: The multidimensional impacts of climate change on the health of Indigenous Australians. Medical Journal of Australia, 190(1), 4–5. Hamel, G., & Valikangas, L. (2003). The quest for resilience. Harvard Business Review [online]. URL: http://www.gilbertacton.com/PDF/Other/The%20Quest%20for%20Resilience.pdf Haxeltine, A., & Seyfang, G. (2009). Transitions for the people: Theory and practice of ‘transition’ and ‘resilience’ in the UK’s Transition Movement (Tyndall Working Paper 134). Tyndall Centre, UK. Hess, J., Malilay, J., & Parkinson, A. (2008). Climate change: The importance of place, American Journal of Preventive Medicine, 35(5), 468–478. Holling, C. S. (1996). Engineering resilience versus ecological resilience. In P. C. Schulze (Ed.), Engineering within ecological constraints. Washington, DC: USA National Academy Press pp. 32–43. IPCC. (2007). Summary for policymakers. In Climate Change 2007: Impacts, adaptation and vulnerability. Contribution of working group ii to the fourth assessment report of the intergovernmental panel on climate change (pp. 7–22). Cambridge: Cambridge University Press. Keim, M. (2008). Building human resilience: The role of public health preparedness and response as an adaptation to climate change. American Journal of Preventive Medicine, 35, 508–516. Lengnick-Hall, C., & Beck, T. (2005). Adaptive fit versus robust transformation: How organizations respond to environmental change. Journal of Management, 31(5), 738–757. Luthar, S., Cicchetti, D., & Becker, B. (2000). The construct of resilience: A critical evaluation and guidelines for future work. Child Development, 71(3), 543–562. Maguire, B., & Cartwright, S. (2008, May). Assessing a community’s capacity to manage change: A resilience approach to social assessment. Bureau of Rural Sciences, Australian Government. McKinney, M., & Harmon, W. (2007). Governing nature, governing ourselves: Engaging citizens in natural resource decisions, part 1. International Journal of Public Participation, 1(2), 1–16. McMichael, A., Campbell-Lendrum, D., Corvalan, C., Ebi, K., Githeko, A., Scheraga, J., et al. (2003). Climate change and human health: Risks and responses. Geneva: World Health Organisation.

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Moser, S., & Dilling, L. (Eds.). (2007). Creating a climate for change: Communicating climate change and facilitating social change. Cambridge: Cambridge University Press. Nelson, D., Adger, W., & Brown, K. (2007). Adaptation to environmental change: Contributions of a resilience framework. Annual Review of Environmental Resources, 32, 395–419. Norris, F., & Stevens, S. (2007). Community resilience and the principles of mass trauma intervention. Psychiatry: Interpersonal and Biological Processes, 70(4, Winter), 320–328. Norris, F., Stevens, S., Pfefferbaum, B., Wyche, K., & Pfefferbaum, R. (2008). Community resilience as a methaphor, theory, set of capacities, and strategy for disaster readiness. American Journal of Community Psychology, 41, 127–150. Olsson, P., & Folke, C. (2004). Adaptive co-management for building resilience in socialecological systems. Environmental Management, 34(1), 75–90. Oxfam International. (2009). People-centred resilience: Working with vulnerable farmers towards climate change adaptation and food security, Oxfam Briefing Paper 135 [online] URL: http:// www.oxfam.org/sites/www.oxfam.org/files/people-centred-resilience-en-0911.pdf Reser, J., & Morrissey, S. (2008). Situating and framing individual and community experience and response: A psychological perspective. In K. Gow & D. Paton (Eds.), The phoenix of natural disasters: Community resilience (pp. 47–72). New York: Nova Science Publishers. Resilience Alliance, http://www.resalliance.org/576.php Schellnhuber, H. (2008, September 15). Cited in D. Adam, Roll back time to safeguard climate, expert warns: A return to pre-industrial levels of carbon dioxide urged as the only way to prevent the worst impacts of global warming, Guardian (UK). Transition Network WIKI. (2010). http://transitiontowns.org/ Transition Town Totnes Website (2010): http://totnes.transitionnetwork.org/ Walker, B. (2009). Specified and general resilience. http://wiki.resalliance.org/index.php/1.5_ Specified_and_General_Resilience Walker, B., Holling, C. S. Carpenter, S. R., & Kinzig A. (2004). Resilience, adaptability and transformability in social–ecological systems. Ecology and Society, 9(2). [online] URL: http://www. ecologyandsociety.org/vol9/iss2/art5/

Chapter 11

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

Climate change is increasing the severity of disasters and adverse weather conditions worldwide, with particularly devastating effects on developing countries and on individuals with lower resources. The purpose of the book has been to outline and discuss the potential impact of climate change on psychosocial well-being and mental health from various interdisciplinary perspectives. Possible effects range from anxiety related to the perceived threat of climate change, and the sadness and distress related to gradual environmental changes of one’s home environment, to the devastating effects of natural disasters and humanitarian emergencies, and the potential relationship with violent conflict. Considerations for special populations such as women and climate change refugees have been explored, in addition to ways in which communities and individuals make sense of and respond to disaster and climate change. As elaborated in this volume, mental health and psychosocial well-being are likely to be impacted via multiple direct and indirect pathways, exacerbating existing social and economic disparities, while also creating new challenges. However, the advent of climate change also presents us with new opportunities and an urgent imperative for action to join other disciplines in addressing climate change with the goal of improving mental health and psychosocial well-being among individuals and communities who are at risk for or already affected by climate change. The diverse effects that climate change is expected to have on mental health and psychosocial well-being also call for comprehensive solutions at every level of prevention, preparedness, and response. Reducing carbon emissions is one of the obvious and most upstream solutions, while providing interventions for mental health problems is one of the most downstream solutions, yet several potential entry ways for intervention lie in between. The various pathways connecting climate change and mental health also serve as another reminder that psychologists carry out their work within a larger environmental social, political, and cultural I. Weissbecker (B) Washington, DC e-mail: [email protected]

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framework. This requires an interdisciplinary and public health approach, which takes complex relationships between various factors into account and goes beyond the traditional confines of academic work by reaching out to various stakeholders and disciplines. This chapter outlines some of the lessons learned and cross-cutting implications that can be gained from the different perspectives presented in this volume. The following recommendations can serve as a starting point for psychologists and others who want to advance practice, research and policy in this emerging field.

Focus on Vulnerable Regions and Groups Climate change, which is largely the product of industrialized nations, is projected to magnify existing inequalities and to impact the most vulnerable, including those with low resources, individuals living in developing countries, and specific populations such as women, children, and those with preexisting mental and physical disabilities. Climate change is expected to magnify already-existing problems and inequalities, with the likelihood of further reducing health and well-being among vulnerable populations. The advent of climate change should provide a new incentive to address long-standing problems of inequalities, low resources, and limited opportunities in many parts of the world. As outlined in previous chapters, it is not only absolute deprivation but also relative deprivation of some groups compared to others that contributes to vulnerability. Such relative deprivation may also play a role in triggering the risk for other adverse outcomes such as violent conflict (see Chapter 6). It is therefore especially important to focus attention and resources on developing countries and vulnerable populations, who are much less responsible for climate change yet expected to be most affected and least equipped to mitigate the effects. The goal of such supporting activities should be to facilitate adaptation within the framework of self-sustainability and empowerment rather than continued dependency.

Strengthen Community Adaptation, and Preparedness As noted previously, the adverse effects of climate change are the result of both the severity of climate-related events and underlying vulnerabilities (e.g. natural, human, social, economic, physical) and adaptive capacities (e.g. individual, community, national). Ways of reducing vulnerability while increasing adaptive capacity and resilience have been recurring themes throughout this volume, with various possible solutions in building local capacity, addressing social and economic inequalities, and developing best practice models and research to engender change and inform policy makers. The active involvement of local communities in these processes is critical.

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Although the scientific evidence for potentially severe climate change scenarios is accumulating, it remains a challenge to engage industrialized countries in taking serious steps for reducing carbon emissions. While the issue of aiding adaptation to climate change in resource poor regions is being discussed, it appears unlikely that global and national actors will be able to mobilize sufficient resources to meet this challenge (e.g. see Page & Howard, 2010). The role of communities and networks in mobilizing resources, setting examples, and sharing local knowledge will be crucial in reducing vulnerability and aiding adaptation. Different cultural groups are likely to have knowledge and insights about their natural environment and potential ways of adapting to climate change, which can inform and guide support from national and international actors. Community adaptation and preparedness activities should therefore be implemented from a multicultural and multiethnic perspective that is sensitive to specific contexts and makes the best use of local and traditional knowledge. Strengths of specific social groups as well as talents and skills within the community should be identified and utilized as well. Assessments of vulnerable communities to guide adaptation efforts should explore both strengths and weaknesses, building capacity and filling gaps in knowledge, which can help community members prepare. Addressing identified risks and weaknesses should involve active partnerships and buy in from affected communities and engage key agents of change such as women or community leaders can aid adaptation efforts (see Chapters 4, 5, 7, 9, and 10). Furthermore, community-based training and support in areas such as disaster response, physical and psychological first aid, and search and rescue have already been conducted in various contexts and could be scaled up (e.g. see Chapter 4 on disaster in this volume). Promoting adaptation and preparedness at the local level also have the potential of reducing psychological distress and anxiety resulting from experiencing a lack of control and uncertainty due to the threat of climate change or alreadyoccurring adverse events (see Chapter 2). Actively involving communities and making use of their knowledge and resources for adaptation can contribute to empowerment and a sense of agency among potentially affected populations. It has also been suggested that engaging communities in adaptation activities could facilitate community cooperation and cohesion (e.g. Chapters 6 and 10). Indeed, Berry (2009) has suggested that climate change could provide an important opportunity for mental health promotion and community support. Such an approach would involve partnering with vulnerable and disadvantages communities, assessing their own priorities and coping strategies, and providing support with the aim of self-sufficiency and sustainability (Berry, 2009). In this way, resources could be mobilized for adaptation and mitigation, while at the same time fostering community dialogue, common action, cooperation, and sense of agency. Such an approach may also be relevant for engaging different opposing groups that are in conflict over natural resources. Creating win-win situations around common goals over the preservation of renewable resources has been suggested to reduce the risk for violent conflict and increase cooperative behavior, as elaborated in Chapter 6.

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Involve Affected Communities in the Response to Adverse Environmental Events It has been suggested in this volume and elsewhere that affected communities should be actively involved in responding to adverse environmental events such as natural disasters (Inter-Agency Standing Committee, 2007). Special attention should be paid to rebuilding key community institutions and structures such as schools, places of worship, and community centers and to engaging the community in structured purposeful activities that aid in various aspects of community recovery. Those recommendations are especially relevant in the context of mental health and well-being. Communities affected by adverse environmental events such as disaster or slow-onset events such as droughts often experience a lack of control and predictability, which can contribute to fear, anxiety, and distress (see Chapter 2). If those communities are merely receiving handouts from organizations while strangers take on the task of making decisions on priorities and providing relief and recovery efforts, this sense of loss of control will likely be reinforced and contribute to enduring feelings of helplessness and victimization. Therefore, it has been recommended that communities should, to the extent possible, be involved in all aspects of emergency response (e.g. IASC, 2007). This also encompasses asking various community members about their own priorities. Semrau and others (e.g. see King’s College London, 2009) have recently developed the Humanitarian Emergency Settings PERceived Needs (HESPER) Scale, which assesses the perceived physical, social, and psychological needs and priorities of populations affected by disaster or conflict in low-resource settings. Such participatory methods and community recovery activities may also confer mental health and well-being benefits. Berry (2009) suggests that interventions and services in the context of adverse environmental events related to climate change should not focus “directly” on mental health problems, but facilitate community cooperation toward a common good which is chosen according to priorities of the community. Indeed, research has shown that individuals who are able to function, contribute to community recovery, and maintain their role during stress often cope better and experience less mental health problems following a stressful event (Caplan, 1975 and Chapters 4, 5, and 10). Furthermore, community and family (rather than individual) interventions, have resulted in improved mental health in rural Australian communities affected by drought (Stehlik, 2003; Berry, 2009).

Address Resource Loss and Promote Resource Gain As elaborated throughout this book, adverse environmental events due to climate change are likely to result in multiple and large-scale losses among affected populations. Potential losses include the loss of sense of place and connection with the homeland, loss of traditional ways of life, loss of homes and communities, loss of livelihoods and employment opportunities, loss of cultural and religious heritage,

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loss of access to education and health care, and loss of certainty, identity, and social support and connectedness (e.g. see Chapters 4, 5, and 10). Consistent with the Conservation of Resources theory described in Chapter 8 on climate refugees, the perceived and actual loss of resources has shown to be a key predictor of psychological distress, which can in turn lead to impairment in functioning and in further resource loss. Supporting individuals and communities in maintaining resources, restoring previous resources, or obtaining new resources should therefore be an important part of assisting populations affected by climate change.

Increase Community Cohesion and Social Capital As elaborated in this volume, environmental stressors and resulting effects such as loss of life, economic hardship, displacement, and relocation are likely to adversely affect community cohesion and social networks. Yet, positive relationships and social support are key protective factors that lower the risk for developing mental health problems among adults as well as children (e.g. see Chapters 4, 5, 9, and 10). It is therefore important to find ways of keeping families and communities together in the face of environmental threats and stressors. Strategies should include facilitating community activities and events such as safe play spaces for children and youth, support groups (e.g. mother and baby groups), and opportunities for recreation and cultural events (e.g. singing, drama) and sports (IASC, 207). Such activities can also aid in building trust and promote common social identities among groups with different background or engaged in conflict (see Chapter 6).

Promote Access to Green Spaces and Connectedness It has been argued in this volume and elsewhere that being emotionally disconnected from other people, communities, and the environment is another risk factor for mental health problems and a potential consequence resulting from gradual and sudden environmental changes, urbanization, and displacement (Nurse, Basher, Bone, & Bird, 2010 and Chapters 3 and 8). Interventions that connect people with each other and with the broader environment such as improving access to green spaces and outside recreational activities and events may be promising in this regard. Indeed, contact with the natural environment has been shown to reduce physiological stress reactions and improve well-being. It has been suggested that creating green spaces and providing access to such spaces have the potential to have both human and environmental (e.g. temperature control, absorption in flooding) benefits (Nurse, Basher, Bone, & Bird, 2010).

Support Individual and Community Coping Mechanisms Ways of making sense of climate change and related events are deeply affected by cultural and historical contexts and can be individual (e.g. re-authoring or reframing events) and social (e.g. social construction religious meanings) as described in

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several chapters (e.g. Chapters 2 and 9). This also applies to individual ways of coping (e.g. problem solving, seeking information, seeking social support) as well as social and cultural processes following adverse environmental events (e.g. religious ceremonies, mourning rituals in case of mass casualties, volunteering and helping the community). Populations affected by such events may not share Western conceptualizations of causes and effects and may instead have their own interpretations and strategies of coping. When attempting to assist those affected by crises, it is important to attempt to understand and respect such different meanings and strategies when designing and implementing relief and development activities. Indeed, it has been recommended that ways in which communities are already helping themselves should be supported as much as possible (IASC, 2007). Such efforts can also promote mental health and well-being by increasing sense of agency, enhance social support, and contribute to a sense of group identity (see Chapters 2, 4, 5, and 10).

Strengthen Local Capacity for Mental Health and Psychosocial Well-Being Interventions While significant segments of the population may suffer from psychological distress and reduced well-being as a direct or indirect result of climate change, a smaller percentage is likely to develop more chronic and severe mental health problems, especially in the context of disaster or humanitarian emergencies. It has been recommended that affected populations should have access to quality psychosocial and mental health services, which must be scaled up especially in low-resource settings (World Health Organization, 2008). However, it is important to invest in mental health and community support systems rather than engage in short-term relief work. Mental health services should be integrated with primary care and other community health services, which make them more accessible, less stigmatizing, and more sustainable (Prince et al., 2007). Since most groups suffering from distress respond better to people from within their own community, community support services should be given particular attention (see Chapters 4, on disasters, and 10, on community resilience in this volume). Interventions should be empirically based and culturally sensitive, address the whole range of environment-induced as well as chronic and preexisting mental health problems (Inter-Agency Standing Committee, 2007, Page & Howard, 2010), involve training and capacity building of local staff (rather than solely rely on direct service provision by outsiders), consider local culturally specific expression of distress including those related to ecological factors (termed psychoterratic by Albrecht in Chapter 2, this volume), and follow recently developed IASC guidelines (Inter-Agency Standing Committee, 2007).

Attend to Populations at Risk Special attention must be paid to populations at risk for the psychological effects of climate change. These include children, women, the elderly, the disabled, those with less access to resources, and those with preexisting mental health or substance use problems (Lancet Global Mental Health Group, 2007). Providing aid to at-risk

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populations through social inclusion, training, advocacy, and community mobilization is essential (see Chapters 4 and 10). At the same time, it is important to note that groups at risk have unique strengths and capacities, which should be enhanced and supported rather than undermined. Children and youth have shown considerable resilience and creativity in the aftermath of disasters and involving them in meaningful activities, age-appropriate decision making, and community efforts is important. Furthermore, women can play a key role in disaster mitigation and response as elaborated by Wenden in Chapter 7 of this volume.

Conduct Research and Document Outcomes National governments have a responsibility, under the UN’s Framework Convention on Climate Change (1992), to carry out formal assessments of the risk to their population’s health posed by global climate change. This should include mental health issues. Current projections of climate change outcomes have mostly focused on direct weather-related effects on the environment. Together with other disciplines, psychologists can contribute to monitoring and documenting climate-related effects on more complex issues, including direct and indirect effects on mental health and well-being. Specifically, more research is needed to examine individual and societal responses to climate change, to investigate how individuals and communities prepare for and respond to climate change related environmental events, and how affected populations adapt, cope, and recover. Psychologists have a unique contribution to make in documenting mental health and quality of life outcomes, which are an important but neglected aspect of social and economic development (e.g. see Marsella, Levi & Ekblad, 1997). However, it has been pointed out that it is not enough to invest in research and generate more publications and reports and to focus on problems without having an impact on them (Kazdin, 2009). Research findings should drive the design of interventions and policies that are informed by local knowledge and culture and that have the potential of protecting at-risk or already-affected populations. The impacts of climate change are likely to be context and culture dependent, with various complex and interrelated factors (American Psychological Association, 2009). Therefore, it is crucial to get out of the laboratory and to evaluate interventions and outcomes in the field, especially in low-resource settings. Such outcomes should be shared with various stakeholders and inform scale-up where possible. At the same time, it is important to conduct such research in an ethical way that ensures participation and consent of affected communities as well as the prospect of tangible benefits (Allden et al., 2009).

Promote Interdisciplinary Collaboration and Inclusive Partnerships Meeting the multiple challenges arising in the context of climate change requires the expertise and collaboration of various disciplines including psychology, political science, medicine, ecology, anthropology, economy, law, and others. Such collaboration should be facilitated by organizing interdisciplinary conferences, working

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groups, and forums, which ensure a broad range of participants including those living in low-resource countries. Collaboration between disciplines would not only promote finding synergistic and creative solutions but would also accelerate the dissemination of information, foster the development of a common language, and increase visibility and credibility of psychologists working in this field. Coordinated efforts and partnership building must also take place among different groups and stakeholders such as scientists, practitioners, local and international NGOs, governmental and international agencies, donors, affected community groups, and civil society at large (Miller, 2007). Such collaborations should specifically pay attention to the divide among low-, middle-, and high-income countries and ensure participation of those with low resources as well as marginalized and vulnerable communities.

Engage in Advocacy with Key Stakeholders and Policy Makers Psychologists and others in the field should also make active efforts to engage policy makers, which some have already started, while others have strongly advocated for it (e.g. Vlek, 2000 in Gifford, 2008). Those already engaged in such efforts will often find that politicians and legislators want and need input and information that is evidence based and relevant for decision making, from various groups and disciplines. This requires taking the first step by reaching out, contacting key persons, and being prepared with talking points and a one- to two-page policy brief describing the problem and possible solutions that are feasible and relevant for this particular person’s work. There appears to be renewed interest in making policies “evidence based” (e.g., Davies, Nutley, & Smith, 2000), which is a strength of psychology with its strong base in research and methodology (Gifford, 2008). A shift is also needed in educating the next generation of young psychologists and in preparing them to tackle issues of global significance such as climate change. The curriculum at academic institutions should reflect such new challenges. Topics such as cross-cultural psychology should be included and take a more global and inclusive approach that goes beyond covering different ethnic groups within the academic institutions’ home country. It is important to include the work of international organizations such as the UN and WHO, issues of social justice and low-income countries, as well as challenges and controversies of international relief and development efforts (e.g. see Miller, 2007; Marsella, 2006). Global considerations can be explored with readings from different disciplines, followed by discussions on how psychology as science and practice can contribute to addressing such issues. For changes to occur that can have a real impact on the ground, we need more than gloomy predictions of the impacts of climate change; we need positive visions of what could be achieved in the face of adversity, how people and communities could help themselves, and how people of different disciplines, nations, and ways of life work can together toward common goals. Psychologists now have the opportunity in helping to shape such a vision, which can protect and promote the mental health and psychosocial well-being in the context of a changing climate.

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References Allden, K., Jones, L., Weissbecker, I., Wessells, M., Bolton, P., Betancourt, T. S., et al. (2009). Mental health and psychosocial support in crisis and conflict: Report of the Mental Health Working Group—Harvard Humanitarian Action Summit 2009. Prehospital Disaster Medicine, 24(4), s217–s227. American Psychological Association. (2009). Psychology and global climate change: Addressing a multi-faceted phenomenon and set of challenges a Report by the American Psychological Association’s Task Force on the interface between psychology and global climate change. Washington, DC: American Psychological Association. Berry, H. (2009). Pearl in the oyster: Climate change as a mental health opportunity. Australasian Psychiatry, 17(6), 453–456. Caplan, G. (1975). Support systems in times of war, the individual and community in emergencies. Jerusalem: Hebrew University. Davies, H. T. O., Nutley, S. M., & Smith, P. C. (2000). What works? Evidence-based policy and practice in public services. Bristol, UK: Policy Press. Gifford, R. (2008). Psychology’s essential role in alleviating the impacts of climate change. Canadian Psychology/Psychologie Canadienne, 49(4), 273–280. Inter-Agency Standing Committee (IASC). (2007). IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings. Geneva: IASC. Kazdin, A. E. (2009). Psychological science’s contributions to a sustainable environment: Extending our reach to a grand challenge of society. American Psychologist, 64(5), 339–356. King’s College London. (2009). Informing the task of aid workers. Towards Mental Health. 4, 16. Lancet Global Mental Health Group. (2007). Scale up services for mental disorders: A call to action. Global Mental Health Lancet Series, 6. DOI: 10.1016/S0140-6736(07)61242-2. Marsella, A. J. (2006). Justice in a global age: Becoming counselors to the world. Counselling Psychology Quarterly, 19(2), 121–132. Marsella, A. J., Levi, L., & Ekblad, S. (1997). The importance of including quality-of-life indices in international social and economic development activities. Applied & Preventive Psychology, 6(2), 55–67. Miller, T. W. (2007). Trauma, change, and psychological health in the 21st century. American Psychologist, 62(8), 889–898. Nolan, S. (2009, October 18). A role for psychology in the shadow of the UN conference on climate change: The field of psychology is in a key position to drive conversations about environmental sustainability. Psychology International. http://www.apa.org/international/pi/2009/10/climatechange.aspx Nurse, J., Basher, D., Bone, A., & Bird W. (2010). An ecological approach to promoting population mental health and well-being--a response to the challenge of climate change. Perspectives in Public Health, 130(1), 27–33. Page, L. A., & Howard, L. M. (2010). The impact of climate change on mental health (but will mental health be discussed at Copenhagen?) Psychological Medicine, 40(2), 177–180. Prince, M., Patel, V., Saxena, S., Maj, M., Maselko, J., Phillips, M. R., et al. (2007). No health without mental health. Global Mental Health Lancet Series, 1. Doi:10.1016/S01406736(07)61238-0 Stehlik D. (2003). Australian drought as lived experience: Social and community impacts. In L. Botterill & M. Fisher (Eds.), Beyond drought: People, policy and perspectives (87–108). Melbourne: CSIRO Publishing. Vlek, C. (2000). Essential psychology for environmental policy making. International Journal of Psychology, 35, 153–167. World Health Organization. (2008). Scaling up care for mental, neurological and substance use disorders. Geneva, Switzerland: Mental Health Gap Action Program.

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A Absolute deprivation, 105 Acute weather disasters, 84 Adaptation and climate change failure of alienation, 146–147 demoralization, 146–147 pre- and post-displacement impact, 151 psychiatric disorders, 147–148 psychobiology and long-term health consequences, 150–151 psychosocial problems, 149–150 solastalgia, 146–147 somatic symptoms, 148–149 Sri Lanka, needs assessment, 149 global responsibilities in challenge in, 151–152 primary and secondary prevention, 152–153 tertiary prevention, 153–155 resistance and resilience chronic distress, 145 consensus, 144–145 external protective factors, 145 internal resiliency, 145 resilience-as-outcome constructs, 144–145 symptom trajectories, 145 traumatic experiences, 144–145 See also Refugees Adger, W., 196 Africa, 47 Aguilar, L., 127 Aid organizations and researchers, 87 Albrecht, G., 29, 43–54, 147 Amazon basin, 135 American psychological association (APA), 2 9/11 and Hurricane Katrina, role in, 32 psychological benefits, 129

report on psychology and climate change, 8 Taskforce on psychology and climate change, 25 Antarctic landmass, 46 Anti-Tamil riots, 139–140 Anxiety, 27–28 Asian Tsunami, 24, 46 The Atlantic Monthly, 99 Attachment and Loss, 137 Australia and climate change, 4, 10 continent, nature and global location, 30 drought circumstances, 31 economy and agricultural, societal changes, 31–32 mental health impact issue, 30–31 survey results, 36–37 Australian psychological society (APS), 32 Australian Spring of 2009, 46 B Barnett, J., 196 Beijing Platform for Action (BPfA), 125 Berry, H., 204 Biopsychosocial homeostasis, 139 Biopsychosocial model, 138–139 Black Saturday bushfires, 24 Bosnian refugees in USA, 146 Bourque, L. B., 69 Bowlby, J., 137–138, 143 Brahma Kumaris (BKs), 172–173 philosophy, 169–170 psychological frame for, 176 reflective practice, 175 spirituality, 173 values, 174–175 Briggs, C. M., 97–111 British national survey, 36 Brody, A., 130

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

211

212 Brown, K., 196 Buddhists, 170 C California, 4 Cambodian refugees, 87 ‘Camellones’ farming systems, 195 Cardiff University’s Understanding Risk Centre, 36 Cartwright, S., 187 Center for Research on Epidemiology of Disasters (CRED), 58 Central American disaster prevention agency, 127 Chawla, L., 143 Children and elderly disaster victims, 69–70 China, 4 Chronic environmental change ecoanxiety, see Ecoanxiety econostalgia, see Econostalgia ecoparalysis, 50 human beings, climate stress on, see Human beings, climate stress on non-human beings, climate stress on, see Non-human beings, climate stress on psychoterratic and somaterratic syndromes, 48–49 regularity loss biological and ecological responses, 44 humans, origin and adaptation, 43–44 phenology, 44 pre-existing pattern, 43–44 solastalgia, see Solastalgia Chronic stress-related HPA activation, 67–68 Climate change APA Taskforce report, 2 biosphere, 4 community adaptation and preparedness, 202–203 cohesion and social capital, 205 comprehensive solutions, 201 defined, 1 by IPCC, 2 disasters, 7 environmental events, 204 ethical issues, 8 greenhouse effect, 3 green spaces and connectedness, 205 and human activity, 1 individual and community coping mechanisms, 205–206

Index interdisciplinary collaboration and inclusive partnerships, 207–208 population at risk, attention, 206–207 precipitation, 4 projected impact of heat stress, 6 human health, 6, 9 natural resources, 5 rainfall patterns, 6 social and economic, 5 psychologists and mental health professionals, contributions of, 8–11, 206 research and document outcomes, 207 resource loss and gain, 204–205 sea levels, 3–4 social justice and responsibility, 7–8 stakeholders and policy makers, advocacy in, 208 surface temperatures, 3 tropical storms, 4 vulnerable regions and groups, 202 women’s human rights, 126 Climate-related food insecurity, 105 Cold War, 98 Community resilience, 63–64, 187 adaptation and transformation attributes, 196–197 catastrophic climate change, 197 COP15, 198 institute for climate impact research, 197 strengthening adaptation strategies, 193 community competence, 192 economic development, 191 information and communications, 192 social capital, 192 Conflict climate change, connection between, 97 government, dissatisfaction environmental and political factors, 107 failures, 107 ‘human security’, 98 migration climate change and violent conflict, 101 difficulties of, 102 food and water availability, 101 forced displacement, 101 historical process, 101 instability, 101–102 ‘national security’, 98 poverty

Index absolute deprivation, 105 relative deprivation, 105–106 previous approaches and analyses climate changes, 103–104 climate security, 102 environmental, 103 politically charged situation, 102 proxy issues idea, 102–103 rational actions, 103 traditional security definitions, 103 resolution mechanisms and techniques, 110 resource scarcity climate-induced environmental change, 100 realistic group conflict theory, 100 US Department of Defense report, 99–100 violence outbreak, 98–100 seven areas, security threats, 98 social division and fragmentation stress and economic, communities, 106–107 vulnerable network topologies, 106 weak network connections, 106 vulnerability and risk factors aims and assessments, 104 climate change, social impacts, 104–105 cross-disciplinary research, 104 linear cause–effect, assumptions, 104 violent conflict causes, 104–105 Conservation of resources (COR) theory, 137 Cooperation and collaboration benefit-sharing factors, 110 characterization of, 110 resource-based conflict, 110–111 warfare, 110 zero-sum fashion, 110 See also Risk mitigation and peace building Copenhagen UN Climate Change Conference (COP15), 198 Corruption and cronyism, 110 Cross-cultural psychology, 208 Cupples, J., 129 Czincz, J., 79–92 D Darfur, 107 The Day After, 23–24 The Day After Tomorrow, 23–24 Deepwater Horizon oil spill, 59 Demoralization, 146–147 Developing country and disaster, 70

213 Disasters agents and aspects, 60–61 Brahma Kumaris (BKs), 172–173 and climate change adaptation efforts elements, 111 ENVSEC, 111 peace agreement, 111 CRED definition, 58 demand-capability ratio, 58 faith-based response Brahma Kumaris (BKs), 167 ECOSOC and DPI, 167 IASC, 168 movements, 166–168 NVOAD and NGOs, 167 religious organization, 166–167 service, 166–167 UNICEF, 167 family relationships and, 65 individuals, 65–68 mental health services, 69 natural and technological, 58–59 posttraumatic growth, 171–172 re-authoring, 176–177 related stress, 64 resilience, 168–171 spiritual practitioners, 177–178 super cyclone, 173–176 vulnerable population, 68–70 weather-related, 64 E Earth Summit in Rio de Janeiro, 19–20 Ecoanxiety, 10 eco-information as source, 49 features, 49 research and articles, 49–50 Econostalgia biophysical location, 54 ‘nostalgia’, 54 Ecoparalysis, 50 Ecosystems, 196 Edwards, T., 185–198 Ellul, M., 19–37 Enarson, E., 128 Engel, G., 138–139 Engel’s biopsychosocial model, 138–139 Environmental refugees, see Refugees Environment and security initiative (ENVSEC), 111 Epstein, L. G., 28 Ethnicity and disaster victims, 69 Europe, 3

214 “Evidence based” policies, 208 Extreme weather events, impacts on differential effects characteristics, 60–61 disaster agents and aspects, 60–61 disaster CRED definition, 58 demand-capability ratio, 58 natural and technological, 58–59 effect and scope, 58 families disaster-related stress, 64 relationships, 64–65 global climate change, see Global climate change individuals flooding, 65–66 physical and mental health, 66–67 psychological distress, 67–68 severe outcomes, risks for, 65 mental health, 57–58 physical and community systems infrastructure, 61–62 resilience, 63–64 social systems, 62–63 practice recommendations in developing countries, 73 individual and family support, 73–74 preparedness, community-based models, 72–73 research recommendations models/procedures and measurement, 71 policy and practice, 71–72 vulnerable populations children and elderly disaster victims, 69–70 in developing nations, 70 ethnicity, disaster victims, 69 low-income disaster victims, 68–69 F Fall of Berlin Wall, 103 Famine and malnutrition, prenatal exposure, 84 Fazel, M., 148 Federated States of Micronesia, drought in, 127 First World War, 98 Fossil fuel–generated wave, 47 Frankl, V. E., 165, 169–170, 174 Free Aceh Movement, 111 Fullilove, M. T., 135–155

Index G Gap Action Programme, 90–91 Gender-based violence, 150 German Advisory Council on Global Change, 103 Gheytanchi, A., 68–69 Global climate change and disaster, 59–60 global impacts, 59 natural disasters, 59 technological disasters, 59 Global disaster, 59–60 Global Energy and Environmental Strategic Ecosystem (GlobalEESE), 108 Global Environment Facility, 111 Global Humanitarian Forum Report 2009, 191 Global Platform for Disaster Risk Reduction, 63 Global surface temperatures, 3 Greece, bushfire crises in, 46 Greenhouse effect, 3 Greenland, 3–4 H Hazards and vulnerabilities, 80–82 Health and mental health anxiety disorders, 27–28 anxious individuals, 29 articles and research reviews, 26–27 avoidance-oriented coping, 28 future-oriented proactive coping strategies, 28 impacts on human environments, 25–26 natural environmental changes, 27 individual experience, research on, 27 nuclear threat, 28 psychological responses, 27 psychology science-based literatures, 26 Hicks, M. H. R., 148 Hobbs, F., 69 Hobfoll, S. E., 135–155, 145 Hollifield, M., 135–155 Holmes, J., 6 “Horizontal inequality”, 105–106 Human beings, climate stress on and bushfire crises in Greece, 46 Eastern Australia, water shortages, 46 geologically stable parts, changes in, 46 mass migration, 46–47 mental health impact, 47

Index place-based distress, 47–48 territorial relationship, 45 transformation, 45–47 ‘uggianaqtuq’, 47 Western European heatwave, 46 Humanitarian crises challenges and cross-cultural considerations assessment and intervention, 86–89 assistance, 85–86 emergencies, 79–80 hazards and vulnerabilities armed conflict risk, 80–81 climate change, 80 community and individual levels, 81–82 harmful consequences, 80 regions at risk, 80–81 “risk hot spots,” 80–81 mental health and psychosocial well-being as consequence, 83–85 as vulnerability, 82–83 psychologists and mental health professionals local capacity building, 90–91 research directions, expanding, 91–92 responding, 89–90 temperatures rise, 79 Humanitarian Emergency Settings Perceived Needs (HESPER) Scale, 204 Human spirit, 170 Human vulnerability indicators, 84–85 Hunter Valley, 51–52 Hurricane Katrina, 21, 24 Hyogo Framework for Action (HFA), 63–64 I An Inconvenient Truth, 23–24 India, 4 forced displacement, 101 ISDR publication, 73 Inter-Agency Standing Committee (IASC), 83–84, 89 guidelines, 168 Intergovernmental Panel on Climate Change (IPCC), 19 Assessment Report, 2 climate change definition, 2 predictions, 5 International Federation of Red Cross Red Crescent Societies, 6 Inuit of Arctic Circle, 47 Irish immigrants to USA, 102

215 J Jains, 170 Japan, resilient communities in, 72–73 K Kane, C. F., 146 Kaplan, R., 99 Kazdin, A., 2 Kennan, G., 99 Keyes, E. F., 146 Kobe and Northridge earthquakes, 66 Kyoto Protocol Adaptation Fund, 91 L Lancet Global Mental Health Group, 206–207 Lertzman, R., 29 Lewes in Southern England, severe river flooding, 65–66 Local communities and climate change adaptive capacity limits global mean warming, 196 transformability, 196 aims, 185 community well-being determinants, 187–188 impacts, 188–189 ‘Transition Towns Movement,’ 192–195 assumptions, 194 resilience projects, 194 vulnerable places and populations components, 190 elements of vulnerability, 191 IPCC, 189–190 local variability, 190 place-based communities, 190 population groups, 190–191 working with, 195 Logotherapy, 168–169 Low-carbon transition plan, 197 Lowder, D., 66 Low-income disaster victims, 68–69 M Maguire, B., 187 Manderson, L., 165–179 Manila Declaration for Global Action on Gender, Climate Change and Disaster, 119–120 Man’s Search for Meaning, 169 Manyena, S. B., 63 Mental health community-based services, 87 as consequence of humanitarian crises

216 Mental health (cont.) acute weather disasters, 84 children and youth, 83–84 climate change, 85 famine and malnutrition, prenatal exposure, 84 human vulnerability indicators, 84–85 severe and interrelated stressors, 83–84 services and WHO recommendations, 206 and vulnerability associated factors, 82–83 developing countries and, 82–83 narrow focus, 82 psychiatrists, number of, 82–83 severe mental disorders, individuals with, 82 Mental Health and Psychosocial Support in Emergency Settings, 89 Micronesian women, 128 Morrissey, S. A., 19–37 Mountain pygmy possum, 44 Murray-Darling River basin in Eastern Australia, 46 N National Adaptation Programs of Action (NAPA), 91 National Institute of Mental Health for all terrorism-related research after September 11, 2001, 152 National Voluntary Organizations Active in Disaster (NVOAD), 167 Natural disasters, 64 See also Disasters Nelson, D., 196 Netherlands, sea water flooding, 101 Neumayer, E., 123–124, 130 New Mexico Refugee Project, 145 New Mexico Refugee Symptom Checklist–121 (NMRSCL-121), 148–149 New Orleans, 67 Non-human beings, climate stress on climatic and weather change, 44 disease patterns, 45 mountain pygmy possum in Australia, 44 predator–prey relationships, 45 temperature change and, 44–45 territorial issues and animal survival, 45 Norris, F. H., 149 North America, 4, 6, 11 North Atlantic, 4 Northern Europe, 6

Index North Korean invasion of South Korea, 103 Nuclear Tipping Point, 23–24 O O’Brien, L. T., 120–121 Office for Coordination of Humanitarian Affairs (OCHA), 79 Olsson, C. A., 144 Orissa illustrate, extreme weather events in, 179 P Pacific Northwest, 4 Pakistan, severe earthquake in, 111 Palestinians, forced removal from Gaza, 143 Pan-American Health Organization, 63–64 Peduzzi, P., 60 People-centred resilience camellones, 195 Oxfam report, 195 principles, 195 Peraliya area, 140 Peru, ISDR publication, 73 Phenology, 44 Philopatridomania, 147 Piana, G., 130 Plümper, T., 123–124, 130 Postcoloniality and the Aftermath of Revolution among Vietnamese Refugees, 141–142 Post-Katrina context in 2006, 150 Post-migration stressors, 151 Post-traumatic growth inventory (PTGI), 171 Post-traumatic stress disorder (PTSD), 52–53, 59, 65–67, 69–70, 82, 84, 91, 124, 140–141, 147–148, 150–151, 153 Poverty absolute deprivation, 105 relative deprivation affluent and poorest sections, gap between, 105 climate-related food insecurity, 105 “horizontal inequality,” 105–106 resources, unequal distribution, 106 societal polarization, conflict, 105–106 Pre-Colombian Andean people with risk of earthquakes, 168 Psychological distress, 66 Psychological resilience, 186 See also Resilience Psychoterratic syndromes climate change and people, 48 illness domain, 49

Index mental health problems, 49 physical and psychological responses, 48 PTSD, see Post-traumatic stress disorder (PTSD) Q Quadrennial Defense Review (QDR), 97 Quadrennial Diplomacy and Development Review (QDDR), 97 Quarentelli, 58 R Ramsay, T., 165–179 Randall, D., 99 Realistic group conflict theory, 100 Re-authoring as explanatory tool, 176–177 Red Cross in Australia, 32 definition of disaster, 149 environmental disasters, 6 Refugees Adaptation, see Adaptation and climate change climate change, effects of, 135–136 definition, 136 environment and stressors types, 135 tsunami, 143–144 world, betrayal by, 143–144 global temperatures, 135 helping host communities, 155 identity and belonging disruptions alienation problem, 142–143 confusion and conflict, 142 dual response, 141 mental health effects, 141–142 mental health services, 153 place disruptions biopsychosocial homeostasis, 139 dimensions of, 139 poor mental health, predictor of, 140–141 in Sri Lanka, 139–140 resource conservation and loss COR theory, 137 individual and collective adaptive capacity, 136 “loss spiral”, 136–137 stressful events types, 137 well-being dependence, 136–137 resources in and around self adaptive attachment behaviors, 137–138 biopsychosocial model, 138–139

217 health outcomes, 138 social relationships, internal working model, 137–138 screening, 153–154 Relative deprivation climate-related food insecurity, 105 “horizontal inequality”, 105–106 most affluent and poorest sections, gap between, 105 resources, unequal distribution, 106 societal polarization, 105–106 Report of the Office of the United Nations High Commissioner for Human Rights, 125 Reser, J. P., 19–37 Resilience eco-systems, 186 engineering perspective of, 186 organizational level, 186 psychological resilience, 186 resilient ecosystem, 186 Risk and concerns evaluation and sense making, 22–23 perception, 22 psychological response, 22 psychology-based risk research, 22–23 social representation, 23 Risk mitigation and peace building community adaptation and resources environmental wars, 108 financial and resource access, 109 traditional societies, 109 trust and administration, 108–109 violent incidents and crime, 108–109 cooperation and collaboration benefit-sharing factors, 110 characterization of, 110 resource-based conflict, 110–111 warfare, 110 zero-sum fashion, 110 disasters and climate change adaptation efforts elements, 111 ENVSEC, 111 peace agreement, 111 governance conflict resolution mechanisms and techniques, 110 corruption and cronyism, 110 inequalities standard development economics, 109 structural peace building, 109 The Road, 23–24 Rwanda, genocide in, 103

218 S Samoa, ISDR publication, 73 Schellnhuber, H. J., 197 Schwartz, P., 99 Security climate change, connection between, 97 government, dissatisfaction environmental and political factors, 107 failures, 107 ‘human security’, 98 migration climate change and violent conflict, 101 difficulties of, 102 food and water availability, 101 forced displacement, 101 historical process, 101 instability, 101–102 ‘national security’, 98 poverty absolute deprivation, 105 relative deprivation, 105–106 previous approaches and analyses climate changes, 103–104 climate security, 102 environmental, 103 politically charged situation, 102 proxy issues idea, 102–103 rational actions, 103 traditional security definitions, 103 resource scarcity climate-induced environmental change, 100 realistic group conflict theory, 100 US Department of Defense report, 99–100 violence outbreak, 98–100 seven areas, security threats, 98 social division and fragmentation stress and economic division, communities, 106–107 vulnerable network topologies, 106 weak network connections, 106 vulnerability and risk factors aims and assessments, 104 climate change, social impacts, 104–105 cross-disciplinary research, 104 linear cause–effect, assumptions, 104 violent conflict causes, 104–105 See also Conflict Self-sufficiency and sustainability, 203 Sen, A., 105

Index Sephton, S. E., 57–75 Severe and interrelated stressors, 83–84 Severe mental disorders, individuals with, 82 Sheehan global disability scale, 150 Simpson, D. M., 57–75 Sino-Vietnamese civilization, 141 Sinsibere project, 128 Six Degrees, 23–24 Small Pacific island nations, 101 Social relationships, internal working model, 137–138 Solastalgia, 10, 29 in Australia, 51–52 biophysical environment, chronic desolation, 53 concept, 50–51 ‘desolation,’ origin, 51 global warming, anthropogenically induced, 53 home environment, 50 iconic trees, 53 mining-induced chronic environmental change, 52 natural change agents, 52–53 New Orleans, place-based stress, 52–53 nostalgia and, 51 PTSD, 52–53 Somali adolescents displaced to USA, 143 Somaterratic syndromes climate change and people, 48 illness domain, 49 mental health problems, 49 physical and psychological responses, 48 Somatic symptoms, 148 South Africa, ISDR publication, 73 Southern Europe, 4 Soviet coup, 103 Sphere Handbook, 89 Sphere Project, 168 Spiritual practitioners, 177–178 Sri Lanka after tsunami psychosocial problems, 150 range of harms and subsequent needs in, 149 resettlement and rebuilding within, 140 Statement of the CEDAW Committee on Gender and Climate Change, 125 State of the Planet, 23–24 Stoops N., 69 Super cyclone Brahma Kumaris (BKs), role in, 174 good action, 176

Index in Orissa, 173–174 reflective practice, 175 service to others, 175 T Ta, L., 148–149 Tamil Nadu, global warming in, 128 Technological disasters, 59 Tet Offensive in Vietnam, 103 Thailand tsunami, 66–67 The 11th Hour, 23–24 Threat of climate change and Australia continent, nature and global location, 30 drought circumstances, 31 economy and agricultural, societal changes, 31–32 mental health impact issue, 30–31 survey results, 36–37 available resources and APA and APS, 32 government and nongovernment agencies, 32 psychological advice, 32–33 environmental impacts community relocations and forced migration, 29–30 feelings and sentiments, 29–30 literatures, 29 global weather pattern changes, 20 health and mental health perspectives, see Health and mental health media, nature and role, 23–24 perceived threats and areas impacted, 20–21 chronic environmental stressor, 20–21 environmental and societal risk, 20–21 risk domains nature, 20–21 physical environmental impacts indirect and virtual experience, 21 media-based risk representations and communications, 21–22 ‘social amplification of risk’, 21–22 psychological responses and adaptations APA Taskforce on, 25 cognitive adaptation, 24 psychological adaptation, 24 stress and coping perspectives, 25 risk and concerns, see Risk and concerns well-being and psychological impacts, see Well-being and psychological impacts

219 ‘Tipping points’, 196 “Tragic optimism”, 169 Transformability, 196 ‘Transition Towns Movement’, 192–195 Typhoon in East Pakistan, 107 U United Nations Environment Program (UNEP), 2 United Nations framework convention on climate change (UNFCCC), 19–20 United Nations Security Council, debate on climate change, 97 United States, 7 UN’s Framework Convention on Climate Change, 207 V Vietnam ISDR publication, 73 trauma and displacement, 141–143 Vulnerability, 187 and climate change, 190 components, 190 Global Humanitarian Forum Report, 191 and mental health associated factors, 82–83 developing countries and, 82–83 narrow focus, 82 psychiatrists, number of, 82–83 severe mental disorders, individuals with, 82 and risk factors aims and assessments, 104 climate change, social impacts, 104–105 cross-disciplinary research, 104 linear cause–effect, assumptions, 104 violent conflict causes, 104–105 vulnerable populations and children and elderly disaster victims, 69–70 in developing nations, 70 ethnicity, disaster victims, 69 low-income disaster victims, 68–69 W Weather-related disasters, 64 Weissbecker, I., 1–11, 57–75, 79–92, 97–111, 201–208 Well-being and psychological impacts analyses and discussions, 33–34 confused societal and policy focus, 34–35

220 Well-being and psychological (cont.) cultural beliefs and values, 35 ignoring reasons, 33 social psychological and risk perspectives, 35 survey research evidence, 34 traditionally oriented communities, 35 Wenden, A. L., 119–131 Western Europe, 7, 11 Western European heatwave of 2003, 46

Index Western mental health professionals, 86 Wiseman, J., 185–198 Wong, P. T. P., 170–171 World Health Organization, 6, 9, 82–84, 103, 179 World Meteorological Organization (WMO), 2 Y Years Lived with Disability (YLDs), 49