The alarming hidden mental health dangers of heatwaves
Health dangers during heatwaves for the elderly and young are well known but specialists say another large at risk group has been overlooked.
Worldwide research, including a major study in Adelaide, shows those with mental health issues are equally vulnerable during sustained extreme heat
Those with a pre-existing psychiatric illness are up to three times more likely to die than at any other time.
Dr Tony Eliseo, an emergency specialist at the Royal Adelaide Hospital, said mental health patients prescribed antipsychotic, anti-depression or anti-anxiety medications were at significant increased risk.
"Those drugs have three or four mechanisms that can see people burning up during a heatwave including causing dehydration," Dr Eliseo said.
"They also impair the ability to sweat, increase agitation which leads to greater muscle activity and heat production and can send the body's temperature control centre haywire.
"The biggest issue of all is many of these patients cannot stop taking their drugs without other consequences making them difficult to treat."
Dr Eliseo said high recreational drug use in South Australia was an added complication in hospital admissions.
"Per capita, Adelaide is the world capital for methamphetamine use," he said.
"We also have a large number of people with mental health issues (around 20 per cent) with a significant number taking medications.
"Combine that with extreme summer heat and it's a dangerous cocktail."
The issue gained national prominence in Queensland in 2002 when mystery surrounded the deaths within a week of three middle-aged mental health patients in Townsville, all taking the same prescription drug.
Extreme heat and the inability of the patients to control their body heat and be properly hydrated as a result of the drugs they were taking was considered a factor in the deaths.
A research paper by a team from the Faculty of Health Sciences at University of Adelaide and SA Health, that gathered data over 14 years, is a leading authority on the subject.
The medical journal 'The Effect of Heatwaves on Mental Health in a Temperate Australian City' concludes that "episodes of extreme heat pose a salient risk to the health and wellbeing of the mentally ill".
The paper published in 2009 identified deaths due to schizophrenia and other delusional disorders increased by more than twice for all patients and especially for females aged 15-64.
There was a more than seven per cent increase in hospital admissions for mental health problems during Adelaide heatwaves.
Dr Eliseo said the RAH was expecting a large spike in patients to its resuscitation room for the fourth day of the record heatwave.
"The ambulance officers have been coming in absolutely dripping - they often say it's hotter in people's houses than outside which is unthinkable," he added.
"All things considered it is surprising we don't see even more heat related illness.
'I think the campaigns around the issues with the elderly and young have helped.
"That's why it's important we don't overlook those with mental illness also need additional care during the summer heat."
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