The mental health burden of climate change is growing – now it’s time to act

Acknowledging the mental health impacts of climate variability and change is a first step towards addressing the risks to psychological wellbeing through explicit policy measures.

Cambodia flood

How are you today? I mean, how are you really feeling? In recent years – and especially in the context of COVID-19 – it’s become a lot more normal to talk openly about our emotions. Faced with unprecedented disruption, the fear of life-threatening illness, and a general sense of uncertainty about what lies ahead, you might have found yourself talking about your psychological wellbeing more often than ever before.

According to Katie Hayes, a climate change and mental health researcher in Canada, an increasing willingness to talk about mental health is actually a positive outcome of the pandemic.

“We often feel so alone in the emotions that we’re experiencing […] in reality, the more we talk about it, the more we normalise it and realise that we’re all experiencing some range of feeling in crisis or in need of support at some point in our lives, we’re normalising this conversation and it’s really starting to bring mental health to the forefront.”

And in the context of climate change, it’s all the more important to be able to talk openly about mental health, says Katie, as “what we’re reading or what we’re experiencing can be very scary”.

Understanding and managing the psychological effects of climate variability and change is a growing field of research, and the recognition that climate change can profoundly affect our mental health was highlighted as one of Future Earth’s Ten New Insights in Climate Change for 2020.

The effects of climate change and environmental degradation on physical health are already widely researched and reported. The impact of air pollution on respiratory health is a concern for many cities across the world, estimated to cause up to 9 million premature deaths a year by 2060. In recent weeks the deadly heatwaves in Canada and the Pacific Northwest of the United States, and massive flooding in parts of Europe and in China, have served as a tragic reminder of the risks of extreme climatic events. In addition to the impacts on physical health, today there’s a growing evidence base for how a changing climate and changing weather patterns can negatively affect our psychological wellbeing. These effects may be direct or indirect, can take place over different timescales and affect people differently, and may be cumulative.

The kinds of gradual environmental degradation being seen in many places all over the world, such as biodiversity loss, or increasing deforestation, can be distressing for anyone observing changes in the environment they call home. The concept of ‘solastalgia’, recently included in the first-ever Australian Glossary on Health and Climate Change, aims to put a name to the distress produced by environmental change damaging the integrity of environments that people call home and feel connected to, in a way that leads to feelings of isolation from one’s surroundings (adapted from Albrecht et al, 2007). With regular reminders in the media of how the climate is changing – and why we should care – we are all potentially at risk of feeling a generalised sense of stress and uncertainty about climate change, sometimes called ‘eco-anxiety’.

Climate and weather-related shocks may have sudden, direct effects on physical and psychological health. Researchers have observed an increase in hospital admissions for behavioural and psychological conditions and an increase in suicide rates during heatwaves. Climate-related natural disasters may force people to relocate temporarily or permanently, and also cause less immediately visible disruption, such as difficulty sleeping. These stressors can combine and negatively reinforce one another, and may continue over a long period of time.

When climatic risks occur repeatedly, the mental health impacts are further aggravated:

“It’s really, really vital for policymakers to understand that many communities are experiencing shocks one after the other. For example, in the context of Australia, last year we had devastating fires, then we had COVID, then we had floods. These are examples of the cascading shocks and stressors that we’re dealing with, and we can expect the mental health impacts to be quite immense in communities that are feeling the brunt. Individuals and communities don’t necessarily have the resources to respond to shocks and stresses of this nature: it’s unrelenting.”

Kathryn Bowen, Professor, Melbourne Climate Futures and Melbourne School of Population and Global Health, University of Melbourne

The mental health risks of climate change tend to be most acute among the most marginalized populations, who may not have access to the kind of physical or financial infrastructure that supports adaptation, and among people whose livelihoods depend on access to natural resources, such as farmers and fishers. Groups who are already experiencing health inequalities, such as those linked to race, gender or socioeconomic status, or living in areas most at risk of dangerous climate change, are especially vulnerable. Indigenous peoples, many of whom are among the world’s poorest, may be particularly at risk.

It’s estimated that one in four people globally will experience a mental health condition during their lifetime, and that number is increasing. Mental health conditions can affect all aspects of life, and the cost of poor health and reduced productivity is projected to cost the world economy US$6 trillion per annum by 2030. Despite this, mental healthcare tends to be under-resourced worldwide, with less than 2% of government health expenditure on average going to mental healthcare.

With the impacts of climate change projected to become more severe, there’s a clear need for a proactive approach to improving mental health provision and building resilience in the healthcare system.

“As adaptation funding increasingly begins to address the health risks of climate change, it will be important for projects to ensure they promote mental health. Projects can move beyond just (for example) developing and deploying early warning and response systems, to incorporating protection of mental health before, during, and after exposures to climate-related hazards, disease outbreaks, periods of undernutrition, etc”, says Professor Kristie L. Ebi of the University of Washington’s Center for Health and the Global Environment (CHanGE), “Better quantification of the mental health benefits of mitigation policies and technologies would extend the evidence that the economic benefits from avoided hospitalizations and deaths more than outweigh the costs of mitigation.”

The evidence on what works is available, and it’s time to start putting it into practice, says Kathryn Bowen:

“We actually know a lot about what can be done. And so now it’s actually about supporting policy-makers to develop appropriate policies and practices that are informed by communities so that implementation happens without delay.”

At the community level, that means ensuring that community health workers are trained to understand the mental health needs of the populations they serve, including with regards to environmental change and climate hazards, and are equipped to provide appropriate services.

“A quick and easy win is to support mental health first aid training for frontline workers. In many cases, in many countries, these are already established, through frontline workers such as village health workers. If frontline workers are able to be equipped with additional knowledge around climate change and its mental health impacts, then this would be a very rapid way to scale up the understanding and then the response mechanisms,” says Kathryn.

At the national level, mental health indicators could be built into climate change and health vulnerability assessments (such as V&As or VCAs), which are used to assess people’s exposure to and capacity to resist hazards such as climate change. These assessments can then be incorporated into national adaptation plans that are communicated to the UNFCCC, for example. By taking a ‘strengths-based’ approach that examines what communities are already doing well within their health services, policy-makers can identify successful initiatives that could be scaled up or out.

It can also be useful to look at research exploring affirmative mental health outcomes, say both Katie and Kathryn. For example, if people report strengthened social connections when communities work together following an environmental disaster, it adds weight to the argument that strong social connections are significant for increasing mental wellbeing and building resilience within communities. Some evidence also points to the value of nature for improving health and wellbeing, further illustrating the importance of protecting ecosystems and promoting access to blue and green spaces.

Echoing the points made by Kim Nicholas on finding joy and purpose in taking action on climate change earlier on in this series, psychologist Susan Clayton argues that trying to make a difference on sustainable development, however small it might appear, can help to counter feelings of helplessness and eco-anxiety, especially if it’s done in collaboration with others. So on a personal level, by doing your bit to tackle climate change, you could be not only contributing to the health of the planet, but also improving your own mental health.

Photo: Cecile Pichon EU/ECHO via Flickr.