Modern Challenges in Psychiatric Education: Climate Change and Forced Migration

Abstract: The rapidly changing global climate is the defining crisis of our time. Much of the world lacks resources to adapt to an increasingly hostile environment with drought, floods, and wildfires leading to insufficient water, arable land, and safe housing. The interaction of climate change and policies that limit access to resources to the wealthy elite precipitates conflict and forces millions of people around the world from their homes. Disaster displacement is altering the demographics of cities and countries, which was evidenced by a record high of 31 million people having to relocate due to climate change-induced disasters in 2020. Migrants are frequently traumatized in their country of origin, and then marginalized as immigrants, leading to severe general and mental health consequences. Consultation Liaison Psychiatrists are often on the frontlines, seeing immigrants in the general hospital. To adapt to the ever-increasing numbers of the climate displaced, CL Psychiatry training should include focused instruction on recognizing and treating mental health issues in immigrant populations. This live workshop, sponsored by the Global Health and Culture SIG, will help psychiatrists prepare for the future by providing an overview on working with displaced patients.

Stephen Nicolson will discuss the how climate change exacerbates inequalities and leads to the increased urbanization of fragile cities, contributing to further social unrest. He will also review the epidemiology of disaster displacement, using audience quizzing to underscore principal take home points.

Sanjay Yadav will discuss the psychiatric work up of a traumatized migrant patient, using his work with Bhutanese refugees to highlight language and cultural concepts. He will use role playing to facilitate the audience in gaining confidence with immigrant work.

Jose Arriola Vigo will further examine cross cultural issues and clinical considerations in working with Central and South American migrant populations. He will involve the audience in a mock interview using an interpreter to call attention to misconceptions and communication barriers.

Mary Burke will provide an overview of evidence-based therapies used at the University of California San Francisco's Trauma Recovery Center in the treatment of asylum-seekers who have experienced torture an/ or persecution, and immigrants who have experienced trauma. These will include Narrative Exposure Therapy and Exposure, Relaxation, and Rescripting Therapy. She will use the audience to help demonstrate the general technique.