Published in the journal JAMA Psychiatry, the study on how extreme heat is linked to mental health emergencies, found that days with higher-than-normal temperatures during the summer season in the United States were associated with increased rates of emergency department (ED) visits for any mental health-related condition, particularly substance use, anxiety and stress disorders, and mood disorders.
The impact of heat on physical health is well documented, but few studies have examined the effects of extreme heat on mental health. This nationwide study is the largest and most comprehensive analysis of daily ambient temperature and mental health-related ED visits among US adults of all ages. As days of extreme heat 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 costliest interactions within the healthcare system,” says study lead author Dr. Amruta Nori-Sarma, assistant professor of environmental health at BUSPH. “Addressing the needs of the most vulnerable to preempt some of these visits can have a positive impact on individual health and costs, as well as preserve healthcare resources for other emergencies.”
The new findings should prompt healthcare providers to prepare for an increased need in mental health services during times when extreme heat is predicted, Nori-Sarma says. “When heat waves are forecasted, clinicians and public health experts may use our findings to prepare especially for outreach to patients with existing mental health conditions.” The general public can also benefit from this insight, says study senior author Dr. Gregory Wellenius, professor of environmental health and director of the Climate and Health Program at BUSPH. “On days of extreme heat, it is important that we each take the precautions necessary to take care of ourselves and our loved ones,” he says, which can include checking on neighbors or family members who may be susceptible to health impacts of heat exposure.
For the study, Nori-Sarma and colleagues obtained medical claims data on mental health-related ED visits from OptumLabs Data Warehouse, which contains de-identified, longitudinal health information on more than 200 million commercial and Medicare Advantage enrollees throughout the US. The researchers analyzed approximately 3.5 million ED visits among 2.2 million adults ages 18 or older who had commercial or Medicare Advantage health insurance during the warm season (May to September) from 2010 to 2019.
Days of extreme heat—defined as temperatures above the 95th percentile of temperature distributions by county—were most strongly linked with ED visits for childhood-onset behavioral disorders and substance use disorders, followed by anxiety, stress-related, and somatoform disorders, and mood disorders.
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