Written by Dr Emma Lawrance, Mental Health Innovations Fellow at the Institute of Global Health Innovation, Imperial College London
COVID-19 is affecting every aspect of our society and producing a parallel mental health pandemic that clinicians predict will be with us for years to come (references 1–4). Yet the pandemic is a mere foreshadowing of the impact scientists anticipate the climate crisis will have on our lives. While the climate crisis is increasingly recognised as a health emergency, its relationship with mental health has been relatively neglected, but is a vital piece of the climate puzzle (5–8).
The links between climate change and mental health are important for three key reasons. First, the climate and ecological crises are associated with a range of psychological responses and mental health impacts. Second, the climate crisis will increase mental health needs while potentially disrupting mental health systems, straining health systems and services. Third, the climate crisis is fundamentally a product of human behaviours and therefore an understanding of human psychological needs and responses is required in order to solve it. COVID-19 has highlighted the importance of understanding behavioural change and in acting preemptively to build resilient healthcare systems, even in the face of uncertainty (9).
In the UK, increased temperatures, more frequent heatwaves, and disasters such as floods can increase frequency and severity of mental ill-health and endanger the lives particularly of those on some mental health medications (e.g. some antipsychotics) or at risk of suicide (10–15). Healthcare and emergency systems have been under-aware and ill-prepared to manage this. Even simply an awareness of the climate crisis and witnessing our planetary emergency can generate a range of strong psychological and emotional responses, including grief, fear, anxiety, anger, dread, and significant distress (16,17). These psychological responses interact with subsequent actions and behaviours and ‘deeply colour visions of a desirable future’ (18), as we are witnessing with COVID-19, and can impact mental health and wellbeing, often in ways that exacerbate existing inequalities (19).
In particular, young people are only too aware that they are inheriting a slow-motion catastrophe, with enormous consequences for their mental health (20). Prince William, speaking about the climate crisis, said: “I also worry from a mental health point of view, the anxiety and the worry that many of these younger generations are going to have. Hearing about what we’re talking about, it’s going to weigh on them” (21). This comment echoes reports by mental health charities, psychiatric associations, parents, teachers and young people themselves, of rising distress associated with awareness of these crises. We need to work with young people as co-researchers to understand these experiences of distress and the mental health impacts, while co-designing appropriate psychological support that can build resilience and generate action.
In September 2020, the UK Climate Assembly (a representative sample of the UK population) published their report on how the UK should achieve Net Zero greenhouse gas emissions by 2050. One of the key recommendations of this report was the need for education and information on climate change for everyone in the UK (22). Curricula and awareness-raising campaigns should consider the potential psychological and emotional responses they may engender, and ensure appropriate resources are provided to enable people to have healthy responses to these thoughts and feelings and build mental resilience, with the opportunity to facilitate individual behaviour change.
Accounting for positive and negative mental health impacts associated with both current practices and climate action
The mental health impacts and outcomes of climate change and climate action are not currently accounted for. This is a huge oversight. But also an opportunity to leverage multiple benefits from actions that reduce carbon emissions, and to align policy agendas across mental health and wellbeing, and climate action.
The consequences of unmitigated climate change are and will produce worsening rates of population mental ill-health. Further, there may be co-risks or common causes associated with current practices that are both contributing to the climate and ecological crises and worsening mental health, such as overconsumption and a disconnection of people from the natural world. Air pollution, nature deprivation, low nutrient food systems, poorly insulated homes, ecological breakdown and sedentary commutes are connected with the climate crisis, but also known to impact mental health.
There are co-benefits of action, as highlighted in the Climate Assembly report, which can create public buy-in around policies that reduce carbon emissions while improving air quality and green space, for example (23). A co-benefits narrative needs to emerge that emphasises the benefits that climate action can bring to improving our mental health and wellbeing.
- Support research to develop and track the evidence base for psychological responses to the climate crisis, the impact on mental health and wellbeing, and the interactions with behaviour, particularly for vulnerable groups. Such evidence will inform future policy narratives, education initiatives and campaigns to generate individual and collective behaviour change.
- Support convening of an international network across sectors and disciplines to accelerate the emerging field of climate change and mental health.
- Learn from current global best practices – support collation and evaluation of both formal and informal interventions arising to meet the growing needs. Embed evidence-based recommendations into mental health systems to build resilience, and scale-up evidence-based interventions to meet emerging psychological needs of vulnerable individuals and communities.
- Account for the mental health related positive and negative externalities associated with the climate crisis and climate action, while leveraging the co-benefits to support further action to reduce greenhouse gas emissions.
Relevant work at Imperial
Imperial’s Grantham Institute and Institute of Global Health Innovation are producing a Briefing Paper summarising the current evidence on the Impacts of Climate Change on Mental Health and providing policy recommendations.
The Climate Cares programme is a research, policy, education and design program to understand and respond to the mental health needs of the climate crisis. Their first study, Changing Worlds, is examining psychological responses to COVID-19 and the climate crisis in UK 16-24 year olds, with parallel studies to be run in the Philippines and India. This study also explores the interaction of the range of psychological and emotional responses with mental health, and young people’s agency to shape the world they wish to see. Helix Centre designers are developing highly scalable low-cost interventions to support young people in building mental resilience in response to these crises, working with a diverse group of UK youth.
- Diseases, T. L. I. The intersection of COVID-19 and mental health. Lancet Infect. Dis. 0, (2020).
- Lally, C. Child and adolescent mental health during COVID-19. (2020).
- Cullen, W., Gulati, G. & Kelly, B. D. Mental health in the COVID-19 pandemic. QJM Int. J. Med. 113, 311–312 (2020).
- Pierce, M. et al. Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population. Lancet Psychiatry 0, (2020).
- Berry, H. L., Bowen, K. & Kjellstrom, T. Climate change and mental health: a causal pathways framework. Int. J. Public Health 55, 123–132 (2010).
- Berry, H. L., Waite, T. D., Dear, K. B. G., Capon, A. G. & Murray, V. The case for systems thinking about climate change and mental health. Nat. Clim. Change 8, 282–290 (2018).
- Dodgen, D. et al. Ch. 8: Mental Health and Well-Being. The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment. https://health2016.globalchange.gov/downloads#mental-health-and-well-being (2016) doi:10.7930/J0TX3C9H.
- Hayes, K., Blashki, G., Wiseman, J., Burke, S. & Reifels, L. Climate change and mental health: risks, impacts and priority actions. Int. J. Ment. Health Syst. 12, 28 (2018).
- How will coronavirus shape our response to climate change? | Imperial News | Imperial College London. Imperial News https://www.imperial.ac.uk/news/197473/how-will-coronavirus-shape-response-climate/.
- Mason, V., Andrews, H. & Upton, D. The psychological impact of exposure to floods. Psychol. Health Med. 15, 61–73 (2010).
- Burke, M. et al. Higher temperatures increase suicide rates in the United States and Mexico. Nat. Clim. Change 8, 723–729 (2018).
- Page, L. A., Hajat, S. & Kovats, R. S. Relationship between daily suicide counts and temperature in England and Wales. Br. J. Psychiatry 191, 106–112 (2007).
- Obradovich, N., Migliorini, R., Paulus, M. P. & Rahwan, I. Empirical evidence of mental health risks posed by climate change. Proc. Natl. Acad. Sci. 115, 10953–10958 (2018).
- Lee, S., Lee, H., Myung, W., Kim, E. J. & Kim, H. Mental disease-related emergency admissions attributable to hot temperatures. Sci. Total Environ. 616–617, 688–694 (2018).
- Thompson, R., Hornigold, R., Page, L. & Waite, T. Associations between high ambient temperatures and heat waves with mental health outcomes: a systematic review. Public Health 161, 171–191 (2018).
- Cunsolo, A. et al. Ecological grief and anxiety: the start of a healthy response to climate change? Lancet Planet. Health 4, e261–e263 (2020).
- Cunsolo, A. & Ellis, N. Hope and mourning in the Anthropocene: Understanding ecological grief. The Conversation http://theconversation.com/hope-and-mourning-in-the-anthropocene-understanding-ecological-grief-88630.
- Moser, S. Navigating the political and emotional terrain of adaptation: Community engagement when climate change comes home. Success. Adapt. Link. Sci. Pract. Manag. Clim. Change Impacts 289–305 (2013).
- Ingle, H. E. & Mikulewicz, M. Mental health and climate change: tackling invisible injustice. Lancet Planet. Health 4, e128–e130 (2020).
- Wu, J., Snell, G. & Samji, H. Climate anxiety in young people: a call to action. Lancet Planet. Health 4, e435–e436 (2020).
- Earthshot prize: Prince William launches £50m drive to repair planet. the Guardian http://www.theguardian.com/environment/2020/oct/08/earthshot-prize-prince-william-launches-50m-drive-to-repair-planet (2020).
- UK, C. A. The path to net zero. Climate Assembly UK https://climateassembly.uk/report/read/.
- 23. Mapping the co-benefits of climate change action to issues of public concern in the UK: a narrative review – The Lancet Planetary Health. https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(20)30167-4/fulltext.