Mental heat, with Alessandro Massazza

(upbeat music) Drivers appear to honk their horns more frequently and for longer when it's really warm outside. Baseball pitches are more likely to hit batters with their pitches on hot days. More serious considerations. So for example, immigration judges seem to be less likely to ruling favour other silent seekers on warmer days. (upbeat music) (upbeat music) So it looks like 20, 25 is yet again, gonna be the hottest year ever. That is according to boffins and we just had the hottest summer ever. Maybe not here in the UK and most of my listeners are in the UK, well actually it's been relatively clement. I say relatively, there were still plenty of nights that were sweaty and claggy and they didn't like it at all. But globally, heat is a problem and climate change and heat go together very, very well. So what does it do when you are too hot to your mental health? We hear a lot about the mental health impacts of climate change here in the UK anyway, but I think often through the lens of what's often called sometimes called climate distress or climate anxiety which is the idea of climate change for eating people out. But if you have pre-existing mental conditions or are in general vulnerable, then climate change can make those worse because climate change of course factors across a load of old stuff. So what do we know about it? What do we know about how heat affects mental health? In this episode of Your Brain on Climate, we're going to be finding out all about it. I am chatting to the fabulous doctor, Alessandra Massazza or Ali to his friends and Ali to me from now on. About all of this stuff, Ali is a policy and advocacy advisor for your knighted in mental health and international NGO works on mental health policy and advocacy around the world and as an NGO, they will know that mental health isn't talked about enough in general and it's certainly not talked about enough in relation to climate change. Even physical health impacts a climate change really don't get the coverage they deserve given how vast they are. So we're going to hear all about it. We're going to hear about how people tweet angry at stuff when it's hot, how judges give out worse sentences when it's hot, all of that stuff that can of course have societal impacts and are about how the brain works. And also for the poor so to suffer from mental health conditions, how heat can affect how the drugs work, how heat can make things so much worse than they already are for people with mental health problems. And what should be done about it, not just in terms of how we talk about it, but how each of us can check in on people who really need help when it's warm. As always when you hear this noise, it denotes wisdom. That wisdom will be coming from Ali and not from me. So check in the show notes. You can find a link for more information. It means you don't have to stop and Google a thing that has been talked about. A massive thanks as always to everyone who sponsors me on Patreon. Couldn't do this show without you. I pay my guests, including Ali of course and thank you very much for enabling that. You can check in a couple of quid and join them at www.patrion.com/yourbrainonclimer. And if you're umming and areing about doing that, remember that independent podcasting, what is me is the best. There are no massive luminaries or whether they're cold or spotifies behind this. It's just Dave banging on to people and I need your help if you enjoy what I do. And if you can't or you won't do that, look, I get it, that's fine. If you could give me a review on your podcast medium of choice and write something that would be fab. - Your breath, breathe, breathe on climate, climate. (soft music) - Ali, thank you so much for coming on your brain on climate. I can't wait to get talking about something that's, you know, pretty serious, pretty contemporary, getting more contemporary. We're gonna talk about heat. And I hate, I hate, hate, hate being too hot. I hate it. Some people seem to like it. I hate it. How do you fare in the heat? - Good question. I wouldn't say that I'm empty heat or some sort of summer grinch. Like I don't start bunkering down in the AC over 25 degrees, but I would say that it probably depends on where I am. So if I'm on a beach or if I'm on a sauna, I actually quite like it. But if I'm stuck in my apartment without AC doing heat waves less so. I don't know why that my bead doesn't have to do with a kind of sense of control. The maybe limited amount of exposure to heat is it because of people's ability to get used to heat to a degree. The fact that you can sort of get some respite from it. But I think definitely the location plays a role. And together with the location, I think the timing. So I think it also really depends on when during the day I am experiencing heat. So I can actually cope quite well of, for example, working in relatively high temperatures. But I really dislike heat at night. - Right. - Feeling of waking up sort of basically imprinted in your bedsheeters, yeah, not. I really don't like that. - And I remember. - I hate it. No, I just, before we move too far away, sorry, I conduct this. Soreners, soreners is a thing. I do not with apologies for Scandinavian listeners. But what the hell is that all about? You sit in a shed and you get sweaty. I don't understand the fun. - I actually really enjoy it. And I do think that it might have to do, yes, with the fact that you obviously decide, you should heat when you decide to go to a sauna. It's limited in time. And I think one aspect that complicates the relationship between heat and mental health is that there is some literature indicating that whole body hyperthermia by which your core body temperature is kind of slightly increased over a short, repeated amounts of times can have potentially some antidepressant properties. So there was a recent randomized central study published in JAMA that looked at this specifically in people suffering from major depressive disorder. And again, found that relative to control to a sham intervention, people that were exposed to a whole body hyperthermia did see some improvements in their symptoms. So again, even though most of this conversation will probably focus on how extreme heat can usually make people's mental health worse, the relationship is a bit more complicated than that often. Right, I guess a large part of it is the ability to escape, like you said, but you know it's going to end or you've chosen to put yourself in a situation where you can go in the sea or something like that. - Exactly, exactly, exactly. - Yeah, we're going to talk about heat and mental health. And it's not really something people talk about, is it sort of an aspect of heat that I guess we could explore a bit more cause when you think about heat waves, when I think about heat waves. I think about like people actually dying because it's too hot, there's that thing like, there was it called the heat bulb, that thing, which you'd maybe say with those in a minute. But I guess also it makes you bloody miserable as well, right? So tell me more, talking more about it, my stupid simplistic take on the whole thing. I imagine it's more complicated than makes you a bit miserable. - I mean, there's definitely an aspect by which heat might impact mental health by its impact on mood. So for example, by the fact that it makes you more irritable, more miserable, but there's also a variety of mental health outcomes that are being impacted by by extreme temperature. So to give you a couple of examples, we know that people living with certain mental health conditions tend to be at higher risk of dying during heat waves. So one study from British Columbia in Canada found that in the context of the 2021 heat dome event, people living with schizophrenia were faced the biggest risk of mortality, even when controlling for other 25 chronic health conditions. At the same time, for example, we see that people with certain mental health conditions tend to be at higher risk of getting hospitalized during heat waves, both in terms of being hospitalized in terms of psychiatric hospitalizations, but also general emergency hospital care, such as A&E. So metanalysis, which is a type of study by which you bring together lots of different studies in a single analysis, was found that extreme temperatures and heat waves were associated with a nearly 10% increase in hospitalization for mental health problems. So that's another outcome that is being impacted by heat. Do we know more? Can you tell me more about? So you said people with schizophrenia were more likely to be hospitalized? Do we know what's going on there? Why that is? Yeah, that's a really good question. And I think it touches on probably one of the eras that we know to be least about in the heat in mental health space, which is what's underpinning these associations, what explains the relationship between extreme heat and poor mental health. And there's probably lots of different possible mechanisms that explains association. So one that you mentioned before might be mood. So we know that extreme temperatures tend to make people more irritable, and most of us have probably experienced that we feel just a bit more moodier when we're supposed to really hot temperatures. And there's also quite a couple of funny anecdotes and studies on this. So for example, drivers appear to honk their horns more frequently and for longer when it's really warm outside. And also more serious considerations. So for example, immigration judges seem to be less likely to rule in favor of asylum seekers on warmer days. Oh, well, so that's really interesting, right? So you might actually get decisions of significant decisions taken that people are in a worse mood and more likely to be punishing people on a hot day. Yeah, exactly. And we can imagine also, obviously, given the fact that mood and mental health are closely related, that if people are feeling generally worse in terms of their emotions and their mood, that can impact also how they might be feeling in terms of their mental health. It's specifically around people with schizophrenia. There might also be other considerations concerning psychotropic medications. So the medications that people with certain types of mental health problems might take. And we know that certain types of psychotropic medications, such as, for example, anti-psychotics, but also certain types of antidepressants, can alter the way that the body thermoregulates itself, meaning that people can be more vulnerable to heat when they're taking these medications. And for example, be more likely to experience heat-related illnesses when they're exposed to very, very warm temperatures. So that's one specific consideration that might be of relevance to people with schizophrenia. And I think another thing to consider is the kind of socioeconomic angle. So often people living with more severe mental health problems might, less likely to have access to resources that might protect them from extreme heat. So they might live in neighborhoods that might have less access to well-insulated housing. They might not be able to acquire adaptive measures such as fans or air conditionings or other tools that might allow them to fear better in extreme temperatures. Because I presume there's a correlation between people who already have mental health problems and being more likely, maybe, to live in worse housing or hot homes in the first place. Yeah, absolutely. So we know that there is quite a strong relationship between mental health problems and poverty, for example. We know that poorer people from lower socioeconomic status tend to experience worse mental health. So within any given location, we tend to see that those in the lowest incomes can be up to 1.5, just three times or likely to experience, for example, depression, anxiety, than people from the higher socioeconomic status. And at the same time, we also know that it's a vicious circle. So people experiencing poorer mental health can be much more likely than the general population to live in a state of poverty, because of, for example, stigma associated with them accessing work or just societal barriers, not allowing people to perform their best, even though they might be living with mental health problems. So is it as simple as saying that one degree higher temperature means you're going to get a certain amount more depression and anxiety reported amongst people, or is it not quite as simple as that? That's a very good question. And to a degree, at the moment, the way the mental health and heat literature has worked is that there has been lots of different ways of measuring heat. So different researchers use different definitions of heat. People define, for example, heat waves in lots of different ways. And this makes it complicated to draw generalizations around how heat might impact mental health and say, is there a specific threshold above which heat becomes dangerous for your mental health? And the reason for that is also that the way in which people respond to heat is highly dependent on a variety of different factors, both of the individual, but also the societal level. So for example, at the individual level, different people base on their age, on their demographic, might respond differently to heat. So we know, for example, that very young people, such as babies and children, and older people, tend to be particularly vulnerable to the potential health implications and mental health implications of heat, because their bodies respond differently to heat. And their ability to thermoregulate is different. At the same time, you know that, for example, people living with certain physical health conditions might respond to heat differently. And all these factors impact how a person will respond to these temperatures. We also know that heat itself is likely, there's no one such type of heat in terms of how it might impact mental health. So for example, human heat might be much more likely to have sort of negative impacts and be perceived as more uncomfortable than dry heat. So I don't know if you've come across this excellent TikTok video of a dad. It's not the heat that gets you. It's the humanity. That's actually quite true in terms of the evidence that we have. So to give you an example, there was a review that looked at the relationship between heat and suicide and found that actually humidity levels more than absolute temperatures were what was most predictive of suicide across the study. So that, I guess, gives you a sense of different environmental variables that might play a role in the heat and mental health relationship. You're talking about TikTok is interesting, actually, because something I read, and I can't remember if this is in something you said or some other reading that I did around this, was that you get stropier tweets when there's a heatwave. Like people are just more likely to post-horrible shit. Is that true? Have I heard that? Yes, it is. And actually, and that's linked to the irritability, aggression, and kind of, sort of, yeah, just people being a bit crankier when temperatures are very high. But there's also a sort of more serious angle to it, which is that every year, there's a commission called The Lancet Cow and Down on Health and Climate Change, and they publish a number of indicators detailing how climate change is impacting health. And also, what are the health co-benefits that come from climate action? And one of their indicators is a mental well-being indicator that actually uses tweets as a proxy measure of how heat is impacting what they call sentiment, which is basically sort of emotions and positive and negative emotions that are expressed on tweets. And they do find that during heatwaves, we tend to see tweets with a higher content of kind of negative sentiment increase and tweets with positive sentiment decrease when we see high temperatures. Quite a lot of them are mine, probably, sorry, everyone. As discussed, I don't like it when it's hot. And actually, I think one of the main reasons you touched on at the start there, which is sleep. Like, I cannot sleep when it's too hot. And all can anyone else, I'm not special, I'm not a snowflake, right? But is that, I've read enough about sleep, including the wonderful book, and it's called Why We Sleep by Matthew Walker, I've read enough about it to know it's like the thing that if you get enough sleep, you're doing yourself a lot of favors in all of the rest of your life, including in your mental health. So is sleep deprivation because of heatwaves? Is that one of the main things that's going on maybe for this, not just for how people are feeling, but maybe their irritability and how that manifests in their life, Jurekann? Definitely. So sleep is probably one of the mechanisms that has been explored the most in the heat and mental health literature. And we definitely see, first of all, how in certain places, nights are warming up faster, the faster rate than days. And this can have a variety of implications on sleep in terms of reducing sleep quantity. So people might struggle to fall asleep in the first place, but they might also end up waking up earlier because temperatures are rising in the morning. But also it can disrupt sleep quality itself. One interesting, huge study projected that without appropriate mitigation by 2099, extreme temperatures may erode between 50 to 58 hours of sleep per year in the global population. So we see how that is quite a significant impact on our ability to sleep. And as you said, sleep and mental health are really closely interconnected and we tend to see a bidirectional relationship whereby worse sleep can worsen mental health, but also people experiencing poor mental health often tend to experience worse sleep as a result of that. So it's a complex relationship and extreme heat can in a way fuel potentially that vicious circle. I was being struck by a couple of episodes ago, I had a conversation all about luck when we were exploring the extent to which, like your circumstances in life, big circumstances, small circumstances can make a massive difference to how much climate change affects you and how not only how worried you are about it, but kind of what the impacts of it are. And this seems like a lot of what you're saying to an extent, like more heat, the planet is warming, we are all going to be affected by that. But some people, like people who maybe have pre-existing mental health conditions and/or live in places that are warming the most are going to get this the worst, right? So it sounds like, yes, this is a problem that heat equals more mental health problems, but it's not going to affect everyone equally. - No, absolutely. As you said, I think, yeah, climate change will impact all of us, but it will do so by following pre-existing vulnerabilities within societies. And within mental health, there's a lot of talk about the social determinants of mental health and how these kind of play a really important role in determining how a person feels, thinks, and behaves in the context of their mental health. And it includes things like housing, income. And this inevitably also plays a huge role in the heat and mental health link. So if we think, for example, about green space, we know that green space can have an impact on heat, especially in cities by, for example, producing the urban heat island effects. - Massive difference, can't it? You know, you get these amazing bits of sort of infrared, whatever it is, infrared, or something. Those things that sort of show the heat difference in a identical bit of urban environment, but some of it's got trees in it and some of it hasn't. And you can be talking like many degrees difference in terms of that, you know? - Exactly. And in most places around the world, poorer neighborhoods are characterized by less green space and also types of green space, which are potentially less positively associated with mental health, such as waste lands and shrub lands rather than parks and tree cover. I think most cities that you can think about, you can relate to wealthy neighborhoods, which might often be leafy, curated, green. And if you compare these to the most deprived areas of your town, that will probably look very, very different because maintaining green space in cities can often be expensive. And only richer communities might be able to afford it. So again, here we see how your postcode in a way can play a huge role in determining how heat impacts your mental health. (upbeat music) - Your brain. - Your brain. - Your climate. (upbeat music) - So you did say to me when we were prepping for this, you did say look, I'm not an expert in kind of the mechanics of the brain and how and how heat might, what it's literally doing to the brain. So I don't expect you to have loads of stuff, but are there any things you have heard that may explain just at the brain chemistry level, when you get hot, what is going on inside your brain? - One key thing is that the heat impacts, when people are exposed to extreme heat, every organ of the body is impacted. And that also includes the brain. So some people have suggested that a potential biological and neurological mechanisms that explain the relationship between heat and mental health might have to do with how the brain reacts in the context of extreme temperatures. So on the one hand, there is kind of very direct, possible physiological impacts that extreme heat can have on the brain in terms of the brain also being able to work through the fact that blood passes through the brain at certain temperatures. And if your core body increases in the context, for example, of heat stroke, that can in turn have a variety of detrimental impacts on the way that your brain functions. And for example, in terms of the oxygenation level as well. We also see some literature pointing to neurotransmitters, such as serotonin and dopamine. And how these neurotransmitters might both be involved in our ability to thermoregulate. But also, we know that serotonin and dopamine have a huge role in mental health and have been hypothesized as playing an important role in a variety of mental health conditions from depression to schizophrenia. So these might be some of the brain angles that might impact mental health. But there is a variety of other hypotheses that had been suggested from oxidative stress, to brain inflammation, to the fact that a heat might, in some cases, impact the blood brain barrier. So lots of different possible mechanisms are the brain level that have been suggested. But there is actually quite little robust research in humans testing these mechanisms specifically. It affects my thoughts about my future almost every day, where I wonder whether even my biggest desired career is doing enough for the planet. I feel that I have to do more and get there earlier just so I can experience the dream life that I want for myself, because I don't believe I have enough time due to climate change. When people saw the title of this episode, and maybe even as we started talking about it, I think a lot of people might have thought we would be taking a slightly different angle on mental health, which is the stuff that in my work shows up a lot, which is young people in Britain, for example, reporting climate anxiety, that they are stressed out and scared of climate change itself. And the impact that that is having on their mental health is a stat from some of my day job stuff that are like a quarter of people when we ask them in the UK, say that the idea of climate change is impacting their both physical but also their mental well-being. I'm interested in what you think about-- let's call it climate anxiety for the purpose of this conversation or climate distress or whatever you want to call it. Whether, firstly, how real is it? Is it something that you think is a significant factor? But also, does that bit of it get too much coverage given all the other impacts of climate change on mental health we've just been talking about? Great question. And I agree. I think it has now become impossible to speak about climate change and mental health without people thinking about climate anxiety, even in my personal life, whenever I tell people what they do for a job, they immediately go to climate anxiety as the thing that they think about when they think about climate change and mental health. I think the interesting thing about climate anxiety is that even though we, as you say, have seen a huge surge in interest in this construct, in research but also in the media, there's actually very little agreement about how to best define it as a term. Broadly speaking, we tend to refer to climate anxiety as distress as it pertains to climate change. And also, while traditionally it has, as you say, been used to refer to the worry about the prospect of future climate change, we're actually also seeing it increasingly used more to refer to any type of distress relating to climate change. I think an important thing to highlight in the context of climate anxiety is that at the moment, climate anxiety is not recognized as a clinical mental health condition. So, for example, the diagnostic and statistical of mental disorders or the international classification of diseases, do not identify climate anxiety as a disorder such as generalized anxiety disorder or social anxiety disorder. On the contrary, the idea is that in most cases, climate anxiety is likely to be an adaptive reaction to climate change. And indeed, some studies seem to have found that climate anxiety can be associated in some people with more pro-environmental behaviors. This is not to dismiss the psychological suffering of people around the world. I think the fact that something is not a psychiatric disorder or is not always maladaptive doesn't mean that the pain is not real or worthy to be listened to. And indeed, we know that actually for a subset of people, their climate distress might make them experience significant levels of psychological distress and may impact their functioning. We also actually still know very little about how climate distress might interact with mental health problems, such as whether people with certain mental health conditions, such as generalized anxiety disorder may be more likely to experience climate distress or whether experiencing climate distress can worsen and act as a stressor for mental health and people with pre-existing mental health problems. But to your point about whether it's taking up too much coverage, I do think that in the media, definitely, climate anxiety takes up a disproportionate amount of attention. When compared, I think to all the other mental health outcomes that are being impacted by climate change. So we've spoken about mortality among people with mental health problems. We've spoken about people more likely to access hospital care. We've spoken about suicide and suicidal behaviors. And these often get a lot less attention than climate anxiety. And I think there is a bit of a risk in seeing climate change in mental health only through the lens of climate anxiety, as I think it potentially risks kind of obscuring other ears of mental health that have historically received also a lot less attention in general. Mental health, in general, doesn't really get enough coverage or funding. Does it? Like not to do a climate change, but just in our society, there's still taboos around it. I think we're getting better as a society. I think a lot of politicians have done well at raising the stakes of it. But we have a long way to go, I think, until mental health and people's both pre-existing conditions. But the impact of society on mental health is understood, talked about, normalized, would you agree? Absolutely. Climate change is obviously not happening in a vacuum. But in the context of a global mental health system that is already experiencing significant challenges, we know that nearly a billion people around the world live with a diagnosable mental disorders. But most people with mental health conditions do not have access to effective cares either because services and supports are not available, because workforce lacks capacity. The services cannot be accessed or are affordable because of stigma that stops people from seeking help. We know, for example, that in some countries, especially low-middle-income countries, the treatment gap for severe mental health conditions can be up to a staggering 90%. And coverage here for certain mental health conditions, such as psychosis worldwide, is estimated to be as low as 29%. So as you say, there is also a financing angle. And all over the world, mental health care receives just a tiny fraction of health budget. So the average expenditure for mental health within health budget tends to be 2.1%, which is really little. Especially if you think that most of it is spent on big psychiatric hospitals, which really provide the care that people need. So absolutely, I completely agree. And then I suppose the other thing that really I don't know if it is thought of enough, and maybe this will change, is the intertwining of climate change and health. So I think climate change, if you listen to how governments talk about climate change, you'll hear that they often talk about economic benefits or economic threats. And they'll talk about jobs and growth. And the risk to businesses and all that sort of stuff. Or of course, you hear about it from a moral point of view, or a nature point of view. But I think it's rarer to hear about climate change as a national and global health crisis. But am I just not reading the right stuff? I think that's correct. I think until recently, the link between climate change and health more broadly was absent. I think that is starting to change. So for example, at last year's COP, COP 28, we saw for the first time ever a health day being held in the context of the UN negotiations. And a substantial number of ministries of health attending COP for the first time. And we know that COP 29, in Baku, Azerbaijan coming up, we're also going to see a health day happening. So I think we are slowly seeing changes at the policy level in terms of the amount of attention that health is receiving. And I think this is particularly interesting because highlighting the health consequences, both physical and mental health consequences of climate change, can be a really powerful tool to show the human face of climate change. I heard a previous speaker on your podcast referred to climate change as this abstract hyper object which people struggle to grapple with conceptually. And I think a health framing really helps with this to show that actions towards mitigating climate change are not only measured in terms of degrees of temperature, but also in terms of human's lives that are being saved. And I think it also highlights, like we were saying before, that nobody is really immune to climate change. And while some of those will be more effective than others, climate change is already impacting us in a very personal way by impacting virtually every aspect of how our bodies function. (upbeat music) I think another angle that is quite powerful in the health framing is that often health professionals are trusted voices within their communities and so they can play a really crucial role in highlighting the importance of mitigating climate change to avert its health consequences. And there is evidence to back up these claims where recent study looked at how the different types of framing climate change can impact the willingness of people to support climate action. And the study found that framing climate change in a way that highlights is health implication, but also it's health co-benefits coming from climate action can actually make people more likely to support climate policies. So it can have a really impactful result on the way people approach climate change and climate policies. And do we think that's because we all know what it's like to have ill health, we can all relate to it in a way that maybe some of the more abstract, distant stories about climate change are a bit hard to get your head around. - I think so. I think there is something powerful about highlighting how climate change that might fuel us a very abstract and far away construct impacts the very way our body reacts and the way, for example, we might feel a thing and how, in a way, climate change really materially gets under our skin. And I think that's something that we're all, in a way, concerned about. But also moving away from this sort of gloom and doom perspective, it's also about highlighting the huge co-benefits for health that come from climate action. We know that one billion people are still served, for example, by healthcare facilities without reliable energy. And a transition to renewables could really power high quality health supportive systems. We know that air quality is a huge source of mortality globally and reducing the burden of fossil fuels could help avoid a large proportion of these deaths. Again, another example is transport. Inactivity and physical inactivity is a huge source of morbidity in our populations and moving where possible to more active modes of transport could have, again, huge benefits for our health. It's also about looking at the virtual cycle that can be initiated by climate action in terms of co-benefits for health. No, you are. Yeah, get on your bike. Get on your bike because you're saving the planet and also it's good for you, right? That's what co-benefit is. So listen, apart from properly funding mental healthcare globally and sorting out climate change to rather large problems, oh, and correcting health inequality so that people who mostly healthcare get it, that's another one. So apart from three massive interlapping challenges, oh, and four, which is making sure we can all connect to all of this in sort of storytelling and stuff. So apart from all of that, very big stuff, is there anything quicker that you or people that you know are calling to be done? Is this all about systemic stuff? Or are there quicker fixes that could be had? I mean, as you say, that the most effective solution is obviously to ensure a full phase out of a fossil fuel is in commitment to new fossil fuel infrastructure to reduce the emissions in line with the Paris Agreement. But there are also a number of more practical and immediate considerations that governments and relevant stakeholders can take to protect and address mental health in the contestant climate change. So to give you some examples, at the policy levels, we know that mental health tends to be one of the least included health outcomes in climate policies. So only 5% of national adaptation plans, which are what countries develop to show how they're adapting to climate change that is happening now or in the future, only 5% of these plans include references to actions to address mental health and psychosocial wellbeing. Similarly, only 3% of nationally determined contributions, which are the so-called climate promises that countries make to align with the Paris Agreement, only 3% of these include a reference to mental health. And that's a really low number when you compare it to the 28% of these documents that include a reference, for example, to vector-borne diseases. So countries must do better to ensure that physical and mental health are included in these and other relevant policies, such as disastrous reduction policies, cleaner policies by diversity policies, and so on. So there's like a profile raising job more like first and foremost, like kind of start talking about it, start understanding it and, you know, factor in both to the case you're making, but also I guess it must help with, you know, thinking about how you fund this stuff, because a lot of climate action, you know, is it actually delivers what you were talking about a minute ago, benefits right across everything, you know? And actually, if climate action could also be helping with your mental health policies, as well as your physical health policies and your transport policies and all of that, it might be a good thing to start raising mental health and other things up the agenda a bit. Absolutely. And we are seeing increased levels of financing being directed towards climate and health. Even though to date, that is still hopefully inadequate. So we see that only 0.5% of multilateral kind of for climate funding is devoted to health. But again, we're seeing some changes. So a COP28, we saw an announcement of $1 billion being committed to climate and health, which is a huge step forward in terms of increasing and raising the profile, as you're saying, of this topic. But it's really imperative that mental health is integrated within these discussions, as we've mentioned before, at the moment, there's a huge financing gap in terms of what mental health receives financially. One other practical kind of solution is also about the integration of mental health considerations in heat adaptation policies. So again, to date, we don't really see mental health considerations being included within these policy mechanisms. But there are some good examples that we can point to. So the Southern Australian heat warning system includes a reference to mental health and it mandates that people with mental health problems are contacted by phone to alert them of a heat wave that is going to happen. And if there is no reply, a home visit is scheduled to check on them and on their well-being. So I think there are examples from other parts of the world that could be integrated within heat adaptation policies. And I guess just sort of what we can all do level, right? If you know somebody who suffers from mental health and there's a heat wave going in, check in on them. Right? Absolutely. And I think specifically in the context of extreme heat, the climate psychiatry alliance has developed some really excellent resources on how to safeguard your mental health and well-being during extreme heat. And these resources have various practical suggestions for people living with mental health problems, as well as their caregivers and health professionals on how to protect mental health in the context of extreme heat. And some of these suggestions include, as you've mentioned, asking maybe a neighbor to check on you a couple of times a day. But also being able to find cool shelterers such as a library and not waiting inside your house alone if your house gets too warm, as many heat related deaths happen in people's homes when they're alone, trying to keep taking your medications as prescribed, but maybe discussed before the heat wave, whether your medication may require any changes during hot weather with your health provider and other very practical things like wearing loose cotton clothing or cooling down wool cool showers and maintaining cross-euroventilation in rooms are some of the things that people can do to safeguard themselves. [Music] Thank you very much for listening. Thank you, Alif, for coming on. That was one of the heavier episodes of your brain on climate. So, I hope you learned something. I hope you're doing all right. Do check out the resources that Alie mentioned. And talk to people if you're not sure, particularly if you know people with mental health trouble and it's warm, do check in on them. I think that's quite a nice and important thing to do. What else has been going on? I thought I'd say a few things about stuff I've been reading or seeing in case you're interested. I'm just finishing off the amazing determined by Robert Sapolsky. It was a book I think was mentioned in our episode back on luck a few episodes ago. All about free will and whether it exists and if it doesn't exist, what the implications are for how we should think about other people and society. It's fascinating, provocative stuff. One of those hyper objects in a way that is quite hard to get your head around. But I really recommend determined by Robert Sapolsky and I'm not being sponsored by it, although Robert, you know where I am. And then just something I saw in passing, I'd love to dig into this a bit more. I saw a thing in the times a couple of days ago saying that people who vote conservative are more likely to have a higher fear response. A slightly bigger amygdala, the bit of the brain that deals with fear. Only a little bit bigger, like a sesame seed bigger, but bigger nonetheless. And that was a study that was reported just last week. I know nothing about the veracity of that study. I think it's likely to be one of those complicated things. And I don't think it means that you can just write off anyone on the right of politics as scared. However, there's something very interesting in that. So yeah, I'll put a link in the show notes to that. You can have a listen or a lucky order if you want to do. Right, that's me. I'm off. I will be back soon. Until then, do check out the back catalogue if this has intrigued and interested you. And I will be back soon for more of this stuff. Check me some quids on the Patreon, give me a review. You know what to do. Email me, hello, at yourbrainonclimate.com. Okay, I'm going to go away. Thank you very much. Bye. Is it still okay to fly? 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