[Stressed Systems - A Qualitative Descriptive Study of the Resilience of Québec's Health-Care Network to Heat Waves and Associated Mental Health Impacts].

Participants demonstrated clear awareness of climate change and described observable effects of heatwaves on mental health in their own experiences and those of the populations they serve.

• Study conducted with 38 individuals working with people living with mental health disorders in the community or with older adults receiving home care
• 4 patient partners also participated in semi-structured individual interviews
• Interviews took place between November 2021 and February 2022
• Study sites were two territories of an integrated health and social services center (CISSS) in Quebec particularly affected by heatwaves and urban heat islands

Current actions in the Quebec health and social services network primarily aim to reduce heat exposure to alleviate physical discomfort, with only indirect effects on mental health.

• Documented actions include access to air-conditioned spaces, ventilation of living or working environments, and regular hydration
• Few measures are currently in place to face a potential increase in mental health consultations during heatwaves
• Actions focus on physical rather than mental health impacts of heatwaves

Heatwaves are associated with distress, irritability, or violent behaviors toward oneself or others, and are linked to an increase in consultations for mental health issues during summer periods.

• These consequences occur during summer when healthcare resources are limited
• Heatwaves are becoming increasingly frequent and intense
• This situation raises questions about the capacity of the Quebec healthcare system to respond to a significant increase in mental health needs associated with climate change

Fostering intersectoral collaboration among older adults, people with mental health disorders, health and social services, and community resources was identified by participants as a key measure to better meet growing demand for mental health services during summer.

• Participants identified intersectoral collaboration as needed to address increased mental health consultation demands during heatwaves
• Increasing access to climate change training for all stakeholders was also identified as a priority measure
• Training would help stakeholders better understand the systemic nature of climate impacts and solutions to be implemented

The study used a qualitative descriptive design to document existing actions and propose measures to make the Quebec health system more resilient to growing mental health needs in the context of climate change.

• Semi-structured individual interviews were conducted with 38 workers and 4 patient partners
• Participants worked with people living with mental health disorders in the community or with older adults receiving home care
• The study was conducted in two CISSS territories in Quebec particularly affected by heatwaves and urban heat islands
• Data collection occurred between November 2021 and February 2022