L E T T E R T O T H E E D I T O R
An update to “ Care for the seafarers: A review of mental health in Austronesia, ” with specific recommendation to address climate change
Dear Editor,
Mindful that continent-based regional reviews of mental health do not fully describe ethnocultural groups that are widely dispersed across multiple continents, we previously reviewed mental health in the world region populated by Austronesian language speakers and mostly inclusive of islands and coastal areas in the Pacific and Indian Oceans and Southeast Asia (Guerrero, Fung, Suaalii-Sauni, & Wiguna, 2013). We recommended culturally relevant and integrative mental healthcare delivery models to address acculturative stressors and related barriers to care; universal health and mental healthcare to miti- gate the effects of poverty and socioeconomic challenges in accessing care; and video-teleconferencing technology to improve connectivity and increase access to services and education in the context of geo- graphic isolation.
It has become more apparent that this region of the world is exquisitely impacted by climate change. Small Pacific Island countries urgently face multiple health impacts of elevated temperature, altered rainfall, and more severe extreme weather events (e.g., tropical storms), ocean acidification, and rising sea levels (McIver, Bowen, Hanna, & Iddings, 2015). Climate change exacerbates poverty, over- crowding, poor sanitation, and scarcity of fresh water and hastens the displacement of people from their homelands (Weiss, 2015). Climate- related health adversities are not just limited to islands, as heavily populated mainland Southeast Asia is also vulnerable to extreme weather events, undernutrition, infectious diseases, and premature death (Bowen & Ebi, 2017).
We wholly agree with Coverdale et al. (2018) that climate change is an urgent priority for psychiatry, given these multiple health and social adversities and its potential to increase anxiety and distress and exacerbate cultural trauma. We further believe that climate change is an especially urgent priority in addressing mental health in Austrone- sia, and we wish to update our previous recommendations to explicitly include carbon footprint reduction, support for resource-sustaining indigenous practices, and care for climate change-affected populations.
Anthony P.S. Guerrero MD1 Daniel Fung MD2,3 Tamasailau Suaalii-Sauni PhD4 Tjhin Wiguna MD5
1John A. Burns School of Medicine, University of Hawai'i at Manoa, Honolulu, HI, USA
2Yong Loo Lin Medical School and Duke NUS Graduate Medical School, National University of Singapore, Singapore
3Institute of Mental Health, Singapore
4Department of Criminology, University of Auckland, Auckland, New Zealand
5Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of Indonesia, Jakarta, Indonesia
Correspondence Anthony P.S. Guerrero, MD, John A. Burns School of Medicine, University of Hawai'i at Manoa, 1356 Lusitana Street, 4th floor, Honolulu, HI 96813, USA.
Email: [email protected]
O R C I D
Anthony P.S. Guerrero https://orcid.org/0000-0002-2496-4934
R E F E R E N C E S
Bowen, K. J., & Ebi, K. L. (2017). Health risks of climate change in the World Health Organization South-East Asia region.WHO South-East Asia Journal of Public Health,6(2), 3–8. https://doi.org/10.4103/2224- 3151.213789
Coverdale, J., Balon, R., Beresin, E. V., Brenner, A. M., Guerrero, A. P., Louie, A. K., & Roberts, L. W. (2018). Climate change: A call to action for the psychiatric profession.Academic Psychiatry,42(3), 317–323.
https://doi.org/10.1007/s40596-018-0885-7
Guerrero, A. P., Fung, D., Suaalii-Sauni, T., & Wiguna, T. (2013). Care for the seafarers: A review of mental health in Austronesia.Asia-Pacific Psychiatry,5(3), 119–140.
McIver, L., Bowen, K., Hanna, E., & Iddings, S. (2015). A‘Healthy Islands’ framework for climate change in the Pacific.Health Promotion Interna- tional,32(3), 549–557.
Weiss, K. R. (2015). Before we drown we may die of thirst.Nature News, 526(7575), 624–627.
Received: 22 September 2019 Accepted: 9 November 2019 DOI: 10.1111/appy.12375
Asia-Pacific Psychiatry.2019;e12375. wileyonlinelibrary.com/journal/appy © 2019 John Wiley & Sons Australia, Ltd 1 of 1 https://doi.org/10.1111/appy.12375
