Extreme heat linked to rise in mental health emergency care: Study

Posted: Post Date – 12:37 pm, Thursday – Feb 24 22

Boston: Does the outside temperature decide the inner temperament of a person? On extremely hot summer days, adults are at higher risk of visiting emergency rooms for mental health crises related to substance use, anxiety, stress, and more.

According to a new study led by researchers at the Boston University School of Public Health, during periods of extreme heat, doctors were expected to see an increase in the number of patients requiring mental health services.
Published in the journal JAMA Psychiatry, the study found that days with higher-than-normal temperatures during the summer season in the United States were associated with higher rates of emergency department (ED) visits for any condition related to mental health, particularly substance use, anxiety and stress disorders, and mood disorders.

The impact of heat on physical health has been well documented, but few studies have examined the effects of extreme heat on mental health. This nationwide study was the largest and most comprehensive analysis of daily room temperature and mental health-related emergency department visits among American adults of all ages. As extreme heat days are expected to increase due to worsening climate change, the findings fill a critical gap in research and provide evidence-based support for proactive interventions and policy solutions that can reduce heat-related crises.

“Emergency department visits represent some of the most costly interactions within the health care system,” said the study’s lead author, Dr. Amruta Nori-Sarma, an assistant professor of environmental health at BUSPH. “Addressing the needs of the most vulnerable to get ahead of some of these visits can have a positive impact on individual health and costs, as well as preserve health care resources for other emergencies.” The new findings should prompt healthcare providers to prepare for an increased need for mental health services during times when extreme heat is forecast, Nori-Sarma said. “When heat waves are forecast, clinicians and public health experts can use our findings to prepare especially to reach patients with existing mental health conditions.” The general public can also benefit from this information, said the study’s lead author, Dr. Gregory Wellenius, a professor of environmental health and director of the BUSPH Climate and Health Program.

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“On days of extreme heat, it is important that each of us take the necessary precautions to take care of ourselves and our loved ones,” he said, which may include checking on neighbors or family members who may be susceptible to impacts in health from exposure to heat. .

For the study, Nori-Sarma and colleagues obtained medical claims data on mental health-related emergency department visits from the OptumLabs Data Warehouse, which contained de-identified longitudinal health information on more than 200 million commercial and Medicare enrollees. Advantage across the US Researchers analyzed approximately 3.5 million emergency department visits among 2.2 million adults age 18 and older who had commercial health insurance or Medicare Advantage during the warm season (May through September ) from 2010 to 2019.

Extreme hot days, defined as temperatures above the 95th percentile of county temperature distributions, were most strongly associated with emergency department visits for childhood-onset behavioral and substance use disorders, followed by anxiety, stress-related disorders, and somatoform and mood disorders. disorders Extreme heat was also associated with visits to the emergency department for schizophrenia.

The researchers found that the impact of heat on mental health was similar across all age groups and was evident in both men and women and in all regions of the country. “These results show that heat can have a profound impact on the mental health of people, regardless of their age, gender or place of residence,” Wellenius said.

The authors found that the impact of heat was slightly higher in the Northeast, Midwest and Northwest. Although those regions generally have cooler temperatures than the southeastern or southwestern US, “that’s exactly why populations in these areas may suffer more during periods of high temperatures,” Nori-Sarma said. . “They don’t necessarily have the skills or the resources to deal with times of extreme heat. Heat events will become even more extreme as the climate continues to warm, so it is doubly important to identify the populations that are most vulnerable and help them adapt to the warmer conditions of summer.” In future studies, the researchers have set out to identify public health strategies that help alert people to the risks posed by extreme heat and better protect the most vulnerable members of the community. Further research will also explore the impact of elevated temperatures on mental health over longer periods of time (i.e., heat waves), as well as the impact on vulnerable groups not assessed by this study, including the uninsured, low income and of diverse races. /ethnicities, and those who are going through less urgent situations.

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The ongoing effects of COVID-19 on mental health will also shape this work. Lockdowns, social isolation and general uncertainty during the early days of the pandemic increased the need and limited the availability of mental health services at the same time that emergency services were overwhelmed with patients experiencing physical emergencies, Nori-Sarma said. .
“As we head into the upcoming summer season, it’s important to keep in mind that the combination of stressors — pandemic and weather — could exacerbate existing mental health conditions,” he said. “The mental health system needs to plan accordingly.”

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