Communities Are Medicine

Are you frightened by what the hotter global temperatures mean for you and your family? Do you know someone who’s life has been turned upside down by the impacts of a surprising windstorm, flood, or wildfire? Do you feel stressed much of the time by what is happening in society? If so, my new Psychology Today blog will offer ways to respond constructively to these challenges.

The central theme is that, without rapid monumental changes, a disrupted global climate system will increasingly alter every aspect of human civilization. In different times, ways, and magnitudes, the impacts are almost certain to severely stress or traumatize nearly everyone and activate profoundly harmful personal and social reactions.

To prevent the traumas, and heal those that occur, we must swiftly expand how mental health and psychosocial struggles are addressed by engaging communities in using a public health approach to build population-level mental wellness and resilience for relentless stresses and adversities.

The information I will share is the outcome of an extensive 2-plus year research project completed by my organization, the International Transformational Resilience Coalition (ITRC), translated into approaches that can prevent and heal widespread mental health and psychosocial struggles resulting from unremitting climate hardships.

We determined that, although they are very important, the number of mental health professionals is nowhere close to the total needed to minimize the mental health epidemics seen today in the US, Britain, and other nations, and there will never be enough to prevent or heal the pervasive mental health struggles generated by the climate catastrophe. In addition, mental health services primarily assist individuals after they experience symptoms. They do not proactively prevent problems from emerging.

This led us to conclude that the responsibility for preventing and healing climate-generated (and other) distresses and traumas must be returned to neighborhoods and communities, where it existed for most of human history and has the greatest possibility of success. Communities can be medicine.

Some background: For well over a century we have known that the human-caused emission of carbon dioxide and other greenhouse gasses will heat up the planet. But fossil fuel and other industries, as well as politicians, have delayed action, so—as predicted—global temperatures are now rising to very dangerous levels. Even if emissions are swiftly slashed, more dangerous heating is certain.

Hotter temperatures add to, and are accelerated by, the degradation of forests, soils, waterways, the oceans, and other ecological systems. These factors are also contributing to the extinction of biodiversity worldwide. Technically speaking, we are facing a global climate-ecosystem-biodiversity (C-E-B) catastrophe, not just an atmospheric climate problem.

I use the term “catastrophe” here not to sensationalize the issue, but to describe it in terms often used in disaster sociology.

In this vernacular, emergencies are typically defined as a sudden, urgent, and dangerous event that requires immediate action to limit its length and consequences.

Disasters involve multiple factors that have larger and longer lasting impacts and require far more resources and time to resolve than emergencies. But both are considered events that eventually end and give people time to recover.

In contrast, a catastrophe is considered to have numerous interacting impacts that build on themselves and produce surprising, persistent, and pervasive social consequences. Because the impacts roll out over long time periods, people often struggle to obtain the safe stable conditions needed to recover.

Accordingly, you do not plan for or try to manage a catastrophe in the same way you do emergencies and disasters, because the causes and impacts are far more complicated, severe, widespread, and long-standing.

Mental health and human services professionals in the US and other nations are, at best, preparing to treat people after they are traumatized by single-event disasters that end and give them time to recover. This is deeply flawed thinking because the interactive stresses and traumas generated by the C-E-B catastrophe will accelerate for decades.

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The most pervasive impacts of the C-E-B catastrophe are already, and will increasingly be, cascading disruptions to the ecological, social, and economic systems people rely on for food, water, shelter, jobs, incomes, health and healthcare, safety, and other basic needs. Over time, these disturbances are almost certain to significantly stress everyone.

The compounding disruptions will sometimes be activated by, and other times be worsened by, more frequent, extreme, and prolonged wind, snow, and rainstorms, floods, droughts, heatwaves, wildfires, hazardous smoke events, ocean storm surges, and other ecological disasters. These events can traumatize 5 to 60 percent of the people directly impacted. When the ecological disasters activate or are combined with human-caused disasters, such as mass violence, 25–75 percent of those directly affected can be traumatized. Both types of events can produce something similar to secondary trauma in people who know someone who is impacted or watch the events from afar.

The combination of increasing disruptions to the systems humans rely on for basic needs and acute disasters will generate wide-ranging individual traumas that produce mental health problems such as severe anxiety, depression, Post Traumatic Stress Disorders (PTSD), and increased suicidality.

Less understood is that the impacts are also very likely to produce pervasive community traumas and societal (or collective) traumas that undermine the social fabric that binds people together and can lead to pervasive hopelessness.

Mental health professionals have mostly focused on individual traumas. However, community and societal traumas are just as important to address when it comes to the C-E-B- catastrophe.

The different traumas are likely to cause millions of people to adopt coping mechanisms intended to dull their pain that end up harming them and others, such as misusing drugs or alcohol. Many people are also likely to turn their distress outward and become aggressive or violent toward their families or outsiders.

If these dysfunctional reactions accelerate, they will progressively undermine the health, safety, and well-being of people far and wide. The fear-based survival reactions they generate will also cause many people to retreat into a self-protective survival mode that leads them to oppose anything deemed threatening. This will make it even more difficult to adopt the changes in policies and practices needed to minimize the C-E-B catastrophe.

Our research found that the most effective way to prevent and heal this type of overwhelming suffering is to use a public health approach in communities to build population-level mental wellness and what I call “transformational resilience.” What does this involve?

Just like all public health approaches, it focuses on the entire population, not merely on individuals with symptoms of pathology or groups deemed to be high-risk. By using variations of proportionate universalism and life-course approaches, everyone can be fully included. We must think and respond through a population lens, not an individual one. Our mantra must be “leave no one behind.”

A public health approach to mental wellness and transformational resilience also prioritizes preventing social, psychological, and emotional suffering before it emerges, not merely treating it after it appears, and it integrates group and community-minded healing methods into the prevention strategies. We must always remember that “prevention is the cure.”

This is accomplished by strengthening “protective factors” –social supports, local resources, individual and collective resilience skills, and more—that build and sustain healthy thinking and behaviors. When those factors also empower people to use painful experiences as catalysts to join with others to build socially, economically, and ecologically healthy, just, and regenerative conditions, they often find new meaning, purpose, and hope in life.

This is what I call transformational resilience. It can mobilize the indomitable spirit and fierce determination inherent in most humans to make what previously seemed impossible become reality. To achieve this we must “enhance strengths, resources, learning, and growth.”

Ample research shows that mental wellness and transformational resilience can be enhanced.

Our investigation found that the most effective way to do this is to establish the horizontal social infrastructure in communities—which can be called a Resilience Coordinating Network (RCN)—that engages local neighborhood leaders, civic groups, non-profit, private, and public organizations in planning and implementing strategies that, in their own unique ways, strengthen the capacity of all residents for mental wellness and transformational resilience.

We identified five foundation areas these community initiatives need to focus on for the C-E-B catastrophe:

• Organize both “strong” and “weak” social connections throughout the community
• Actively engage residents in making a “just transition” by creating healthy, equitable, low/zero emission, and climate-resilient local physical, economic, and ecological conditions
• Build universal literacy about mental wellness and resilience by helping everyone become trauma and resilience-informed
• Continually involve residents in activities that enhance mental wellness and resilience during adversities, such as laughing often and practicing forgiveness
• Establish ongoing group- and community-minded opportunities for residents to heal their traumas, such as healing circles

Numerous community-based initiatives in the US and other nations are engaged in one or more of these foundational focuses.

By organizing a Resilience Coordinating Network in communities everywhere that use a public health approach to build population-level mental wellness and transformational resilience, the concerns listed at the start of this article, and many others, can be addressed. In doing so, we will find that community is the medicine needed for the challenges speeding our way due to the C-E-B catastrophe.