The mental health impacts of climate change

Position statement Last updated: Dec 2021 Published in Australia Reference: PS #106

This position statement recognises the mental health impacts of climate change and supports policy change that addresses these impacts.

Purpose

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) has developed this position statement to recognise the mental health impacts of climate change. The RANZCP supports policy change that addresses these impacts and affirms the importance of turning concern into action through a coordinated effort to respond to the impacts of climate change on mental health.

Introduction

The climate and ecological emergency facing humanity is increasingly affecting the health and wellbeing of populations across the globe.[1, 2] Emerging evidence shows that climate change impacts on mental health, both directly and indirectly with distress about climate change and human inaction to the threat it poses.[3, 4] An increase in the rates of anxiety, depression and post-traumatic stress disorder has been observed as a direct result of an increase in severe weather events. Improving how people respond to potential distress caused by climate change can improve wellbeing and reduce rates of clinical mental health disorder.[1, 5-9] Population groups, such as children, youth, older persons, Indigenous peoples, refugees, persons living with disabilities and people with pre-existing mental health disorders and others are more vulnerable to its direct physical impacts.[10,11]

Key messages

Climate change is a global threat to health and wellbeing and is impacting the mental health of individuals and communities.
The RANZCP recognises increasing mental health disorders and rates of suicide associated with the impacts of climate change.[1, 12]
The RANZCP acknowledges that mental distress caused by the real threat of climate change is an an appopriate response. Climate change contributes to clinical disorders such as anxiety and depression that will greatly impact morbidity and mortality across the globe. Psychiatrists have the opportunity to support individuals and communities to enhance resilience and take action to mitigate the impacts of climate-related anxiety and depression.
Improved dissemination of existing research and further research is required to better communicate and understand the cumulative impacts of climate change on mental health and how it can best be addressed in psychiatric practice. The RANZCP is committed to supporting and developing further discussion to better understand the impacts of climate change and how they relate to mental health.
The RANZCP is committed to turning concern into action through adopting sustainable business practices and through reducing its own carbon footprint.

Impacts on mental health

The impacts of natural disasters, including anthropogenic climate change-related weather events, has been recognised for some time, and the RANZCP Position Statement 35 Addressing the mental health impacts of natural disasters and climate change-related weather events highlights the role of psychiatrists in disaster planning related to climate change. The climate crisis is having an observed impact on mental health and wellbeing and has been linked to increasing rates of mental health distress and suicidal behaviour with rising temperature and humidity. While evidence exists documenting a connection between climate change and mental health, this phenomenon is complex and evolving, and effects will arise in both a direct and indirect manner.[13, 14] Further research establishing a causal link between psychiatric conditions and the mental health impacts of climate change, is required.[6, 7, 15, 16] Together with a growing general anxiety and concern for the future felt by individuals and communities, the more severe impacts may manifest in psychological distress, uncertainty, feelings of helplessness, denial and uncontrolled anger.[17] Major mental health impacts of climate change may increase instances of trauma and shock, post-traumatic stress disorder (PTSD), compounded stress, and substance misuse disorders.[13, 18] The impacts of climate change also increase the risk of unemployment and poverty, relationship stress and family breakdown, leading to community and societal fragmentation.[19]

Vulnerable groups

The impacts of climate change are inequitably distributed. Those in developing countries, rural and remote communities and sea-level geographical locations are already experiencing, and will experience the disproportionate impacts of climate change.[20, 21] Suicide is the leading cause of death of young people in Australia and increased rates of suicide and suicidal behaviour are being seen across populations. This is particularly impacting the regions where frequent heatwaves and greater increases in humid conditions occur.[5-7] Additionally, older people are also vulnerable to the effects of climate change on physical health which in turn impacts their mental health.[7] Indigenous peoples are at greater risk of experiencing environmental distress as they feel helpless to defend and protect their traditional lands, air, water, and country from the deleterious effects of industries and practices that contribute to the environmental crisis.[22-25] The United Nations acknowledges that ‘while Indigenous peoples have accumulated valuable traditional knowledge about nature and sustainable practices, this knowledge often is not recognised as an important tool to protect the environment and to enhance resilience’.[26] The anxiety associated with climate change can cause children and young people to experience feelings of despair for the future and concern about perceived and real inaction from those in authority.[27] Equally, there is potential for heightened stress responses to extreme weather events and intensification of natural disasters that will increasingly present with climate change.[28, 29]

The role of psychiatrists

The UK Royal College of Psychiatrists recent position statement on our planet’s climate and ecological emergency highlights the importance of the therapeutic benefits of nature and the importance of healthy natural environments to wellbeing. Psychiatrists have a crucial role to play in addressing instances of climate-related anxiety, depression and other psychological symptoms among those in their care.[30] Increasing coping skills and development of support mechanisms to assist in building resilient individuals and communities are important ways in which psychiatrists can mitigate climate-related anxiety and depression.[31]

Psychiatrists may also give consideration to integrating climate change impacts into patient health assessments, and health systems should consider integration of health vulnerability and adaptation assessments into their services.[32, 33] In addition to this, psychiatrists and where relevant, multidisciplinary teams, can take leadership in stewardship of resources and promotion of practical action on reducing contributing factors to climate change.

Many psychiatrists are in a position to take an important leadership role in public health discussions on this issue and the mental health impacts of climate change, including advocating for planning and prevention in the face of increased mental health distress and suicidal behaviour.[6, 7, 12, 34] One facet of this leadership is to engage in respectful discussion.[35] Such efforts to address the mental health impacts of climate change can have a profoundly positive effect on momentum for change. As mentioned in the UK Royal College of Psychiatrists recent position statement, significant crises like climate change have the potential to create longstanding change. Psychiatrists can help to strengthen the resilience of communities in preparation for the future challenges of a changing climate.

How psychiatrists can act on climate change

There are many ways that psychiatrists can take action on climate change, including:

Increase awareness of climate and ecological crises by learning about climate change and the impacts.
Share and contribute to evidence-based research on the impacts of climate change on mental health.
Acknowledge that climate change is a health emergency and every voice counts.

Recommendations

The RANZCP commits to taking steps to reduce its own impact on climate change and we support psychiatrists considering relevant actions that they can incorporate into their practice. These actions may include: reviewing financial investments in industries that contribute to climate change, enhancing energy efficiency through reducing resource consumption and increasing the adoption of sustainable travel practices.

As advocates for their patients, psychiatrists have a role to communicate the significant, growing literature evidence on the impacts of climate change on mental health to policy makers at local service, broader community and government levels. Psychiatrists may also consider opportunities to improve their knowledge on how climate change is affecting mental health and be involved in research that further informs our understanding of the impacts of climate change on mental health.

References

1. Burke M, González F, Baylis P, Heft-Neal S, Baysan C, Basu S, et al. Higher temperatures increase suicide rates in the United States and Mexico. Nature Climate Change. 2018;8(8):723-9.

2. Romanello M, McGushin A, Di Napoli C, Drummond P, Hughes N, Jamart L, et al. The 2021 report of the Lancet Countdown on health and climate change: code red for a healthy future. The Lancet. 2021;398(10311):1619-62.

3. Bourque F, Willox AC. Climate change: the next challenge for public mental health? Int Rev Psychiatry. 2014;26(4):415-22.

4. Gifford E, Gifford R. The largely unacknowledged impact of climate change on mental health. Bulletin of the Atomic Scientists. 2016;72(5):292-7.

5. Obradovich N, Migliorini R, Martin PP, Rahwan I. Empirical evidence of mental health risks posed by climate change. Proceedings of the National Academy of Sciences of the United States of America. 2018;115(43):10953-8.

6. Lawrance E, Thompson, R., Fontana, G., Jennings, N. The impact of climate change on mental health and emotional wellbeing: current evidence and implications for policy and practice. Grantham Institute; 2021 May 2021.

7. Charlson F, Ali S, Benmarhnia T, Pearl M, Massazza A, Augustinavicius J, et al. Climate Change and Mental Health: A Scoping Review. International journal of environmental research and public health. 2021;18(9):4486.

8. Dixon PG, Sinyor M, Schaffer A, Levitt A, Haney CR, Ellis KN, et al. Association of Weekly Suicide Rates with Temperature Anomalies in Two Different Climate Types. International Journal of Environmental Research and Public Health. 2014;11(11).

9. Association AP. How Extreme Weather Events Affect Mental Health: American Psychiatric Association; [Available from: https://www.psychiatry.org/patients-families/climate-change-and-mental-health-connections/affects-on-mental-health.]

10. Majeed H, Lee J. The impact of climate change on youth depression and mental health. Lancet Planet Health. 2017;1(3):e94-e5.

11. Trombley J, Chalupka S, Anderko L. Climate Change and Mental Health. Am J Nurs. 2017;117(4):44-52.

12. Royal College of Psychiatrists. Our planet's climate and ecological emergency 2021 [updated 05 May 2021. 27]. Available from: https://www.rcpsych.ac.uk/docs/default-source/improving-care/better-mh-policy/position-statements/position-statement-ps03-21-climate-and-ecological-emergencies-2021.pdf.]

13. Cianconi P, Betrò S, Janiri L. The Impact of Climate Change on Mental Health: A Systematic Descriptive Review. Front Psychiatry. 2020;11:74-.

14. Berry HL, Bowen K, Kjellstrom T. Climate change and mental health: a causal pathways framework. Int J Public Health. 2010;55(2):123-32.

15. Hayes K, Blashki G, Wiseman J, Burke S, Reifels L. Climate change and mental health: risks, impacts and priority actions. International Journal of Mental Health Systems. 2018;12(1):28.

16. Rice SM, McIver LJ. Climate change and mental health: Rationale for research and intervention planning. Asian J Psychiatr. 2016;20:1-2.

17. Usher K, Durkin J, Bhullar N. Eco-anxiety: How thinking about climate change-related environmental decline is affecting our mental health. Int J Ment Health Nurs. 2019;28(6):1233-4.

18. Padhy SK, Sarkar S, Panigrahi M, Paul S. Mental health effects of climate change. Indian J Occup Environ Med. 2015;19(1):3-7.

19. Australian Bureau of Statistics. 4430.0 - Disability, Ageing and Carers, Australia: Summary of Findings, 2015. Canberra; 2015 20 April 2017.

20. Rataj E, Kunzweiler K, Garthus-Niegel S. Extreme weather events in developing countries and related injuries and mental health disorders - a systematic review. BMC Public Health. 2016;16(1):1020.

21. Asugeni J, MacLaren D, Massey PD, Speare R. Mental health issues from rising sea level in a remote coastal region of the Solomon Islands: current and future. Australasian Psychiatry. 2015;23(6_suppl):22-5.

22. Albrecht G, Sartore G-M, Connor L, Higginbotham N, Freeman S, Kelly B, et al. Solastalgia: The Distress Caused by Environmental Change. Australasian Psychiatry. 2007;15(1_suppl):S95-S8.

23. Rigby CW, Rosen A, Berry HL, Hart CR. If the land's sick, we're sick:* The impact of prolonged drought on the social and emotional well-being of Aboriginal communities in rural New South Wales. Australian Journal of Rural Health. 2011;19(5):249-54.

24. Bowles DC. Climate Change and Health Adaptation: Consequences for Indigenous Physical and Mental Health. Ann Glob Health. 2015;81(3):427-31.

25. Jones R, Bennett H, Keating G, Blaiklock A. Climate change and the right to health for Māori in Aotearoa/New Zealand. Health Hum Rights. 2014;16(1):54-68.

26. Challenges and Opportunities for Indigenous Peoples’ Sustainability: United Nations Department of Economic and Social Affairs; 2021 [Available from: https://www.un.org/development/desa/dspd/2021/04/indigenous-peoples-sustainability/.]

27. Burke SEL, Sanson AV, Van Hoorn J. The Psychological Effects of Climate Change on Children. Current Psychiatry Reports. 2018;20(5):35.

28. Cianconi P, Lesmana CBJ, Ventriglio A, Janiri L. Mental health issues among indigenous communities and the role of traditional medicine. Int J Soc Psychiatry. 2019;65(4):289-99.

29. Berry HL, Waite TD, Dear KBG, Capon AG, Murray V. The case for systems thinking about climate change and mental health. Nature Climate Change. 2018;8(4):282-90.

30. Every-Palmer S, McBride S, Berry H, Menkes DB. Climate change and psychiatry. Aust N Z J Psychiatry. 2016;50(1):16-8.

31. Connerton CS, Wooton AK. Building Community Resilience to Mitigate Mental Health Effects of Climate Change. Creat Nurs. 2019;25(3):e9-e14.

32. Nurse J, Basher D, Bone A, Bird W. An ecological approach to promoting population mental health and well-being--a response to the challenge of climate change. Perspect Public Health. 2010;130(1):27-33.

33. Hayes K, Poland B. Addressing Mental Health in a Changing Climate: Incorporating Mental Health Indicators into Climate Change and Health Vulnerability and Adaptation Assessments. International journal of environmental research and public health. 2018;15(9):1806.

34. Coverdale J, Balon R, Beresin EV, Brenner AM, Guerrero APS, Louie AK, et al. Climate Change: A Call to Action for the Psychiatric Profession. Academic Psychiatry. 2018;42(3):317-23.

35. Ventriglio A. TA, Bhugra D. Developing Leadership Skills in Professional Psychiatric Practice. Singapore: Springer; 2018.

Disclaimer: This information is intended to provide general guidance to practitioners, and should not be relied on as a substitute for proper assessment with respect to the merits of each case and the needs of the patient. The RANZCP endeavours to ensure that information is accurate and current at the time of preparation, but takes no responsibility for matters arising from changed circumstances, information or material that may have become subsequently available.