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Mental Health Pathfinders: Mental Health After Disaster with Dr. Andrew McLean · The Medical Mind

• 0:03
  Thank you for joining us for this episode of Mental Health Pathfinders.
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  I'm your host, Aaron Connors.
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  Natural disasters like hurricanes,
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  floods, wildfires, and other crises often leave behind more than physical
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  devastation to homes, schools,
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  and communities. The psychological impact can linger long after the debris
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  has been cleared, affecting the mental health and well-being of survivors
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  for months or even years. To talk about the mental health impact
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  of disasters and the important role psychiatry can play is Dr.
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  Andrew McLean, chair of the APA's Committee of the Psychiatric Dimensions
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  of Disaster.
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  Dr. McLean is also Associate Dean of Wellness and Chair of
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  the Department of Psychiatry and Behavioral Science at the University
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  of North Dakota School of Medicine and Health Sciences.
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  Dr. McLean, thanks so much for joining us today.
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  Thanks for having me, Aaron.
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  You know, it seems like every day we're hearing about another disaster somewhere
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  in the country and frankly around the world.
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  How does the committee approach these events and how do you assess where psychiatry
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  can be most helpful here?
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  Well think you're right. I think literally it is every day.
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  ~ it's ~ it's just amazing ~ how often these disasters are happening,
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  most of them natural, some of them ~ human made.
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  ~ the committee actually was ~ was formed a number of years ago and and
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  ~ also of interest, branched off was the ~ the climate change
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  and mental health committee, although we work very closely together.
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  So what we do, much of what we do is actually outreach.
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  So we have you know we link and as you're well aware we work with the media as well.
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  When we hear of disasters, and as we mentioned,
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  it's happening very often, ~ many of our members actually are
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  not only academic ~ you know people with ~ lived experience,
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  you know, but but they are able to know the literature and they're able
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  to actually know what's happening on the ground.
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  So they often will reach out independently also
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  to
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  specific areas that they know are are suffering.
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  So much of what we do is outreach.
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  We work with the APA to link toolkits to communities to help them as best they might
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  respond. ~ One of the things that when you were talking about with what
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  can psychiatry can offer, much of the time what I tell psychiatrists
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  is what's most important is actually your leadership and
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  not necessarily your psychiatric expertise.
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  There certainly are some psychiatrists who
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  You know, they may be running an inpatient unit or they may be having
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  to take care of their clinic, et cetera.
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  But much of what they can offer within the community is actually just
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  ~ their their leadership, ~ helping to reduce anxiety,
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  helping to link ~ community ~ organizations together.
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  Yeah, and and and thinking a little bit more about the people that are
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  on the ground too, when people experience a disaster and are confronted with
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  so much loss and destruction, they may immediately go into,
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  let's just keep moving forward,
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  let's get through this, that kind of mindset.
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  But even in that business mode,
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  how important is it to just take that pause and pay attention to your own mental
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  health?
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  Yeah, it's it's so important and and where we see many people get into trouble
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  is ~ you know they just do they go forward and they do need to to help
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  to fix things, but if they're not getting sleep,
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  if they're burning themselves out,
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  you can't continue to do what needs to be done,
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  ~ burning the candles, you know,
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  twenty-four hours a day. And so part of it is reminding people you do need
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  to take a step back, you do need to get some rest,
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  you do need to pay attention to those around you and your loved ones.
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  because they're of vital importance as well.
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  And so ~ it it it does take some reminding of people ~ to to pay attention.
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  And we also know that during those times there's an uptick in other stressors which
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  ~ oftentimes leads people to be involved with law enforcement.
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  There can be an increase in substance use,
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  domestic violence, etc. And so you know,
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  just reminding people to to do the basics to take care of themselves
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  is really important.
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  So what some of the warning signs we should be looking for that someone
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  may be struggling emotionally after disaster and and particularly signs parents
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  and caregivers should watch for in in kids?
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  Right.
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  And and so for individuals, you know,
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  again, reminding people much of what their experiences ~ experiencing is
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  ~ a normal response to an abnormal situation.
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  And so ~ part of what I talk with people about is you know,
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  pay attention to those around you,
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  not only for kind of managing and mirroring your own self,
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  how am I doing, but also paying attention to what the needs are of others.
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  But if you're finding that ~
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  you are much more irritable than those around you.
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  You are drinking a lot more than those around you.
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  Or I you know, if if you're behaving significantly different from those around you,
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  ~ I think it's very important to be mindful of that.
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  And and that brings up the point about not isolating yourself.
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  ~ And so people need to hunker down,
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  they need to take care of what they need to take care of.
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  But at the same time, ~ you know,
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  community engagement and being aware of what's going on in the neighborhood
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  is is actually really important.
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  You bring up a really good point about children.
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  And ~ you know it is there are a lot of resources out there actually.
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  The the the Climate Psychiatry Alliance,
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  ~ the ~ the ~ child and adolescent psychiatry websites,
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  they have a lot of good information on how to work with children.
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  We also utilize ~ the Center for the Study of Traumatic Stress.
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  They have many handouts that are that are very helpful for lots
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  of different populations, one of which is children.
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  So it's it's a matter of
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  You know, helping your children to feel safe ~ and ~ you know
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  not to ~ overexpose them to things they don't need to be overexposed to.
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  ~ that's a problem that adults as well as children have.
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  And then paying attention to where they are just in terms of age appropriateness.
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  Some kids just want to know that they're gonna be okay.
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  ~ some want to know more specifics,
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  and as you get into older ages,
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  you know, teenagers, you know,
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  their peer group is probably more important to them.
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  ~ so then it's steering them to appropriate resources to find out what they want
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  to know about as opposed to you know being on some social media sites
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  or others that really aren't that helpful.
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  So it's really being mindful of the ages of your kids,
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  not overly exposing them, but to pay attention to where they are.
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  The other thing that we know about with kids is oftentimes we'll
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  see some regressive behaviors.
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  We may see some bed wetting, we may see some more difficulty with sleep,
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  etc. And again, just being aware that those things are not necessarily abnormal.
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  It it is something that happens.
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  And as we work through the process,
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  ~ usually kids get back to where they were.
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  ~ so just being, you know, a aware of how changes can happen in the midst of this.
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  keeping that open ear. You know,
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  speaking of overexposure, these days it seems like you don't have
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  to experience a disaster firsthand to feel the emotional impact.
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  We're exposed to all these images on television and social media.
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  Can simply watching some of this coverage,
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  you know, really affect our mental health?
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  Yeah, absolutely. And that's why we we oftentimes do ~ recommend that people really
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  limit exposure to, you know, the television and social media.
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  you know, on the one hand it can be very important for information,
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  but it's kind of human nature to be drawn in.
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  And so DSM has actually changed the criteria.
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  You can be diagnosed with a traumatic d you know,
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  stress disorder without actually having the person themselves
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  to experience the trauma.
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  You know, many of us look back to nine eleven and seeing the the the
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  the vision of the planes going into the towers.
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  And and so we really want to say,
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  y yes, I'm I'm curious, but I need to shut it down.
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  We need to be aware that this is not good to just be you know,
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  watching this over and over and over again because it does re-traumatize you.
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  You mentioned climate change a little bit earlier.
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  We have a a committee on that as well.
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  In you know, some people do really believe this climate change is contributing
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  to an increase in the frequency or severity of certain disasters.
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  Mm.
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  Can that uncertainty or fear create a new level of anxiety or distress in people?
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  Yeah, definitely. ~ there's certainly been an uptick ~ in that
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  in people concerned about climate.
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  ~ and you know, more than concern and some have termed it climate anxiety
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  and and some studies have said up to ten percent of the population
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  ~ can be concerned about that ~ you know,
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  to where it's actually ~ impacting their quality of life.
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  And so ~ you know, on the one hand,
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  you know, being aware of what is happening obviously is very important.
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  trying not to catastrophize is very important.
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  And actually one of the things that's most helpful in dealing with that type
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  of climate anxiety is is bonding together and doing something ~ you know that that
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  has an impact. And so if you isolate and stew,
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  ~ that is not going to be helpful.
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  If you actually bond together and move forward ~ with you know activities that
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  may make a difference.
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  That actually helps to reduce people's climate anxiety.
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  So form of advocacy, get out there and do something.
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  Absolutely. Absolutely.
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  ~
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  you we talked a little bit about that.
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  There are healthy ways to manage some of this anxiety.
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  I think people often think therapy,
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  but there are other things that people can probably do to just maybe take that
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  breath and and maybe even just go out for a walk or do something to just manage
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  a little bit of that
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  stress.
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  For sure, for sure. there is ~ I've I've dealt,
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  I've been a flood survivor myself a number of times.
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  I've worked a lot with the communities and and one of the things that came back
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  to me was ~ I used to say, you know,
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  the three R's, rest routine and relationships.
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  And that seems to have stuck with a number of people that you need
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  to get adequate rest, you need to have some ~ rituals that your family
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  or yourself can can continue to experience as a sense of normalcy.
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  Whether it's reading to your kids at night or having a you know sitting down
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  for dinner while you're busy doing these other things.
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  And and then just being aware that you need those relationships.
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  But taking a breath, ~ going out for a walk.
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  We know that nature itself is ~ despite the fact that it can be very terrifying,
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  it can also be very healing. And so ~ just being aware that you need to
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  get up and and do something different and not just sit and stew
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  ~ is really important.
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  Such important information and such important work that this committee is doing.
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  Dr. Andrew McLean, thank you so much for joining me today.
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  I really appreciate it.
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  Thanks for having me.
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  And to our listeners, you can find new and past episodes
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  of Mental Health Pathfinders on your favorite podcast platform.
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  Thanks for listening.
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  Awesome. Eleven minutes. That was perfect.
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  Just what we're looking for.