The Forum

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. 

Policy recommendations

1. 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.
2. Support convening of an international network across sectors and disciplines to accelerate the emerging field of climate change and mental health.
3. 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.
4. 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.

 

References

1. Diseases, T. L. I. The intersection of COVID-19 and mental health. Lancet Infect. Dis. 0, (2020).
2. Lally, C. Child and adolescent mental health during COVID-19. (2020).
3. Cullen, W., Gulati, G. & Kelly, B. D. Mental health in the COVID-19 pandemic. QJM Int. J. Med. 113, 311–312 (2020).
4. 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).
5. Berry, H. L., Bowen, K. & Kjellstrom, T. Climate change and mental health: a causal pathways framework. Int. J. Public Health 55, 123–132 (2010).
6. 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).
7. 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.
8. 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).
9. 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/.
10. Mason, V., Andrews, H. & Upton, D. The psychological impact of exposure to floods. Psychol. Health Med. 15, 61–73 (2010).
11. Burke, M. et al. Higher temperatures increase suicide rates in the United States and Mexico. Nat. Clim. Change 8, 723–729 (2018).
12. 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).
13. 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).
14. 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).
15. 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).
16. Cunsolo, A. et al. Ecological grief and anxiety: the start of a healthy response to climate change? Lancet Planet. Health 4, e261–e263 (2020).
17. 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.
18. 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).
19. Ingle, H. E. & Mikulewicz, M. Mental health and climate change: tackling invisible injustice. Lancet Planet. Health 4, e128–e130 (2020).
20. Wu, J., Snell, G. & Samji, H. Climate anxiety in young people: a call to action. Lancet Planet. Health 4, e435–e436 (2020).
21. 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).
22. UK, C. A. The path to net zero. Climate Assembly UK https://climateassembly.uk/report/read/.
23. 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.

 

Read Mental Health: the underestimated impacts and opportunities of the climate crisis in full

Written by Dr Natalie Shenker, Research Associate in the Department of Surgery & Cancer

All-Party Parliamentary Groups (APPGs) are intended as a vehicle to bring together cross-party MPs and peers from the House of Lords who are interested in a particular area of policy. They also create communities of specialists, special interest groups, and interested members of the public, who can work together and individually to highlight new insights, research and innovations.

There are several APPGs that currently operate in fields related to my research as a UKRI Future Leaders Fellow aiming to understand the public health impacts of human milk bank services. I am an active contributor to the APPG on Infant Feeding Inequalities, and attend APPGs on the First 1001 Days, Premature and Sick Babies and the Microbiome. Being part of an APPG means that you can attend meetings, ask questions and request to submit evidence. Most of the APPGs are free to join, but some have a secretariat that requires funding and will charge members to join (an interesting ethical debate can be had around this practice). Submitting evidence can be as simple as sending a relevant paper to the committee or asking to present a talk on your work.

Presenting at an APPG can be slightly intimidating – the committee proceedings pre-COVID-19 take place in committee rooms in the House of Parliament or at Portcullis House. Security is tight to get in and the queues can be long. On my first attendance, there had been a last minute change of venue (this is common, so make sure you watch out for late emails); all of us including MPs and peers ended up running together down an underground corridor to get to the new room on time. The rooms are usually set up so that the committee are seated in a semi-circle with tables facing them, a little like a Select Committee, and there are chairs at the back for the audience. It took me a couple of meetings to realise that anyone could sit on the central tables, and that actually things are a lot less formal than they appear at first sight. The parliamentarians are genuinely interested in the insights of experts and people with lived experience of the issues they are tackling, and to an academic APPGs offer an accessible insight into the machinations that lead to policy advances.

Post-COVID-19, meetings are held online. My work on the commercialisation of human milk banking was due to be presented in April and was delayed until APPGs started taking place again, this time online. Attendance more than doubled, to over 90 individuals and organisations, and the last First 1001 days APPG had over 400 attendees. There have been recognisable impacts already of my presentations, and excellent opportunities to make contacts with collaborators and parliamentarians. Some of my work was recently quoted in a Commons debate, and the Chair of the APPG sent me a copy of Hansard for that day which was inspiring to keep emphasising the results of my research to support policy development. Going online may make APPGs much more accessible to people across the UK as well as parliamentarians who can access remotely while elsewhere from Westminster and can only be a good thing for information dissemination and policy advance.

List of active APPGs.

Read Presenting research to an All-Party Parliamentary Group in full

Written by Dr Joeri Rogelj, Director of Research and Lecturer in Climate Change and the Environment at Imperial’s Grantham Institute – Climate Change and Environment

With more than a million lives lost so far and no clear exit in sight, the COVID-19 pandemic challenges governments all around the world to their fullest. Besides the public health crisis, the measures necessary to contain the virus have resulted in a global recession that brings additional hardship and suffering. Without any doubt, the events over the past year clearly laid bare our society’s vulnerability to external shocks that governments have insufficiently anticipated and prepared for.

Still, the COVID-19 pandemic is not the only challenge societies face today. A slower, yet more pervasive and harder to mitigate threat is our economies’ on-going contribution to climate change. Because both challenges are inherently linked to how we operate our economies, it makes sense to look for solutions that address both.

As a result of the COVID-19 lockdown measures, economic activities have slowed down markedly. There are periods with fewer cars on the road, fewer flights, and the slower economy results in less energy and goods being shipped around. Because these activities normally produce greenhouse gases, their slow-down also caused a measurable dip in global greenhouse gas emissions and local air pollution. Locked down cities were suddenly quiet, and with clean skies.

However, these reductions are only temporary. As soon as lockdown measures are lifted, people will be using the same cars and the same power plants to provide their electricity. In a recent study, we show that if we simply revert back to old ways of doing things, the impact of COVID-19 lockdowns on climate change would not even be measurable in the real world. A structural change of our economies is needed, and the COVID-19 crisis here presents an opportunity for governments.

Following the economic fall-out of the COVID-19 pandemic, governments are now stepping in with measures to safeguard their public health systems and to put economies back on the rails. The amounts are staggering, with more than USD12 trillion in COVID-19 recovery stimulus announced – about 15% of the combined global gross domestic product (GDP). Reshaping our economies to tackle climate change is often perceived to be extremely expensive, but comparing the investments needed for a green, climate-positive recovery with the announced COVID-19 stimulus we show a quite contrasting picture.

We show that COVID-19 recovery funds dwarf the green energy investment needs for setting the world on track to achieve even the most ambitious 1.5°C limit of the UN Paris Agreement. Over the next five years, the additional green energy investments needed to move the global economy from its current polluting track onto a Paris-compatible path amount to only 12% of the total pledged COVID-19 recovery funding. Combined with divestments from fossil fuels, the net amount becomes of the order of 1% of total COVID-19 recovery funding.

Climate-positive recovery measures bring many things governments are interested in after a crisis: they boost high-quality jobs, can be scaled rapidly, and make a country’s economy more resilient to future shocks. Keeping the bigger picture and a longer-term perspective is thus essential to avoid that our recovery from the COVID-19 pandemic leads our society in the next economic dead end street.

Read Building a climate-resilient post-COVID society in full