The impact of heatwaves on mental health, drug and alcohol conditions

Abstract

Aims: The incidence and severity of heatwaves appears to be increasing. Heat waves kill more people than any other natural hazard in Australia (4287 people died from heat waves 1803–1992). Extreme temperatures over prolonged periods present signifi cant risks to clients with drug, alcohol and mental health problems (comorbidity). Presentation will describe fi rstly, case series of patients with mental health problems admitted to major metropolitan hospital during heatwave and secondly, nature and mechanisms by which heatwaves increase morbidity and mortality of comorbid clients. Method: Firstly, retrospective descriptive analysis was carried out on case series of patients admitted with heat-related illnesses to metropolitan hospital during exceptional heatwave in 2009. Demographic, clinical and outcome data were collected. Secondly, literature review identifi ed physiological impact of heatwaves on individuals prescribed psychiatric medications. Also identifi ed particular physiological changes associated with range of mental, drug and alcohol disorders. Results: During the period 52/270 patients were identifi ed as being admitted with heat-related illnesses. 9/52 (17%) had history of psychotic illness. These patients tended to be younger, longer length of stay (7.3 days versus 4.7 days), less likely have suffi cient airconditioning and greater proportion experienced heat stroke (44% versus 26%). Discussion: Patients with psychosis more likely to experience severe heat-related illnesses. Supports previous fi ndings that those with chronic comorbidity experience high rates of physical morbidities and may be poorly socially supported. Potential for physical morbidity factors to increase clients’ vulnerability during heatwave is discussed. Increased risk during heatwaves due to pharmacological effects of psychoactive medications and drugs of misuse also presented. Conclusion: Health services should be aware of potential risks to clients during heatwaves. Steps should be taken to reduce likelihood of adverse health outcomes. All services (mental health, drug treatment, primary health and welfare) have responsibility to increase capability and resilience of clients to manage their health safely during heatwave. We examine these responsibilities and consequences for service failure.