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High temperatures are not only a strain on the body; they can be mentally stressful as well. So hot weather can be particularly problematic for people with a mental health condition.
“On hot days people are less alert and productive, mental illness symptoms worsen, and admissions to psychiatric hospitals increase,” says Dr Andrea Benecke, president of Germany’s Federal Chamber of Psychotherapists (BPtK). “The mentally ill are among those at greatest risk.”
At especially high risk, according to the BPtK, are people with an addictive disorder, schizophrenia, dementia, depression, and those who take certain psychotropic drugs such as neuroleptics, antidepressants, anticholinergics or sedatives.
Hot weather is associated with elevated suicide rates. It diminishes cognitive performance, increasing the likelihood of impulsive, risky and aggressive behaviour.

According to the BPtK, heat becomes dangerous for the mentally ill when the apparent temperature – a combination of air temperature, relative humidity and wind speed – is over 30 degrees Celsius (86 degrees Fahrenheit) in the daytime and does not drop below 20 Celsius at night.
In Hong Kong, very hot weather warnings are becoming more regular, as they are in many cities around the world.

An apparent temperature of 32 degrees in the early afternoon results in strong heat stress, and above 38 degrees means very strong heat stress. Excessive heat can trigger a psychiatric emergency and serious physical reactions that require immediate medical attention.
Persistently high temperatures are especially taxing on the body and mind, says the BPtK – which defines a heatwave as temperatures exceeding 28 degrees for more than three consecutive days.
Certain medications can adversely affect the body’s ability to maintain a healthy core temperature, and hot weather can alter the effects of medications, for example by reducing their potency or intensifying their side effects.
It’s imperative that the mentally ill be protected from the effects of high temperatures
Eva-Maria Schweitzer-Köhn, president of the Berlin Chamber of Psychotherapists
The BPtK advises those suffering from a mental illness to protect themselves from the heat by staying in the shade, drinking sufficient fluids and avoiding physical exertion.
Consumption of alcohol and drugs and vigorous exercise increase the risk of dehydration and hyperthermia, and so should be avoided on hot days, the BPtK says. Those who want to be active regardless should find a cool, shady place and drink plenty of water.
It is also important that those who take medication to speak with a doctor about what they need be mindful of on hot days, and whether an altered dosage is advisable. They should also consult a psychotherapist about where to turn for help in the event of a psychiatric emergency.

This advice can be useful for the family members and friends of people with mental health issues too, says Eva-Maria Schweitzer-Köhn, president of the Berlin Chamber of Psychotherapists.
“It’s imperative that the mentally ill be protected from the effects of high temperatures,” she says, “since their condition often renders them insufficiently capable of protecting themselves.”
If you have suicidal thoughts or know someone who is experiencing them, help is available. In Hong Kong, dial +852 2896 0000 for The Samaritans or +852 2382 0000 for Suicide Prevention Services.
In the US, call or text 988 or chat at 988lifeline.org for the 988 Suicide & Crisis Lifeline. For a list of other nations’ helplines, see this page.
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