Examining the Association Between Apparent Temperature and Mental Health-Related Emergency Room Visits in California

Abstract

The association between ambient temperature and morbidity has been explored previously. However, the association between temperature and mental health-related outcomes, including violence and self-harm, remains relatively unexamined. For the period 2005-2013, we obtained daily counts of mental health-related emergency room visits involving injuries with an external cause for 16 California climate zones from the California Office of Statewide Health Planning and Development and combined them with data on mean apparent temperature, a combination of temperature and humidity. Using Poisson regression models, we estimated climate zone-level associations and then used random-effects meta-analyses to produce overall estimates. Analyses were stratified by season (warm: May-October; cold: November-April), race/ethnicity, and age. During the warm season, a 10°F (5.6°C) increase in same-day mean apparent temperature was associated with 4.8% (95% confidence interval (CI): 3.6, 6.0), 5.8% (95% CI: 4.5, 7.1), and 7.9% (95% CI: 7.3, 8.4) increases in the risk of emergency room visits for mental health disorders, self-injury/suicide, and intentional injury/homicide, respectively. High temperatures during the cold season were also positively associated with these outcomes. Variations were observed by race/ethnicity, age group, and sex, with Hispanics, whites, persons aged 6-18 years, and females being at greatest risk for most outcomes. Increasing mean apparent temperature was found to have acute associations with mental health outcomes and intentional injuries, and these findings warrant further study in other locations.

The Impact of Climate Change on Mental Health: A Systematic Descriptive Review

“…For example, temperature stress can influence psycho-physiological functions by directly affecting bio-chemicals levels, (e.g. altering the production of serotonin and dopamine) (120) or by disrupting the homeostasis of thermoregulation (121,122). Additionally, direct heat could result in sleep disturbance, exhaustion, and heat stress associated with suicide (56,123).…”

“…People are more affected by high temperature especially if they have schizophrenia, schizotypal disorders, and mood disorders (121). During the increase of temperature, there is a risk of mental states of aggression resulting in violence and self-harm, inflicted injury/homicide, and self-injury/suicide (122). Many studies found no significant associations with cold temperatures (51,120).…”

Strategies for Delivering Mental Health Services in Response to Global Climate Change: A Narrative Review

“…These impacts will be widespread, profound, and cumulative [3,6] and include elevated rates of anxiety and mood disorders, acute stress reactions and posttraumatic stress disorders, sleep disruption, suicide and suicidal ideation, substance use disorders, and a decreased sense of self and identity from loss of place and connection to the environment [1,2,[6][7][8][10][11][12][13][14][15][16][17][18][19][20]. Indeed, numerous studies have linked three specific forms of climate change to mental health impacts: (1) acute and extreme weather events (EWEs) and natural disasters, such as hurricanes [8,12], floods [13,14], wildfires [15], and heat waves lasting for days or weeks [16,17]; (2) sub-acute weather events lasting for months or years such as droughts [1,2,18,19] and longer-duration heat waves [1,2,20]; and (3) and a permanently altered and potentially uninhabitable physical environment that is either too dry or too wet, but ultimately too hot [1,2,4,5,7,9,10]. Each form of climate change can contribute to an increase in mental health problems that are directly linked to property damage, loss of income and employment opportunities and reduced economic productivity [1,…”

Strategies for Delivering Mental Health Services in Response to Global Climate Change

“…Several empirical studies and systematic reviews have documented the mental health impacts of global climate change [1][2][3][4][5][6][7][8][9][10][11]. These impacts will be widespread, profound, and cumulative [3,6] and include elevated rates of anxiety and mood disorders, acute stress reactions and post-traumatic stress disorders, sleep disruption, suicide and suicidal ideation, substance use disorders, and a decreased sense of self and identity from loss of place and connection to the environment [1,2,[6][7][8][10][11][12][13][14][15][16][17][18][19][20]. Indeed, numerous studies have linked three specific forms of climate change to mental health impacts: 1) extreme weather events (EWEs) and natural disasters lasting for days, such as hurricanes [8,12], floods [13,14], wildfires [15], and short-duration heat waves [16,17]; 2) sub-acute weather events lasting for months or years such as droughts [1,2,18,19] and long-duration heat waves [1,2,20]…”

“…These impacts will be widespread, profound, and cumulative [3,6] and include elevated rates of anxiety and mood disorders, acute stress reactions and post-traumatic stress disorders, sleep disruption, suicide and suicidal ideation, substance use disorders, and a decreased sense of self and identity from loss of place and connection to the environment [1,2,[6][7][8][10][11][12][13][14][15][16][17][18][19][20]. Indeed, numerous studies have linked three specific forms of climate change to mental health impacts: 1) extreme weather events (EWEs) and natural disasters lasting for days, such as hurricanes [8,12], floods [13,14], wildfires [15], and short-duration heat waves [16,17]; 2) sub-acute weather events lasting for months or years such as droughts [1,2,18,19] and long-duration heat waves [1,2,20]; and 3) environmental changes lasting to the end of this century and beyond such as higher temperatures, sea level rise, and a permanently altered and potentially uninhabitable physical environment [1,2,4,5,7,9,10]. Each form of climate change can result in varying degrees of economic losses associated with property damage, loss of income and employment opportunities and reduced economic productivity, especially in agriculture and fishe...…”