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The article is titled “People with schizophrenia were hit hard by B.C.’s deadly 2021 heat dome.” It was originally published on September 23, 2025 and is authored by Liv Yoon, Assistant Professor, School of Kinesiology, University of British Columbia and Samantha Mew, Research Assistant, School of Kinesiology, University of British Columbia.

In June 2021, British Columbia experienced an extreme climate event. A heat dome trapped hot air over the province, pushing temperatures to record highs for several days, killing more than 600 people.
A closer look at the numbers revealed something even more startling: people with schizophrenia — just one per cent of the population — made up 15.7 per cent of the deaths. This statistic underscores a troubling truth: climate change does not affect everyone equally.
Research by the BC Centre for Disease Control found that during the heat dome, people with schizophrenia had roughly three times the risk of dying compared to those without schizophrenia, more than any other chronic condition. Even before introducing housing or other critical social determinants of health, this diagnosis alone carried a much higher mortality risk.
Without targeted action, the most marginalized will continue to face the greatest risks. The heat dome revealed how schizophrenia combined with poverty, precarious and poor-quality housing, medication effects, stigma and social isolation led to a uniquely lethal risk.
As heatwaves grow more frequent and intense with climate change, public health and housing policy must shift from expecting people to cope on their own toward ensuring people are able to stay cool enough.
How schizophrenia increases heat risks
In a recent study, we interviewed 35 people with schizophrenia who lived through the 2021 heat dome for a more granular look at what it took to survive. Participants described suffering the physical effects (fainting, heat rash, exhaustion) and worsening symptoms like hallucinations, disrupted sleep and emotional distress.
Symptoms such as paranoia caused many to avoid news coverage, government warnings or even caretakers. This means many never received — or trusted — urgent alerts issued during the heat dome, and knowledge gaps were common.
For many, public cooling centres felt unsafe or unwelcoming due to previous experiences being stigmatized and feared because of their schizophrenia diagnosis. The stigma around schizophrenia also discouraged many individuals from seeking medical care or other public supports.
Homelessness or poor housing quality was another significant factor that compounded vulnerability. Many interviewees lived in older apartments without air conditioning. Others were unhoused and had to cope without shade, water or safe places to rest. For these reasons, staying cool indoors was not an option for many.
The result was a tragic overlap: people with the fewest resources to cope with extreme heat were also the least able to access help.
Why individual advice isn’t enough
Public health advice for heatwaves often focuses on individual actions: seek shade, buy a fan or check in on neighbours. While important, these messages assume equal access to information and resources — but evidence shows that many people with schizophrenia experience significant barriers to accessing them.
This way of thinking reflects a broader societal tendency to treat health as a matter of personal responsibility: that in the heat, each of us is on our own to prepare. But the disproportionate number of deaths among people with schizophrenia illustrates the flaw in this approach.
Our interviews revealed that many indeed internalized their struggles during the heat dome as personal shortcomings, when in reality, the problem was systemic: inadequate housing, limited access to care, widespread and debilitating social stigma and the lack of tailored public health strategies.
A different approach
To prevent the tragedies of 2021 from happening again, policymakers and experts need to view access to cool, safe spaces as a basic right. This means moving beyond a one-size-fits-all approach for advice, to one addressing the realities faced by those most at risk.
To be clear, this rights-based approach does not mean abandoning practical individual measures that save lives, such as opening public cooling centres or reminding people to drink water. These remain essential in the short term. But on their own, they are not enough.
To truly protect people with schizophrenia and others at high risk, these responses must unfold within a broader vision that treats access to safe temperatures as a basic right.
That means investing in affordable, climate-resilient housing and ensuring cooling centres are welcoming and accessible for all. It also means addressing stigma around mental health challenges, tailoring health advice to account for anti-psychotic medications and supporting outreach through trusted community networks.
We need both immediate interventions that provide relief during a heatwave and structural changes that address the root causes of vulnerability. Without this dual approach, responses to heatwaves will leave the same people exposed when the next extreme event arrives. Our goal should not be fewer deaths; we should aim for no deaths.
Structural solutions needed
The 2021 heat dome was tragic — more so because deaths were not inevitable. They were the result of overlapping vulnerabilities that our current housing and welfare systems fail to address. People with schizophrenia are not inherently more vulnerable to heat; they are made more vulnerable by the obstacles that shape their lives.
This means that solutions must also be structural. We need to change how we think about extreme heat; it is not just a natural hazard. It is a reflection of how social systems are failing people, especially those on the sharp edges of inequality.
Viewing cooling as a right means investing in societies that are more resilient to heat. This means governments investing in safer and more accessible housing for all, building welcoming public spaces, fostering a society where neighbours know and care for each other and allowing people with lived experience to play a central role in shaping future heat-health planning.

People with schizophrenia were hit hard by B.C.’s deadly 2021 heat dome

September 23, 2025 • My Project Name

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