SPECIAL ON CLIMATE CONFERENCE 2011
Psychological impact of climate change
When all is lost, trauma grips. Photo: STAR
With climate change comes global warming and a rise in sea levels, and Bangladesh is already the second lowest lying country in the world. A higher sea level makes it easier for freak tides and cyclones to breach the coastal and tidal defences, and the effects of climate change also increases the risks of river flooding and earthquake losses. The effects of such disasters touch all. The Bangladesh Association of Psychiatrists (BAP) conducted a survey 2 months after the cyclone Sidr of November 2007, assessing 750 survivors. Of these, 25.2% had post-traumatic stress disorder, 17.9% had major depressive disorder, 16.3% had somatoform disorder and 14.6% had a mixed anxiety and depressive disorder. Furthermore, 17.1% reported the death of a family member, and 82.9% were homeless. There were therefore major losses and bereavements outside of formal mental health disorder, with issues of bereavement and adjustment. The frequency and severity of climatic events is going to increase, creating a high need for psychological management, not just a high need for practical preventative steps and for the preparation of the physical aspects of the disaster recovery plan (food, sanitation, water and so on). The disaster recovery plan for Bangladesh needs a psychological dimension, in which all front line staff (army, relief workers, aid workers, community workers) have some knowledge of psychological first aid (the importance of rapport, the need for active listening, the promotion of problem solving rather than despair, basic do's and don'ts when dealing with traumatised people). There needs to be short training courses for everyone in psychological first aid, run by clinical psychologists. After the first aid comes a further level of psychological management, the setting up of psychosocial support in the community, the profiling of psychosocial needs, the launching of psychosocial activities, activities for children and for adults that promote psychological adjustment and build on residual community supports. After this there is another level, identifying the vulnerable and the most affected and providing specific psychological advice for them. Finally there is formal psychological treatment for those who do not recover. Yet there are only 39 clinical psychologists in the whole country. Therefore in planning disaster recovery there needs to be a manpower development plan that includes the provision of more clinical psychologists, who can train people in psychological first aid, train people in how to promote psychosocial supports, and who can treat the worst affected whose problems become chronic. The disaster recovery plan for Bangladesh needs to help the survivors survive psychologically. The writer is Member of the Board of Trustees, the Governing Body of the British Psychological Society (BPS) and Clinical Psychologist, UK.
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