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Climate change and mental health: A causal pathways framework


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Climate change will bring more frequent, long lasting and severe adverse weather events and these changes will affect mental health. We propose an explanatory framework to enhance consideration of how these effects may operate and to encourage debate about this important aspect of the health impacts of climate change. Literature review. Climate change may affect mental health directly by exposing people to trauma. It may also affect mental health indirectly, by affecting (1) physical health (for example, extreme heat exposure causes heat exhaustion in vulnerable people, and associated mental health consequences) and (2) community wellbeing. Within community, wellbeing is a sub-process in which climate change erodes physical environments which, in turn, damage social environments. Vulnerable people and places, especially in low-income countries, will be particularly badly affected. Different aspects of climate change may affect mental health through direct and indirect pathways, leading to serious mental health problems, possibly including increased suicide mortality. We propose that it is helpful to integrate these pathways in an explanatory framework, which may assist in developing public health policy, practice and research.
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Climate change and mental health: a causal pathways framework
Helen Louise Berry Kathryn Bowen
Tord Kjellstrom
Received: 18 December 2008 / Revised: 23 November 2009 / Accepted: 1 December 2009 / Published online: 22 December 2009
¨user Verlag, Basel/Switzerland 2009
Objectives Climate change will bring more frequent, long
lasting and severe adverse weather events and these changes
will affect mental health. We propose an explanatory
framework to enhance consideration of how these effects
may operate and to encourage debate about this important
aspect of the health impacts of climate change.
Methods Literature review.
Results Climate change may affect mental health directly
by exposing people to trauma. It may also affect mental
health indirectly, by affecting (1) physical health (for
example, extreme heat exposure causes heat exhaustion in
vulnerable people, and associated mental health conse-
quences) and (2) community wellbeing. Within community,
wellbeing is a sub-process in which climate change erodes
physical environments which, in turn, damage social envi-
ronments. Vulnerable people and places, especially in low-
income countries, will be particularly badly affected.
Conclusions Different aspects of climate change may
affect mental health through direct and indirect pathways,
leading to serious mental health problems, possibly
including increased suicide mortality. We propose that it is
helpful to integrate these pathways in an explanatory
framework, which may assist in developing public health
policy, practice and research.
Keywords Climate change Mental health
Public health Adaptation
Our world is facing potentially catastrophic climate change
(Intergovernmental Panel on Climate Change 2007) and
this has the capacity to damage human health in multiple
ways (Costello et al. 2009). Human life has evolved within
a temperature, humidity and solar radiation environment
that has not varied much over thousands of years; we, and
the flora and fauna with which we share our planet, have
limited capacity to adapt to rapid or extreme climatic
changes (McMichael 1993). However, as climate science
advances, it is becoming evident that we may have to
prepare for dramatic changes, mostly for the worst
(McMichael et al. 2006b). We have begun to consider
some of the ways in which our health may be affected: our
greatest challenges may come from lack of food and
drinkable water, wider spread of certain vector-borne dis-
eases and increased heat exposures (McMichael et al.
2004). However, little consideration has been given to how
climate change may affect mental health, perhaps due to its
‘neglected’ (Horton 2007) status as the poor relation of
health (Hickie 2002). Although it is important not to
pathologise normal psychological reactions to adversity
and disaster (Horwitz and Wakefield 2007), we do need to
consider the mental health implications of climate change
This paper belongs to the special issue ‘‘Climate changes health’’.
H. L. Berry (&)K. Bowen T. Kjellstrom
National Centre for Epidemiology and Population Health,
College of Medicine, Biology and Environment,
The Australian National University, Canberra, Australia
H. L. Berry
Centre for Rural and Remote Mental Health, School of Medicine
and Public Health, The University of Newcastle,
Newcastle, Australia
H. L. Berry
Centre for Research and Action in Public Health,
University of Canberra, Canberra, Australia
Int J Public Health (2010) 55:123–132
DOI 10.1007/s00038-009-0112-0
and why this aspect of health has received so little atten-
tion. The aims of this paper are to highlight the importance
of the possible impacts of climate change on mental health
and to propose a framework for better understanding on
how climate change may affect mental health.
Climate change and health
The latest evaluation by the Intergovernmental Panel on
Climate Change (2007) has concluded that greenhouse gases
from human activity are a major cause of continuing global
climate change. Global temperature will increase, perhaps
between 1.8 and 4.0°C, by 2100 (Intergovernmental Panel
on Climate Change 2007), depending on which actions are
taken to mitigate greenhouse gas emissions. This will mean
more variable and extreme weather conditions (mainly
extremely hot or violent weather but, in some places, also
extremely cold weather). It is essential to note that estimates
of average global climate change mask the variability of
impacts and extremes that some locations will experience
(Kjellstrom 2009a). For instance, in Cairo and Athens, at 4.8
and 5.3°C per century, respectively, temperatures are rising
more rapidly than the global average (Fig. 1).
Extreme heat exposure will be associated with sub-
stantial fatalities and injuries (Kovats and Hajat 2008),
particularly where other extreme weather events also occur,
such as floods and droughts (Huq et al. 2007). Cases of
diarrheal and vector-borne diseases, and famine, will
increase with rising temperatures (Intergovernmental Panel
on Climate Change 2007; McMichael 2003); and increas-
ing temperatures in combination with high air humidity
will lead to heat exhaustion, heat stroke and fatalities
during heat waves, especially among the elderly (Kovats
and Hajat 2008) and among younger people undertaking
heavy labour (Kjellstrom 2009b). An important concern is
that the effects of climate change may be stronger for those
populations at socioeconomic disadvantage (Commission
on Social Determinants of Health 2008) exacerbating the
already inequitable distribution of health challenges (Friel
et al. 2008), particularly among indigenous peoples (Salick
and Byg 2007).
Climate change and pathways to mental health
Mental health is a key component of the World Health
Organization’s (WHO) definition of health as ‘a state of
complete physical, mental and social wellbeing and not
merely the absence of disease or infirmity’ (World Health
Organization 1948). More elegantly and pragmatically,
mental health may be considered a person’s ability to think,
to learn, and to live with his or her own emotions and the
reactions of others (Herrman 2001). The first definition
views mental health as a stable state of positive wellbeing
while the second more properly implies a dynamic con-
tinuum. Mental health problems are part of this continuum
of mental health. They differ in their causes, symptoms,
effects and treatment, but are all characterized by altera-
tions in thinking, mood or behavior, and associated distress
or impaired functioning. Some mental health problems are
uncommon (such as schizophrenia, other psychoses, bipo-
lar disorder and some anxiety and personality disorders),
some are common (including depression and other mood
disorders, some anxiety disorders, psychological distress,
substance use and eating disorders, dementia and other
forms of cognitive decline), and all may be severe and/or
enduring (Berry et al. 2007a).
Different types of extreme weather events appear to
relate to somewhat different mental health impacts, parti-
cularly at onset. The link between extreme anxiety reactions
(such as post-traumatic stress disorder, or PTSD) and acute
weather disasters, such as floods (the most common disas-
ters at global level), forest fires, heat waves and cyclones, is
Cairo 1980-2007
y = 0.0262x + 27.437
y = 0.0484x + 21.11
y = 0.0658x + 15.353
Athens 1980-2007
y = 0.0409x + 21.661
y = 0.053x + 17.222
y = 0.0514x + 13.154
Fig. 1 Temperature (°C) time trends in two cities, Cairo and Athens,
based on the daily weather station data, and including linear
regression equations (from Kjellstrom and Lemke, unpublished).
Each plot shows annual average of daily averages; middle line is
average temperature, and the other two lines are averages of
maximum and minimum temperatures in daily data for each year;
the equations describe the fitted linear trend as change per year, since
1980: x=year -1980, y=temperature
124 H. L. Berry et al.
well established (e.g. Salcioglu et al. 2007), as are the
emergency and other response procedures that are deployed
when they occur. However, not much research has been
conducted into their long-term effects. However, long-term
anxiety and depression, as well as PTSD, increased
aggression (in children) and perhaps even suicide, have
been found to be associated with floods (Ahern et al. 2005).
There is almost no quantitative epidemiological evi-
dence for the mental health effects of sub-acute weather
disasters, such as long-term drought (Berry et al. 2008).
But it may be expected that the same loss of people,
property and possessions, dislocation from community and
disruption of key social connections that precede or
amplify the development of mental health problems fol-
lowing acute disasters would apply in response to chronic
disasters of equivalent magnitude. Symptomatology related
to chronic loss and failure, such as helplessness depression,
chronic psychological distress and generalized anxiety may
be expected (Coelho et al. 2004). This is because, com-
monly, these mental health problems develop following
multiple adversities (Brugha and Cragg 1990), and slow-
creeping climate change-related weather events, such as
drought, tend to accumulate adversities.
Fritze et al. (2008) have also proposed that climate
change will have significant mental health implications
noting the psychological distress and anxiety about the
future that may result from acknowledging climate change
as a global environmental threat. They describe the
immediate (direct) mental health impacts of climate
change: the disruptions that vulnerable communities, in
particular, face with regard to the social, economic and
environmental determinants of mental health; and the
future distress and anxiety that climate change may create
on an individual level (Fritze et al. 2008).
Berry et al. (2008) and Fritze et al. (2008) concur that
climate change will have both direct and indirect effects on
mental health but there is, currently, no integrative
framework to guide research or policy making. Figure 2
illustrates putative direct and indirect relationships among
factors. Climate change may affect mental health directly
by exposing people to the psychological trauma associated
with higher frequency, intensity and duration of climate-
related disasters, including extreme heat exposure (Kjell-
strom 2009a), and also by destroying landscapes, which
diminishes the sense of belonging and solace that people
derive from their connectedness to the land (Higginbotham
et al. 2007). In addition, indirect effects may occur via two
further pathways. Climate change may affect (1) physical
health, through increased heat stress, injury, disease and
disruption to food supply, and (2) community wellbeing,
through damage to the economic and, consequently, the
social fabric of communities.
Direct effects of climate change on mental health
Acute weather events
Most research into the mental health impacts of weather
events has concentrated on acute events such as,
Causal, reciprocal
Damage to landscape
and agriculture
Direct (smoke, burns,
Indirect (food supply)
Loss of livelihoods,
poverty, isolation,
alienation, grief,
bereavement, displacement
Economic, social
demographic impacts
High/low prevalence
Local cultural, economic, social, developmental and environmental context
Fig. 2 Framework showing
putative causal pathways
linking climate change and
mental health
Climate change and mental health 125
earthquakes, floods, fires and hurricanes, and associations
with the onset of PTSD. Because climate change is asso-
ciated with an increase in the frequency and severity of
these acute weather events, people will be increasingly
exposed to the precursors of PTSD—danger, injury and
death, including harm to significant others. Consistent with
pathways models of mental health, PTSD is sensitive to a
range of exposure and predisposing social and emotional
factors, with young people particularly vulnerable (Sal-
cioglu et al. 2007). In addition to the development of severe
anxiety disorders, traumatic exposures can also cause
reactions ranging from general somatic and mental health
problems, followed by resilient recovery to several types of
enduring, severe psychopathology (Norris et al. 2002), as
well as loss of resources (Freedy et al. 1994) and sub-
stantial psychological distress (Beaudoin 2007; Wickrama
and Wickrama 2008).
Extreme heat events will be especially common as
global temperatures rise and these events may also be
associated with a general increase in aggression (Anderson
and Anderson 1998). Increasing temperatures (especially
lengthy spells of hot weather) have been associated with
higher rates of criminal and aggressive behavior (Brearley
1929; Cheatwood 1995; Cohn et al. 2004) and higher sui-
cide rates (Maes et al. 1994). Extreme heat events may also
be linked to suicide and psychiatric and other hospital
admissions. In a recent meta-analysis, Bouchama et al.
(2007) concluded that pre-existing mental health problems
tripled the risk of any-cause mortality during a heat wave.
In Adelaide, Australia (Nitschke et al. 2007), heat wave-
related hospital admissions increased for mental and
behavioral disorders, including organic illnesses, dementia,
mood disorders, anxiety, stress-related and somatoform
disorders, disorders of psychological development and
senility (Hanson et al. 2008). A related issue is the physical
and psychological exhaustion caused by extreme heat
exposure (Parsons 2003), which will be a more common
feature of already hot regions of the world (Global
Humanitarian Forum 2009). Humidity has also been asso-
ciated with mental functioning. For example, it is related to
poorer concentration and elevated fatigue (Howarth and
Hoffman 1984). However, the relationships among heat,
humidity and mental health may be sensitive to local
context or confounded by research methods (Berry et al.
2008). For instance, decreasing temperatures have also
been associated with increasing aggression (Howarth and
Hoffman 1984), suggesting perhaps that significant tem-
perature deviations up or down from local norms may be
related to increasing mental health problems.
A recent review of the mental health impacts of climate
change in rural and remote Australia identified an urgent
need to understand the likely consequences of climate
change (particularly drought and long-term drying) on
mental health and wellbeing (Berry et al. 2008). The
review drew attention to a spectrum of chronic to acute
(fast onset) climate change-related adverse weather events
(see Table 1): acute events include heat waves, floods,
storms and fires, while drought is an example of a sub-
acute event. Long-term underlying drying and warming are
chronic events. The occurrence of such events is associated
with increased mental health problems. In emergencies
generally, the number of people with mental disorders is
estimated to increase by 6–11% (World Health
Sub-acute weather events
Climate change will also be associated with an increase in
sub-acute adverse weather events, most notably with more
frequent, longer and more severe periods of extreme heat
and/or drought. At its worst, this may dislocate people
permanently from their land, creating cohorts of displaced
persons who will experience depression and trauma
(Campbell and Campbell 2007; Haq et al. 2007) associated
with loss of home, place and social networks (McMichael
et al. 2009). The IPCC has estimated that there may be 150
million such displaced persons by 2050, due primarily to
coastal flooding, shoreline erosion and agricultural degra-
dation. In addition to too little (or too much) rain, rain may
fall outside the periods in which it is needed for particular
agricultural purposes, especially for cropping, exacerbating
the underlying difficulties associated with inadequate
Table 1 Nature of weather events (acute vs. chronic) and putative pathways to effects on mental health (direct vs. indirect)
Acute weather event (e.g. increased frequency of cyclones) Sub-acute weather event (e.g. more extremely hot days,
Direct effects
on mental
More frequent exposure to physical danger due to storms or
floods; elevated rates of acute anxiety disorders
More frequent exposure to chronic stress, e.g. from long
periods of extremes of heat or lack of (clean) water; elevated
rates of violence and aggression
effects on
More frequent and/or severe damage to homes and physical
infrastructure, including community buildings (halls,
churches, schools); physical injury to self or significant
others; elevated rates of anxiety and mood disorders
More frequent and/or severe physical health impacts and
damage to livelihoods and soft social infrastructure
(disruption of networks, lack of time to socialize); elevated
rates of chronic mood disorders and suicide ideation and
126 H. L. Berry et al.
precipitation (Intergovernmental Panel on Climate Change
Heat exposures in working environments are of great
significance: they reduce people’s capacity to undertake
physical (Bridger 2003; Kerslake 1972; Kjellstrom et al.
2009d), mental task capacity is diminished (Ramsey 1995)
and the risk of accidents is increased (Ramsey et al. 1983).
The primary cause of these effects is excessive core body
temperature (Leithead and Lind 1964); dehydration due to
inadequate fluid intake while sweating is also important
(Schrier et al. 1970). The loss of work capacity due to
increasing heat exposure while working (particularly out-
doors) and resulting loss of income (Kjellstrom 2009b)is
also likely to cause mental health problems for many
millions of people.
Indirect effects of climate change on mental health
Impacts via physical health
Physical health problems are causally and reciprocally
associated with the development of mental health problems
(Miller et al. 2009; Prince et al. 2007), particularly among
vulnerable groups, such as older people (Katz 1996) and
indigenous people (Berry 2009). Mental health problems
are among the risk factors for communicable and non-
communicable diseases, increasing the likelihood of their
development. The reverse is also true with: for example,
obesity has been associated with increase in depression,
bipolar disorder and panic disorder (World Health Orga-
nization 2009).
Impacts via the physical environment
Long periods of high temperatures, heat and drought-
related events (such as fires) can be expected to increase, as
can flood and related events (such as landslides). These will
be accompanied by consequential environmental risk fac-
tors, such as increased smoke, pollen density, dust
(McMichael et al. 2006a) plant disease, and infestations.
The quality and availability of water for human and live-
stock consumption may be compromised, with possible
increases in water-borne disease (Rose et al. 2000). In
developing countries, which will endure the bulk of
adverse climate change, many people may be forced from
land that they can no longer farm into urban slums (UN
Habitat 2006); here, the additional heat exposures due to
climate change and the indirect health risks (such as
extended lack of clean drinking water) are much greater
than in other parts of cities (World Health Organization
2008b). These threats to physical health will directly affect
mental health and also compound the underlying risks to
mental health inherent in living in urban slums (Berry
Environmental relationships to health have often been
narrowly articulated in terms of biophysical conditions
(Horwitz et al. 2001). There is, also, an important rela-
tionship between sense of place, the environment and
human wellbeing, sometimes expressed as ‘biophilia’
(Gullone 2000; Wilson 1984) and ‘solastalgia’ (Higgin-
botham et al. 2007). Biophilia describes the relationship
between humans and their environmental conditions, while
solastalgia describes the distress, the loss of solace, caused
by degradation of the environment, home and sense of
Climates everywhere are characterized by daily and
seasonal variations and we are acclimatized to these; but
climate change-induced increases in climate variability will
not be spread evenly across the day or the year. Instead,
there will be increased extremes. This will increase the
variability in climate-related mental health problems. For
example, seasonal variation in mood has already been
documented, with seasonal affective disorder, depressive
symptoms, bulimia nervosa, anxiety disorders and other
mental health problems usually peaking in the cold season
when there is limited sunlight (Magnusson 2000). Where
the climate warms, seasonal affective disorder may reduce
somewhat, while it may be exacerbated in regions that
receive fewer hours of sunlight. Periods of drought in rural
areas over spring (a significant time for agricultural pro-
duction) are associated with a reduction in life satisfaction
(Carroll et al. 2009) and more of these shifts in the timing
of droughts can be expected (Berry et al. 2008).
Impacts via the social environment
In communities dependent on agricultural production
(which are more common in least developed countries and
among Indigenous peoples; Agriculture Food Organization
2008), climate change may, in some cases, particularly in
vulnerable places and among vulnerable populations
reduce agricultural productivity and the viability of agri-
cultural support industries. For example, extreme heat
exposure in farm fields reduces agricultural laborers’ work
capacity (Kjellstrom et al. 2009d), further undermining
agricultural support industries which include local busi-
nesses and services and employment brokers for casual
labor (Berry et al. 2008). These losses create socioeco-
nomic hardship and subsequent poor mental health
(Dohrenwend 1990; Faris and Dunham 1939; Hollingshead
1958; Leighton 1965; Srole 1962). In Australia, in the
drought period from 2002 to 2003, GDP growth fell 1.0
percentage point, with gross value added falling by 28.5%
compared with the preceding year (Australian Bureau of
Statistics 2004). Natural disasters cost Australia A$37.8b
Climate change and mental health 127
between 1967 and 1999. All, but A$5b (earthquakes) of
these losses were attributable to climate factors (Inter-
governmental Panel on Climate Change 2007). In long-
term drought, specifically, deterioration in economic
conditions over time has been associated with depression
and demoralisation among parents (Conger et al. 1992) and
their children. Indeed, it has been proposed that socioeco-
nomic circumstances may be a more potent source of
vulnerability to poor mental health than is the rural setting
itself (Judd et al. 2002; Smith et al. 2008). Drought-prone
areas are vulnerable to chronically lower socioeconomic
status and educational attainment than are other areas and,
consequently, to higher levels of distress and learned
helplessness (Coelho et al. 2004).
Importantly, economic pressures undermine social cap-
ital that is protectively related, possibly causally, to mental
health and wellbeing (De Silva et al. 2005; Sartorius 2003;
Whitley and McKenzie 2005). Social capital is a combi-
nation of community participation and social cohesion,
with higher levels of social capital related to better health
(particularly where there are high levels of inequality), and
especially to mental health (Berry and Welsh 2009); where
increased workloads and lack of time and money-keep
people from social activities, particularly from the informal
social connections that are so important for mental health
(Berry et al. 2007b), or place pressure on important rela-
tionships, mental health problems are likely to increase.
Women may be particularly affected, being more likely
than are men (Alston and Kent 2004; Stehlik et al. 2000)to
migrate for employment or for their children’s education
with consequent impacts on family wellbeing.
The importance of the social impacts in indigenous
peoples and on those living in tropical low and middle-
income countries is highlighted by the examples in
Impacts via adaptation or mitigation
Adaptation and mitigation actions may, in themselves,
increase climate change-related mental health risks via
various causal pathways. For example, reduced car travel
by car-reliant populations would, desirably, reduce green-
house gas emissions and, possibly, increase physical
activity. For those who may stop driving to work, instead
walking or cycling, there could indeed be very substantial
co-benefits for chronic disorders, such as obesity and car-
diovascular disease (Besser and Dannenberg 2005; Frank
et al. 2004). However, travel by alternative means, whether
these are public transport, walking or cycling, may, for
some people, increase travel time; where this were the case,
commuters would have less time to spend at work or,
perhaps more likely, at home, reducing the time available
to engage with family and friends. Given that time devoted
to informal social connectedness is very strongly protec-
tively related to mental health (Berry and Welsh 2009),
increasing travel time would be related to adverse impacts
on mental health. Further, as those who are most disad-
vantaged tend to have least access to services, such as
transport, this would differentially be a disadvantage those
in most need (Currie et al. 2009). Adaptation also poses
health risks. For instance, when air conditioning is not
available, excessive heat exposure at work may require
working less in the hottest parts of the day, thus reducing
daily output. For low-paid workers, especially in devel-
oping countries where occupational health systems may
provide only limited protection (Kjellstrom and Hogstedt
2009), this may translate to reduced income. To compen-
sate, these workers may find it necessary to increase their
work hours, or to work more at night, with negative
implications for their health (Harrington 1994) and for
family life.
The role of the health system in preventing
or reducing effects
Not much is being done to address physical health needs
and even less to address mental health concerns relating to
climate change and this is not surprising. The neglect of
mental health is reflected in the inadequate level of
resources made available for mental health services (Hor-
ton 2007) and also in the poor resourcing of mental health
research (Jorm et al. 2002). Mental health resources are
‘inadequate, insufficient and inequitably distributed’
(Horton 2007 p. 806), a situation that has been called a
‘silent scandal’ (Thornicroft 2007). Mental health resour-
ces are catastrophically inadequate in low-income
countries, which have 0.05 psychiatrists and 0.16 psychi-
atric nurses per 100,000 people, as compared to 200 times
more in high-income countries (World Health Organization
2009). Despite strong evidence for expanding mental
health services and integrating them into primary health
care (Horton 2007), especially in responding to climate
change (Blashki et al. 2009), worldwide, the majority of
people (between 32 and 97%) usually do not receive any
treatment at all for a wide range of mental health problems
(Thornicroft 2007). Perhaps, there are some understandable
reasons for this. It is fair to acknowledge, perhaps, that the
complexity of mental health may account for why greater
consideration is given to physical health. Maybe there is
also a genuine lack of understanding about the importance
of mental health and its interdependence with physical
health (Horton 2007). Substantial continuing worldwide
stigma (and associated exclusion and discrimination)
linked to mental health (Sartorius 2007) may also con-
tribute to this research and policy aversion. As Horton
128 H. L. Berry et al.
(2007) writes: ‘Despite the great attention western coun-
tries pay to the mind and human consciousness in
philosophy and the arts, disturbances of mental health
remain not only neglected but also deeply stigmatised
across our societies’ (p. 806).
Yet mental health is a major and growing global concern
(Prince et al. 2007), likely constituting the second greatest
burden of non-fatal disease by 2030 (Mathers and Loncar
2006), and we cannot ignore it. Within the mental health
system, a graded spectrum of approaches, ranging from
prevention and early intervention to treatment, is needed to
properly respond to mental health needs from onset
through recovery, especially for indigenous peoples. The
WHO’s pyramid (World Health Organization 2008a) for an
optimal mix of services for mental health identifies an
appropriate range: from self-care and informal community
care; through mental health services via primary health
care; community mental health services; and the most
intensive interventions at the treatment end of the spectrum
(long-stay facilities and specialist services). This pyramid
is relevant and can be adapted to the needs of climate
change-related mental health problems.
The debate about the impact of climate change on human
health has, very recently, included consideration of mental
health. By increasing the frequency, severity and duration
of adverse weather events, climate change will affect
mental health via at least three pathways. It will, first,
directly affect mental health by inflicting more and worse
natural disasters on human settlements which, typically,
cause serious anxiety-related responses and, later, chronic
and severe mental health problems. Second, it will increase
the risk of injury and physical health problems which are
causally and reciprocally related to mental health. Third, it
will endanger the natural and social environment on which
people depend for their livelihoods and wellbeing. These
effects will not be felt equally by all, but will fall dispro-
portionately on those who are already vulnerable,
especially on indigenous peoples and those living in
developing countries, which will bear the brunt of adverse
climate change. The present paper proposes a framework
showing direct and indirect pathways via which climate
change may affect mental health.
The health system, broadly defined, must play an
important role in identifying possibilities for preventive
actions that reduce population vulnerability, and in acting
to support people whose mental health has been affected.
Health systems that meet WHO climate change guidelines
and achieve the millennium development goals can do
much to limit the health effects of climate change.
A continuum of approaches is appropriate, depending on
the stage of illness, ranging from prevention through
treatment and recovery. We hope that our proposed
framework may encourage further debate, and contribute a
perspective that may assist in the formulation of policy and
services for the impact of climate change on mental health.
Acknowledgments This research was supported by The Australian
National University general facilities and not by any specific research
Conflict of interest statement The authors have no conflicts of
interest to declare.
Two case studies illustrating how climate change may
affect societal and demographic factors that may, in
turn, affect mental health security
Increasing heat exposure on working people in tropical
There is a physiological limit to the ability of humans to
carry out strenuous work in hot conditions (air tempera-
tures above 37°C and at high humidity level). To prevent
heat stroke in such conditions, workers have to reduce
their work output and avoid working during the hottest
part of the day. Increasing heat exposure may, therefore,
reduce income, disrupt daily social activities and create
psychological distress. For example, we have observed
work situations at construction sites in India and shoe
factories in Vietnam where the long actual working hours
and heat exposure (requiring lengthy rest periods during
the hottest hours) demand 15–16 h of daily presence at
the workplace (Kjellstrom et al. 2009d). Increasing tem-
peratures with climate change would make this situation
Drought and long-term drying in Australia
Australia’s Bureau of Meteorology has concluded that the
severity of the recent drought, 2001–2007, was, in part, due
to the underlying warmer temperatures caused by climate
change (Nicholls and Collins 2006). The recent Kenny
Review of the Social Impact of Drought in Australia
(Drought Policy Review Expert Social Panel 2008) has
described the increased hardships that have been experi-
enced in rural lifestyles: livelihoods are at stake, and those
who are most vulnerable, geographically or socioeconom-
ically, appear to be worst affected. The stresses of lost
income, debt and damage to property have spilled over into
Climate change and mental health 129
mental health problems for some and to the tragedy of
despair and suicide for a few (Berry et al. 2008). The
severity and distribution of these mental health problems
appear, also, to have been influenced by aspects of com-
munity—resources, cohesion, resilience and external
supports; where community support has been strong,
communities appear to have fared better than where less
support has been available.
Agriculture Food Organization (2008) The State of Food and
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... Likewise, protected areas have been found to improve general well-being (Reining et al., 2021;Buckley et al., 2019;Wood et al., 2017). However, the rapid severity of climate change (Bellard et al., 2012;Dale et al., 2001) has led to increased negative consequences affecting both physical and mental health (Clayton, 2021;Cianconi et al., 2020;Berry et al., 2010). Solastalgia, or emotional distress due to environmental changes (Albrecht et al., 2007), exemplifies the complex interplay between mental health and climatic factors, with potential differential effects on populations. ...
... As the climate crisis worsens, humans are experiencing a growing negative influence on their mental health. While for many, nature has traditionally acted as a sanctuary of safety and peace, the deteriorating state of our Eureka || 6 planet is threatening our physical, emotional, and mental well-being (Clayton, 2021;Cianconi et al., 2020;Berry, et al., 2010). Communities living in cryospheric environments are particularly vulnerable to the complex challenges to their physical and mental health related to rapid changes in their surroundings (Cunsolo et al., 2015;Cunsolo et al., 2013). ...
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Background Glaciers are integral in maintaining hydrological cycles, moderating oceanic levels, and preserving valuable ecosystems. Cryospheric regions are often overlooked in evaluating the environmental factors affecting mental health. This study investigates the potential influence of glacial presence and melt behaviour on global mental health, particularly among marginalized communities. Methods National suicide rates of general population and specific age categories were gathered from World Health Organization between 2012-19. Glacial data was sourced from the World Glacier Monitoring Service, and Randolph Glacier Inventory. Wilcox testing was conducted to identify mean suicide rates across countries with and without glaciers. Pearson and Spearman correlation testing were employed to identify relationships between melt rate indicators and suicide rates. Results Over the entire eight-year duration, countries with the existence of glaciers revealed a notably higher suicide rate (p-value of 0.0001). Children aged 5-15 years old demonstrated a consistently higher suicide rate amongst countries with glacial bodies (p-value between 0.020-0.037). A positive correlation between regional suicide rates and glacial area was revealed, except in low-latitude countries. Although melt rate variability showed no significant correlation with suicide statistics, Greenland was the only country to demonstrate a negative relation among all populations. Conclusions To address the ongoing impacts of the climate crisis, further research is necessary to develop an inclusive framework that acknowledges the unique challenges faced by communities living in cryospheric regions. This study is the tip of the iceberg, recognizing the importance of inclusivity in addressing the mental health implications of climate change in these environments.
... Individuals with low socio-economic status who live in low and middle-income countries (LMICs) and areas that are more impacted by climate change seem to be at higher risk of declined mental health [7,36,43,44]. LMICs' vulnerability to climate change relates to their limited capacity to offer economical and health support in response to climate change threats. LMICs have limited resources, weak infrastructure, and health services to cope with climate-related disasters and increased damage to the local and national economies when affected by climate change-related events. ...
... Prior climate change literature highlighted that a country's socio-economic status plays a crucial role in how their populations will receive climate change influences [36,43,44]. Thus, in this section, we separate our findings according to the socio-economic status of a given region/country. ...
The Western Pacific Region (WPR) is on the front line of climate change challenges. Understanding how these challenges affect the WPR populations' mental health is essential to design effective prevention and care policies. Thus, the present study conducted an umbrella scoping review that examined the influence of climate change on mental health in the WPR, using review articles as a source of information. Ten review articles were selected according to eligibility criteria, and the findings were synthesized according to the socio-economic status of the countries identified: Australia, the Republic of Korea, the Philippines, Vietnam, the Pacific Islands (broadly), and China. The findings revealed that each country and sub-region has its own unique profile of climate change-related challenges and vulnerable populations, highlighting the need for specific approaches to mental health care. Specifically, the influence of climate-related challenges differed according to populations' region (e.g., rural populations), demographic characteristics (e.g., age and gender), culture (e.g., traditional tights to land), and employment (e.g., farmers and fishers). The most frequently reported mental health outcomes in response to climate change-related challenges such as droughts, floods, storms, tornadoes, typhoons, and climate-related migration were the decline in mental well-being and the increase in post-traumatic stress disorder symptoms. In addition, using the GRADE framework for assessing the certainty of the findings, we identified that the number of articles discussing associations between a given climate change challenge and a mental health outcome was overall limited. Based on our findings and findings on a global scale, we identified several key research gaps in WPR and provided recommendations for future research and policy strategies.
... Estos niño/as se enfrentan a una combinación mortal de exposición ambiental y alta vulnerabilidad social, que incluye la falta de servicios básicos como agua, atención médica y educación. Se estima que alrededor de 820 millones de niño/as están altamente expuestos a las olas de calor, lo que tiene consecuencias en su salud física, socioemocional, económica, entre otros ámbitos (Berry et al., 2010). ...
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El cambio climático y el aumento de las olas de calor tienen un impacto negativo en el bienestar subjetivo de niños y jóvenes. Este estudio examinó la experiencia de bienestar en jóvenes chilenos frente a las olas de calor. Utilizando entrevistas y grupos focales, se seleccionaron diez participantes con diferentes trayectorias educativas y niveles de contacto con la naturaleza. Los resultados mostraron que predominaban percepciones negativas del clima y emociones displacenteras como preocupación y desmotivación. Sin embargo, se encontró que aquellos con mayor contacto con la naturaleza experimentaban un mayor bienestar subjetivo. Se concluye que las olas de calor asociadas al cambio climático afectan negativamente la salud mental, pero también se destaca el papel que desempeñan los jóvenes en las acciones de mitigación y adaptación ante el cambio climático.
... In addition, hot weather affects people's willingness to make short trips, while cold weather promotes more frequent short trips. Fear of natural hazards such as heat stroke, heat stroke, and severe cold can affect people's willingness to travel (Berry et al., 2010). Extreme heat tends to last longer, and the personal hazards of heat exposure are greater, making people more selective in avoiding going out on days of extreme heat (Thorsson et al., 2004) or moving away from the center of the heat island to the cooler countryside. ...
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Extreme temperatures are occurring more frequently and intensely, leading to more significant impacts on a variety of populations in the world as climate change continues. Little research to date, however, has investigated the temporal, spatial, and social patterns in which human mobility responds to extreme temperatures from the perspective of regional heterogeneity. This study, taking the Greater Houston area in the United States as a testbed, conducted statistical and geospatial analyses to measure the unequal impacts of extreme temperatures on human mobility in cities. In particular, the changes in daily human mobility across dimensions (i.e., temperatures , spatial gradients, and social relationships) when experiencing extreme temperatures are examined. The results show that extreme heat inhibits people's willingness to make short trips, while cold weather promotes more frequent short trips. Besides, extreme temperatures impede the mobility of people near the city center while promoting movement to the suburbs. Furthermore, the areas with large numbers of disadvantaged social groups were more likely to be affected by extreme temperatures. The socio-demographic inequalities in the impacts of extreme temperatures quantified in this study could promote more scientific, targeted, and practical policy planning and implementation by local governments.
... Highlighting the impacts of awareness and anticipation, a recent longitudinal study by McBride et al. (2021) found that individuals' concerns about climate change at one time point predicted their levels of psychological distress a year later. Overall, it appears that climate change negatively impacts mental health through both direct and indirect mechanisms (Berry et al., 2010;Doherty and Clayton, 2011). ...
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Introduction Climate change is a source of global concern that has both direct and general impacts on mental health. A recent study conducted following severe bushfires in Australia demonstrated relationships among nature connectedness, climate action, climate worry, and mental health; for example, nature connectedness was associated with climate worry, which in turn was associated with psychological distress. Methods The present study sought to replicate those findings while building on them in two important ways: on those findings in two ways: first, test similar relationships in a different geographical context that has been mostly spared from direct impacts by acute climate events; second, we take into consideration an additional factor, climate knowledge, which has been linked to relevant factors such as climate anxiety. Results The results of a survey completed by 327 adults revealed a similar relationship between nature connectedness and climate anxiety, and between that and psychological distress. Further mirroring those previous findings, nature connectedness was associated with both individual and collective climate action, but the relationships between them and psychological distress differed. Discussion The proposed model was a better fit to the collected data among those with high levels of climate change knowledge than those with low levels, suggesting that such knowledge influences how the above factors relate to each other.
Purpose This paper aims to examine why people with disabilities (PWDs) are at risk due to climate change. It also discusses the linkage between climate change events and the mental health of the disabled population. Design/methodology/approach This paper follows a qualitative approach. Findings Climate change can affect the mental well-being of PWDs in several ways such as increased vulnerability, displacement-related trauma, social isolation, loss of independence, climate anxiety and eco-grief. Practical implications The paper has practical implications for policymakers. Because climate change has a disproportionate impact on PWDs, there is an urgent need to include them in climate action, both as beneficiaries and decision-makers. Originality/value The paper attempts to explore the measures that can be taken for prevention and mitigation of impacts on the mental health of PWDs.
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Background This paper discusses a paradox in mental health. It manifests as a relationship between adverse “bad” effects (suffering, clinical costs, loss of productivity) in individuals and populations and advantageous “good” aspects of mental disorders. These beneficial aspects (scientific, artistic and political accomplishments) emanate at the societal level through the frequently unprecedented creativity of people suffering from mental disorders and their relatives. Such gains can contribute to societal innovation and problem-solving. Especially in times of accelerated social-ecological change, approaches are needed that facilitate best-possible mental health care but also recognize creative ideas conducive to beneficial clinical and social-ecological innovations as soon as possible. Discussion This paper emphasizes the need to account for creativity as a crucial component in evolving mental health systems and societies. It highlights the need for wide-ranging approaches and discusses how research targeting multiple facets (e.g., brain level, cognitive neuroscience, psychiatry, neurology, socio-cultural, economic and other factors) might further our understanding of the creativity-mental disorder link and its importance for innovating mental health systems and societies. Conclusion Our discussion clarifies that considerable research will be needed to obtain a better understanding of how creativity associated with mental disorders may help to create more sustainable societies on a fast-changing planet through innovative ideas. Given the current-state-of-the-art of research and healthcare management, our discussion is currently speculative. However, it provides a basis for how pros and cons might be studied in the future through transdisciplinary research and collaborations across sectors of society.
In the ten years since the publication of the second edition of Human Thermal Environments: The Effects of Hot, Moderate, and Cold Environments on Human Health, Comfort, and Performance, Third Edition, the world has embraced electronic communications, making international collaboration almost instantaneous and global. However, there is still a need for a compilation of up-to-date information and best practices. Reflecting current changes in theory and applications, this third edition of a bestseller continues to be the standard text for the design of environments for humans to live and work safely, comfortably, and effectively, and for the design of materials that help people cope with their environments. See What’s New in the Third Edition: • All existing chapters significantly updated • Five new chapters Testing and development of clothing • Adaptive models • Thermal comfort for special populations • Thermal comfort for special environments • Extreme environments • Weather • Outdoor environments and climate change • Fun runs, cold snaps, and heat waves The book covers hot, moderate, and cold environments, and defines them in terms of six basic parameters: air temperature, radiant temperature, humidity, air velocity, clothing worn, and the person’s activity. It focuses on the principles and practice of human response, which incorporates psychology, physiology, and environmental physics with applied ergonomics. The text then discusses water requirements, computer modeling, computer-aided design, and current standards. A systematic treatment of thermal environments and how they affect humans in real-world applications, the book links the health and engineering aspects of the built environment. It provides you with updated tools, techniques, and methods for the design of products and environments that achieve thermal comfort.
Social capital is a term that has recently gained popularity. It refers to the public good that results from mutually supportive social relationships. Mental health can be defined as the state of balance that individuals establish within themselves and between themselves and their social and physical environment. The article describes the relationship between the two and demonstrates that an increase of social capital supports mental health and that the promotion of mental health and its improvement (as well as the successful treatment of mental disorders) contributes to the growth of social capital.