From the Editor Journal of the Royal Society of Medicine; 2016, Vol. 109(10) 363 DOI: 10.1177/0141076816672596
The biggest challenge mankind has ever faced Kamran Abbasi Editor, JRSM
By the time you read this you might have experienced the hottest August since records began followed by the hottest September? The world is getting warmer, and that rise in temperature brings with it increasing risks to health. The question is why do we remain indifferent to what David King, a former chief scientific officer and now the Foreign Secretary’s special adviser on climate change, describes as the biggest challenge mankind has ever faced? The reasons, as ever, are several. Some people don’t believe the evidence. Others take the view that the consequences are too far away to bother about. Many people, I suspect, accept the evidence but don’t see an impact on their daily lives. The problem doesn’t feel real to them. Perhaps if they lived in a floodplain, or suffered food and water shortages, their view might change? Until a problem directly affects us it’s often hard to be bothered by it. In this context, for climate change read mental health. Despite all arguments emphasising the importance of providing adequate provision of care for people with mental illness, both in the UK and internationally, arrangements for managing mental illness are largely inadequate. While some success has been achieved by liaison psychiatry departments in secondary care, 90% of adults with mental health problems are supported largely or exclusively by primary care.1 Preety Das
and colleagues argue that the focus on new care models in the NHS’s General Practice Forward View is an opportunity for primary care to deliver closer integration of physical and mental healthcare. Elsewhere, for climate change you might read antidepressants. Evidence points to a link between selective serotonin reuptake inhibitors and suicidal behaviour but this has been explained away, say researchers from Denmark, as a disease symptom or as a risk confined to children.2 Their research paper in this issue examines the effect on healthy adult volunteers, and finds a doubling of harms related to suicidality and violence. Climate change might be the biggest challenge mankind has ever faced but like mental health and harms caused by antidepressants, it deserves a better solution. References 1. Das P, Naylor C and Majeed A. Bringing together physical and mental health within primary care: a new frontier for integrated care. J R Soc Med 2016; 109: 364–366. 2. Bielefeldt AØ, Danborg PB and Gøtzsche PC. Precursors to suicidality and violence on antidepressants: systematic review of trials in adult healthy volunteers. J R Soc Med 2016; 109: 381–392.
The biggest challenge mankind has ever faced Kamran Abbasi Editor, JRSM
By the time you read this you might have experienced the hottest August since records began followed by the hottest September? The world is getting warmer, and that rise in temperature brings with it increasing risks to health. The question is why do we remain indifferent to what David King, a former chief scientific officer and now the Foreign Secretary’s special adviser on climate change, describes as the biggest challenge mankind has ever faced? The reasons, as ever, are several. Some people don’t believe the evidence. Others take the view that the consequences are too far away to bother about. Many people, I suspect, accept the evidence but don’t see an impact on their daily lives. The problem doesn’t feel real to them. Perhaps if they lived in a floodplain, or suffered food and water shortages, their view might change? Until a problem directly affects us it’s often hard to be bothered by it. In this context, for climate change read mental health. Despite all arguments emphasising the importance of providing adequate provision of care for people with mental illness, both in the UK and internationally, arrangements for managing mental illness are largely inadequate. While some success has been achieved by liaison psychiatry departments in secondary care, 90% of adults with mental health problems are supported largely or exclusively by primary care.1 Preety Das
and colleagues argue that the focus on new care models in the NHS’s General Practice Forward View is an opportunity for primary care to deliver closer integration of physical and mental healthcare. Elsewhere, for climate change you might read antidepressants. Evidence points to a link between selective serotonin reuptake inhibitors and suicidal behaviour but this has been explained away, say researchers from Denmark, as a disease symptom or as a risk confined to children.2 Their research paper in this issue examines the effect on healthy adult volunteers, and finds a doubling of harms related to suicidality and violence. Climate change might be the biggest challenge mankind has ever faced but like mental health and harms caused by antidepressants, it deserves a better solution. References 1. Das P, Naylor C and Majeed A. Bringing together physical and mental health within primary care: a new frontier for integrated care. J R Soc Med 2016; 109: 364–366. 2. Bielefeldt AØ, Danborg PB and Gøtzsche PC. Precursors to suicidality and violence on antidepressants: systematic review of trials in adult healthy volunteers. J R Soc Med 2016; 109: 381–392.
