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Our Moral Obligation: The Duty to Warn... and to Act

By Dr. Lise Van Susteren
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Dr. Lise Van Susteren is an American psychiatrist in private practice in Washington, DC with a special interest in the psychological effects of climate change. She will be presenting in our fourth and final webinar of the Climate Changes Health series, entitled "Climate Changes Mental Health", coming up on June 29th. Participants will gain insights on how the conditions of climate change can impact mental health and how this presents itself in our communities. Register here.


I am a doctor. A psychiatrist. Over the years I have seen some of the darkest parts of the human condition. I have worked with individuals who “live on the ledge” emotionally. I have worked with people who fantasize about killing people, and some who have. I have listened to people recount being tortured, abused. I have evaluated the psychological states of foreign leaders who threaten world security. I have heard the details about children who have died at the hands of people who were out of their minds with drugs or illness. People have died in my arms, dropped dead at my feet.

Nothing has prepared me for what I am now seeing.

With the dawn of each day our world devolves ever more quickly towards violent disruption from climate change. We can’t put the suffering behind us, because there is only more.  And with “the fierce urgency of now” the unrelenting need to push to do more, faster, to stave off even worse climate disasters from those already predicted is ever present.

The news is coming at us from all sides: CO2 emissions climbing faster, hottest year/months spinning by, oceans increasingly depleted of oxygen, acidifying, coral reefs dying, ice sheets melting. A 10 ft. sea level rise now inevitable, animal extinction rates at a pace thousands of times higher than normal, failing nations, the massive displacement of people.

Those least responsible for the climate crisis will be hurt the most: the poor, the elderly, the disabled, the emotionally vulnerable, our children.

The psychological toll is becoming more apparent, but much more focus is needed to respond to the intensity and breadth of what is happening. Much is overlooked, including the growing numbers of “climate Cassandras” in the grip of thoughts of future harm, suffering from “pre-traumatic stress response” – a before the fact version of classic PTSD - because they know the world has not heard the warnings forcefully enough.

What can we do?

Mental health professionals help people face reality, challenge resistance, as they work to uncover the truth, because we know how great the stakes are. Living in denial can ruin a person’s life, and drag others down, too. We “get” urgency, we “get” life-long consequences. We see the anger, anxiety and depression caused by the mistakes and shortcomings of a previous generation. We know people who get marooned on these emotions and never fully emerge to lead productive lives themselves. We know about trauma from repeated exposure to horrifying events. We are trained, indeed we are ethically bound, to respond to emergencies.

How, then, do we explain that the threat to the health of the planet and the public is so excruciatingly underplayed by the very professional organizations and their members who could most be counted on to call us out for being dangerously divorced from reality?

Are we in denial ourselves?

Surely we have enough respect for science that the findings of 99% of climate experts aren’t disputed. Surely we don’t believe that destroying life on our planet is “not our problem.”

Where, then, are the journal articles, the committee reports, the mission statements, action plans, letters to the editor, presentations, the calls on Congress…that attest to the gravity of what we are hearing? Where is the collective focus that shows how to break through denial and get people to change... quickly?

Are we not the most likely people to be at the epicenter of this struggle?

Because greenhouse gases (GHG) last so long in the atmosphere and irreversible systems with feedback loops have been set in motion, “baking in” even more GHG emissions, our global public health emergency has consequences that will endure for thousands of years. Once we wise up, in contrast to other public health threats, we will not be able to regain control. Every other problem society faces pales in comparison.

Our canon of ethics says we have a duty to protect the public health and to participate in activities that contribute to it.

Mental health professionals are required in all 50 states to report child abuse. It is a legal obligation, but it is also a moral one. Is it any the less a moral obligation in the names of our children now and in the future to report that we are on track to hand over a destroyed planet, for generations to come?

Surely in this time of crisis, as truth seekers and healers, so uniquely qualified, and because we are so desperately needed, we will want to act.

What are we waiting for?


Dr. Van Susteren, along with other renowned health leaders, will be contributing to ecoAmerica's forthcoming second research report on the mental health impacts of climate change that will expand upon our “Beyond Storms and Droughts, the Psychological Impacts of Climate Change,“ recently referenced as a key resource in the USGRP’s Climate Assessment report.