Where To From Here? The Potential for Climate Change-Related Migration: What is the State of the International Approach to the Potential Problem of Climate Change-Related Migration, and what Contribution does Hodgkinson, Anderson, Burton and Young's Proposed Climate Change Displaced Persons Convention Make to the International Approach?

Climate change may be a relatively new phenomenon, but its effects are being felt throughout the world and having a significant impact on peoples’ lives in many countries. Some of those most keenly feeling the effects live in areas that are particularly vulnerable to destabilizing factors acting in conjunction with existing challenges. The effects of climate change are an exacerbating factor in sometimes already difficult lives. In some areas, the effects of climate change are or may become such that the inhabitants contemplate migration to find a more viable life elsewhere, either in their own country or in another country. It is by no means guaranteed that the effects of climate change will inexorably lead people, such as those in low-lying small island states, to migrate outside their country, particularly if there are adequate measures taken to mitigate and adapt to the effects of climate change. However, it is becoming increasingly clear that the potential for climate change-related migration is drawing near, if it has not already arrived, as a factor for some people’s decisions to migrate internally or externally. Some work currently underway considers approaches to dealing with climate change-related migration and the possible related issues around human rights protections and practical management. Climate change is an amorphous, complex and politically challenging issue for governments and stakeholders to deal with. Its effects on peoples’ lives can be significant, especially in conjunction with existing development, environmental, and economic challenges. It is important to ensure that any approach created is necessary, in light of existing mechanisms and available resources, and that it does not disadvantage any other groups of people through its creation or functioning. This thesis considers the state of the international approach to the potential problem of climate change-related migration. One recently developed approach was a proposed Climate Change Displaced Persons Convention, which has been formulated by Hodgkinson, Burton, Anderson and Young (2010). A range of information was considered to try and find a balance between the attempt to deal with climate change as a public and foreign policy issue and the human reactions and subsequent choices people make in dealing with the effects of climate change. Due to the complications of holding a position as a public servant working in the field of responses to climate change, I decided to use a methodology that would enable me to remain a step removed from the process, to avoid influencing responses. The thesis reviews current literature and experiences on climate change and migration, particularly in the Pacific, identifies key issues, and assesses the potential effectiveness of the Convention in addressing the issues identified. Information sources included drawing on reports of first hand experience of climate change related migration and those living in the front line on the islands, experiences of working in the public and NGO sectors, and academic considerations of how to address climate change and migration

Psychological distress is highly prevalent in inflammatory bowel disease: a survey of psychological needs and attitudes

Background and Aim: Data on patient needs and access to psychological services in inflammatory bowel disease (IBD) are scarce. This study aimed to describe the levels of distress and the needs, attitudes, and access to psychological services for people within Australia against established Australian IBD Standards. Methods: An online cross-sectional survey was conducted with Australians ≥16 years old recruited via Crohn's & Colitis Australia membership, public and private clinics, and the Royal Flying Doctor Service. K10 was used to measure psychological distress. The Chi-square test was used to compare those with and without distress on key variables. Results: Overall, 731 respondents provided complete data (71.5% female, mean age 46.5 years). Overall, 50% of respondents reported distress; only 15.2% were currently seeing a mental health practitioner; only 16.1% were asked about their mental health by their IBD specialist or IBD nurse; and only 12.2% reported access to a mental health practitioner as part of their IBD service. Those with psychological distress were significantly less satisfied with their IBD care; more commonly hospitalized; had an active disease, fistula or perianal disease, pain, or fatigue; and were receiving steroids, opioids, or antidepressants (all P < 0.05). As many as 68.2% of those with severe distress were not seeing a mental health practitioner. Conclusions: The integrated biopsychosocial model of health care, with regular mental health screening and good access to mental health professionals, is requested by people living with IBD to improve their outcomes