Having recently returned to my home state of Pennsylvania, I was saddened by a news report from Philadelphia. A number of frail people died in the east coast’s recent heat wave, most shut into sweltering apartments, with no air conditioning or even fans, and windows closed tight. The mentally ill are at particular risk. They are often unattended and live in conditions that are far from optimal. They may overdress and inadequately attend to physical cues, such as heat or dehydration. Their life styles can predispose them to the ill effects of prolonged heat. They may shut doors and windows out of suspiciousness—sometimes delusional, but often justified. And sometimes psychiatric medicines can increase the risk of heat stroke, as my newsletter, Biological Therapies in Psychiatry, has highlighted over many years.
Recent studies also indicate that heat and humidity may be particularly dangerous for people with diabetes, whose bodies do not adjust as easily to rises in temperature. Since many psychiatric drugs are now known to increase the incidence of diabetes, this is another important caution.
So, let’s remember the chronically mentally ill—especially in the heat of summer. Can they come to an air-conditioned shelter? Can someone check on them? Do they need reminding to drink water often—ideally with ice? Small attentions may save lives.