Back-to-Back Climate shocks and the mental health crisis: A Texas-sized surge in depression and anxiety ER visits

Abstract

Climate change is intensifying the frequency and severity of climate-related disasters, posing significant challenges to public mental health. This study explores the relationship between successive climate events and emergency department (ED) visits for depression and anxiety in the Greater Houston area from 2019 to 2023. Combining monthly data from the Texas Syndromic Surveillance System, the National Weather Service, and the Agency for Healthcare Research and Quality, we conducted a time-series analysis to assess the impact of successive weather events on ED visits for anxiety and depression. Our random forest models reveal significant associations between weather variables and mental health-related ED visits. Specifically, time series decomposition uncovered distinct seasonal patterns, with specific periods consistently showing higher demand for mental health services. Additionally, the analysis indicates that severe weather events that restrict mobility, such as hurricanes and tropical storms, initially lead to a decrease in ED visits, followed by a surge in the following months, whereas events that do not impede travel, such as heatwaves and droughts, correlate with immediate increases in visits. Feature importance analysis indicated social factors, such as the number of households and children ≤17, along with weather variables like average temperature and total precipitation, were significant predictors of ED visits for both anxiety and depression. Access to healthcare services, including proximity to healthcare clinics and treatment centers, also played a crucial role. These observed patterns underscore the significant influence of seasonal and weather-related factors on mental health and underscore the need for targeted public health interventions that consider the timing and nature of climate events, as well as strategies to enhance community resilience and strengthen mental health support systems.

Keywords: Anxiety; Climate health; Depression; Emergency department visits; Mental health; Natural disasters; Syndromic surveillance; Utilization.