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Droughts are often long-lasting phenomena, without a distinct start or end and with impacts cascading across sectors and systems, creating long-term legacies. Nevertheless, our current perceptions and management of droughts and their impacts are often event-based, which can limit the effective assessment of drought risks and reduction of drought impacts. Here, we advocate for changing this perspective and viewing drought as a hydrological–ecological–social continuum. We take a systems theory perspective and focus on how “memory” causes feedback and interactions between parts of the interconnected systems at different timescales. We first discuss the characteristics of the drought continuum with a focus on the hydrological, ecological, and social systems separately, and then we study the system of systems. Our analysis is based on a review of the literature and a study of five cases: Chile, the Colorado River basin in the USA, northeast Brazil, Kenya, and the Rhine River basin in northwest Europe. We find that the memories of past dry and wet periods, carried by both bio-physical (e.g. groundwater, vegetation) and social systems (e.g. people, governance), influence how future drought risk manifests. We identify four archetypes of drought dynamics: impact and recovery, slow resilience building, gradual collapse, and high resilience–big shock. The interactions between the hydrological, ecological, and social systems result in systems shifting between these types, which plays out differently in the five case studies. We call for more research on drought preconditions and recovery in different systems, on dynamics cascading between systems and triggering system changes, and on dynamic vulnerability and maladaptation. Additionally, we advocate for more continuous monitoring of drought hazards and impacts, modelling tools that better incorporate memories and adaptation responses, and management strategies that increase societal and institutional memory. This will help us to better deal with the complex hydrological–ecological–social drought continuum and identify effective pathways to adaptation and mitigation.

Objectives: The aims of this study were to explore the knowledge of EMS physicians (EMSPs) on the legal aspects related to the management of prehospital psychiatric emergencies, assess their degree of comfort, and measure their perceived communication skills., Methods: A survey was distributed to the 376 EMSPs working in the prehospital setting in Lombardy, Italy. Knowledge of medico-legal aspects was measured through multiple-choice questions; the Comfort Score (CS) and perceived Communication Skills Score (CSS) were calculated using Likert Scale questions. CS ranged from 11 points (lowest) to 44 (highest); CSS ranged from 8 points (lowest) to 32 (highest)., Results: A total of 272 EMSPs answered the survey (RR= 72.3%); 45.2% were women. Mean age was 45.76 years (SD 8.8). Mean percentage of correct knowledge test answers was 52.4 (SD 12.3); 81.3% believed to have little knowledge of the Italian legislation regarding this topic. Mean CS was 29.3 (SD 5.5); mean CSS was 19.1 (SD 3.9). A higher percentage of correct answers in the knowledge test was associated with lower CS (P = 0.019). Higher self-appraised knowledge of the Italian legislation was associated with higher CS (P < 0. 001) and higher CSS (P < 0.001)., Conclusions: These findings should prompt policy makers to ensure proper training and support for EMSPs in the matter of prehospital psychiatric emergency management.