An Evaluation of the impact of Climate change-related extreme events on Mental Health in Isiolo County, Kenya

Abstract

Disaster risks posed by climate change expose uncertainties and dangers to physical environment and mental health globally. Global warming affects climate variability and extreme climate events leading to disaster risks and vulnerability to those events. The increasing disaster risks and/or impacts in Africa are caused by exposures and historical vulnerability to variability of climate. Isiolo County in Kenya is susceptible to the effects of extreme climate events and exposure to natural hazards, and the residents have limited capacity to adapt but also suffer from related mental health conditions that have not been researched with respect natural disaster risks. The overall objective of this research was to evaluate the impacts of climate change-related extreme events on mental health and develop the intervention strategies to deal with mental health in the context of a changing climate. The methods of data collection used included: data mining in published and unpublished sources; rainfall/temperature data derived from gridded 10km of sixteen satellite stations, from Kenya Meteorological Department (1984-2013); mental disorders epidemiological data (2006-2014) from the health information system, Isiolo County and in-depth observation among 60 in-patients and 121 out-patient; six focused group discussion and workshop sessions among selected sample size (N=24); key informants (N=35) and household socio-economic survey (N=288) was conducted to gather socio-economic aspects of the target population. These were utilized to gain insight and data compared to identify the linkages and existing gaps to be able mainstream mental health and extreme climate disaster risks. Generalized Pareto Distribution was used to generate mean excess for extreme temperatures and rainfall peak over thresholds (POT). Also, Palmer drought severity index used temperatures and standard precipitation index (SPI) values to estimate relative dryness. GIS methods were used to explore various properties of the climate system in Isiolo. The hazards and disasters were ranked according to the impacts and the probability of a hazardous event placed on scale 0-1; where 0 indicates no fatality and 1 fatality and socio-economic damages using IPCC risk assessment on severity of uncertainties of climate change related disasters. The quantitative data was analysed using statistical tools in Excel, SPSS version 20 while rainfall and temperature analysis was done using R software (version 3.21), ArcGIS and mental health data was ranked using criteria for Diagnostic and Statistical Manual of Mental Disorders plus International Classification of Diseases (ICD 11) diagnostic tools. The results revealed that the most common disasters risks include: drought and heat waves, strong sand storms, flash floods and floods. The duration of time, frequency and unpredictable weather variability events were above critical threshold, hence categorized as high risk, rated 1, hence fatal. Correlation analysis was done to determine the varying trajectories of sets of bivariate data and positive correlation was noted between mental disorder cases and total annual rainfall. The prevalent mental disorders included: anxiety (54%); 32% each for dissociative, sleeping, and adjustment disorders; and 39% for eating and poly-substance disorder. The mental disorder comorbidity revealed the association to disaster risks which increase mental illnesses. The study found that the prevalence rate of mental disorders was high and resilience was low. The study established that major health and non-health interventions during disasters included: provision of food and medicines (50.9% responses), support by Council of Elders (27.1% responses), restocking (10.2%) and minimal rehabilitation services (11.9% responses). The humanitarian programmes in rural areas is higher than in urban areas because the biggest risks of weather-related extremes lie in rural areas of which is expected to be pragmatic in future. The actor’s involvement to manage disaster risks in context of climate change extreme events on mental health is dismal. The model of inclusivity and integration suggests overlapping and complementary practices of preparedness, response, and recovery. An alternative and participatory Climate Change Disaster Adaptation Model was devised to strengthen institutional coordination mechanisms and monitoring to improve adaptation and resilience building approaches. The study recommends development of robust environmental health procedures to diagnose mental disorders, mapping of disasters; mental disorder epidemiology and make it user friendly to advice policy, scale up solutions and accelerate evidence informed advocacy on adaptation and resilience mental health programme strategies.