美国国家公共电台 NPR How High Heat Can Impact Mental Health（在线收听）

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A new investigation shows that low-income neighborhoods are hotter than wealthier ones in dozens of big cities across the country. This investigation is from NPR and the University of Maryland's Howard Center for Investigative Journalism. And it shows that the heat impacts physical health but also that it might have an effect on mental health. Here's NPR's Nora Eckert.

NORA ECKERT, BYLINE: In Jeanetta Churchill's Baltimore row house, the air conditioning is blasting. She relied on it more than usual when a blistering heat wave swept through Baltimore this summer.

JEANETTA CHURCHILL: I don't even want to see what my power bill is this coming month.

ECKERT: But keeping cool isn't just a matter of comfort for her. It's a way to manage her bipolar disorder.

CHURCHILL: Heat is a challenge for me when it comes to my mental health. When I get too hot, it's hard for me to sleep, and when I don't get enough sleep, that can trip me over into mania.

ECKERT: There are a few signs she's entering a manic episode - rapid speech, irrational purchases or bouts of anger. Sometimes, her episodes spiral more seriously.

CHURCHILL: I have at times had suicidal ideation - not attempt but just my mind was racing so fast, it was out of control.

ECKERT: Heat can be a stressor for most people, but Ken Duckworth, medical director for the National Alliance on Mental Illness, says people with severe mental illnesses are hit harder than most.

KEN DUCKWORTH: In the summertime, heat waves are a risk for people with serious mental illnesses like schizophrenia, schizoaffective disorder and bipolar.

ECKERT: One of the main reasons is medication. Drugs used to manage severe mental illnesses can have dangerous side effects in the heat, like dehydration or heat stroke.

DUCKWORTH: They reduce your body's ability to modulate temperature.

ECKERT: For Andrea Landry-Brown, these side effects hit hard. When she was living in California, on one particularly hot summer day, she says it got up to 110 degrees. She was driving with her kids in the backseat when she started hallucinating.

ANDREA LANDRY-BROWN: I'm driving down the street, and I literally saw people walking in front of my car.

ECKERT: It was a side effect of the medications she took for PTSD, anxiety and bipolar disorder. She'd been sensitive to medications in the past, but she thinks the heat sent her over the edge.

LANDRY-BROWN: The heat would just make it worse. Whatever the side effects were, it was just that much worse.

ECKERT: NPR and the University of Maryland's Howard Center looked at connections between heat and health in Baltimore. The Howard Center analyzed emergency response data from the summer of 2018 and found that calls for psychiatric conditions increased by nearly 40% when the heat index spiked over 103.

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ECKERT: Baltimore Crisis Response, Inc. receives hundreds of calls every day.

UNIDENTIFIED PERSON: Any psychotic symptoms? Are you currently hallucinating, hearing voices?

ECKERT: Their founding executive director, Edgar Wiggins, says although many of their patients experience mental illness, that's usually not the only health condition they're dealing with.

EDGAR WIGGINS: If you've got a chronic behavioral health condition, chances are you're not taking care of or managing your diabetes or your hypertension. So if you want to add to that temperatures of over 100 degrees with this vulnerable population, it really puts them at risk.

ECKERT: Wiggins says 3 out of 4 of their mental health patients also abuse substances. And according to the Howard Center, calls relating to substance abuse more than doubled in extreme heat. Dr. Duckworth from the National Alliance on Mental Illness says the risks of heat are only getting more urgent.

DUCKWORTH: These are risks that you need to be mindful of as you contend with, you know, what is likely to be an increasing run of extremely hot days.

ECKERT: And while climate change wasn't a big part of his training in medical school, he says it's impossible for the field to ignore now. Nora Eckert, NPR News.