Climate change & Mental Health
Mental Health and climate change in context
Mental health conditions are a significant cause of morbidity worldwide. The WHO reports that depression is a leading cause of disability globally. (1) Yet, in many contexts worldwide, stigma against mental health challenges prevails, and effective treatment coverage remains low. (2)
It is against this backdrop of unmet mental health needs that climate change and environmental degradation are taking place. Climate change may impact mental health directly through the trauma of disasters caused by extreme weather events; and through feelings of anxiety, frustration, and powerlessness provoked by an understanding of the trajectory that climate change is currently on. It may also have indirect consequences for mental health – for example, through the losses of livelihoods, food and water insecurity, and violence that will be the likely result of environmental degradation. (3)
It is important to note that the burden of mental health impacts created by climate change will not be distributed equitably. (3) Women and LGBTQ2SAI+ people, young people, and people with low socioeconomic status may be exceptionally vulnerable to anxiety and mood disorders related to environmental change (WHO 2014, in 4).
How does climate change and environmental degradation impact mental health?
Disaster and displacement
Climate change is expected to increase the frequency and severity of extreme weather events, such as wildfires, heat waves, floods, and tropical storms. (5) These extreme weather events have the potential to create significant human disasters, particularly when infrastructure is weak. (6) This may include significant disruption to victims’ lives, including injury and disability, grief and loss, loss of property, resources, social support, social networks, and displacement.
Mental health can be impacted at all timepoints surrounding extreme weather events - during, after, and even beforehand. (4) Outcomes can range from minimal stress to clinical disorders, such as post-traumatic stress disorder (PTSD), depression, anxiety, substance use disorders, and suicidality (4). These impacts may manifest in the short term following a disaster, or continue on for the long term. (4) Mental health impacts following an extreme weather event may also provoke destructive behaviours such as sexual and other forms violence, which in turn may aggravate the mental health burden. (4)
Climate anxiety/eco-anxiety
People may experience a strong sense of fear and worry as a result of uncertainty related to climate change. (7) This may be categorized as “eco-anxiety” or “climate anxiety”. Individuals may find themselves distressed by news headlines about climate change and its impacts on human as well as non-human communities, such as habitat loss and species extinction. (4) It is generally pre-emptive rather than a response to a major climate-related event. It may manifest as anxious or depressive thoughts and feelings; however, it may also manifest in other ways, such as disordered eating. (8)
A closely related concept is solastalgia, characterized as the distress that people feel when environmental change impacts their connection to their home environment. (9) It is of particular concern for the well-being of Indigenous peoples and other land-dependent groups. (10)
Special concerns for patients with mental health concerns
People with a history of mental health concerns may be more likely to suffer adverse mental health as a result of extreme weather events and/or climate change more broadly. (APA 2017 in 4; 11). Certain neuroleptic and antidepressant medications may impair core temperature modulation. (12) Thus, patients may be more susceptible to illness in conditions of extreme cold and, in particular, heat.
Action Strategy #1 Promote and engage in climate change activism
In the existing literature on eco-anxiety, there is an emphasis on clinicians engaging with their feelings about climate change, and activism is found to be protective (11, 13, 14, 15) In any case, there is a pressing need to decarbonize health care: if global health care were a country, it would be among the top 5 emitters – alongside the United States, China, and Russia. (16)(17) As a health care system, it is imperative that we fulfil our duty to “do no harm”: respond to the health impacts of climate change on health while mitigating our environmental footprint, rather than perpetuating the climate problem at hand.
Action Strategy #2: Encouraging spending time in nature
Spending time in nature has been shown to relieve stress and promote environmental activism. It may also alleviate climate anxiety in some patients. (15, 18, 19) A number of clinical approaches have been proposed to respond to climate change; only a small number of observational studies assess their efficacy, so more research is needed. (15, 20)
Case study: Wildfire impacts on evacuated Indigenous communities
There have been a number of large-scale forest fires in Northern Canadian communities in recent years; and the impact of fires is expected to increase. (21) Around 80% of Indigenous communities in Canada are located in or adjacent to forest ecosystems that experience frequent fires. (22) As such, Indigenous people are among those most affected by wildfire evacuation. Forced displacement is associated with a number of mental health issues, including PTSD, anxiety, and depression. People evacuated from First Nations have been shown to face racism & discrimination, poor conditions, family separations and other difficulties in host communities, compounding the stress of evacuation. (22, 23)
“It wasn't a very comfortable place … ‘cause everybody felt like everybody had to watch one another…” Participant 001, evacuated to Marathon during 2011 Northern Ontario wildfires (21)