Healthcare must count costs of climate-driven mental illness and eco distress

A mother teaching her child how to plant a tree (Credit: @eyoel_kahssay_photographer)

Suicides, heatwave deaths for mentally ill, increased care needs and eco-anxiety among the uncounted costs of climate change, says a new expert report

Climate change and mental health are two of the most significant and pressing challenges facing societies across the world.

While the climate crisis is increasingly recognised as a health emergency, the interplay between climate change, mental health and emotional wellbeing has been relatively neglected.

Now, a new report by Imperial College London experts presents substantial evidence that climate change has a detrimental and multi-faceted impact on mental health, with significant costs to individuals, health systems and economies that are currently unaccounted for in policy and practice.

These far-reaching impacts include:

• Rising local temperatures are strongly associated with increased rates of suicide (1% for every 1°C temperature rise) and reduce population mental wellbeing
• People with pre-existing mental illnesses are at increased risk of dying during a heatwave (2-3-fold increase)
• Cases of psychological trauma caused by climate-driven disasters exceed those of physical injury (40:1 ratio)
• Extreme weather events are linked with post-traumatic stress disorder, depression and anxiety, and extreme distress
• By straining limited resources, the climate crisis threatens to disrupt the provision of care for people with a mental illness diagnosis, with fragile health systems particularly vulnerable
• Climate change exacerbates mental distress, particularly among young people, even for individuals who are not directly affected (e.g. 'eco-anxiety').

The authors from the Climate Cares initiative, a collaboration between Imperial College London's Grantham Institute and Institute of Global Health Innovation are drawing attention to the underappreciated interplay between climate change and mental health.

The report, 'The impact of climate change on mental health and emotional wellbeing: current evidence and implications for policy and practice', proposes a detailed set of recommendations to stimulate greater knowledge, awareness and action for policy makers, research institutions, mental health practitioners and health systems, and non-governmental organisations.

These include the development of training programmes to build greater capacity to prevent and respond to the mental health impacts of climate change; the inclusion of people vulnerable to and with lived experience of climate change impacts in research and the development of interventions; and the incorporation of mental health support as a key pillar of climate disaster emergency responses.

Dr Emma Lawrance, Mental Health Innovations Lead at the Institute of Global Health Innovation, said: "As demonstrated by this report and the growing evidence base, both experiences and awareness of the climate crisis are contributing to worse mental health and emotional wellbeing. Proactively considering the relationship between climate change and mental health will enable the costs of inaction can be better assessed, and give leaders the opportunity to seize win-wins that benefit the health of our planet and minds. By uniting experts across sectors and people with lived experience, our programme hopes to raise awareness of these pressing issues and drive action for a healthier future."

Report authors highlight evidence that children, minoritised ethnic groups (such as Black Americans and First Nations Australians), and women are among those particularly vulnerable to the mental health effects of extreme weather events. Other susceptible groups include people with prior experiences of deprivation or mental health issues, those with less social support, and people experiencing inadequate welfare or medical care.

Dr David Nabarro, co-director of the Institute of Global Health Innovation, said: "This report sets out the latest evidence about ways that climate change can affect people’s mental health and wellbeing. The impact is uneven with some groups worse affected.

"Those who already experience mental ill-health are at risk of becoming increasingly unwell as a consequence of climate change, with the greatest risk among poorer people and in under-served communities. People already vulnerable are therefore more likely to be left behind as climate continues to change.  

"Health leaders who take account of these trends can better ensure that people, and health systems, are prepared to help limit the impacts of climate change on people's wellbeing."

The evidence for the multiple impacts of climate change on mental health and emotional wellbeing warrants this issue to be given much greater prominence within public policy and public discourse, say the authors.

They also warn that unless tackled in a coordinated way, these impacts will get worse due to increased mental health needs and associated pressure on mental health services. This in turn threatens to exacerbate health and social inequalities which themselves worsen mental health.

There is still an opportunity to turn this from a 'vicious' to a 'virtuous' cycle, say the authors. Actions that address climate change will have an even greater return than currently expected, as they will prevent or reduce negative effects on mental health that have not yet been considered in policies and budgets.

"Policy responses can make multiple gains, or 'co-benefits', by leveraging common solutions to the dual challenges of climate change and mental health," says Dr Neil Jennings, Partnership Development Manager at the Grantham Institute.

"Such solutions include increasing the amount of green space in urban areas to absorb carbon dioxide, reduce the heat island effect, reduce the risk of local flooding and improve access to nature."

Further, when individuals take action to address and respond to climate change, this may also be protective for their mental health.

Dr Adrian James, President of the Royal College of Psychiatrists, said: "This is a landmark paper providing an essential summary for governments and health-care services alike. Its summary of the literature underlines that without urgent action the planetary crisis will impact on all aspects of health for generations to come."

Download the report, 'The impact of climate change on mental health and emotional wellbeing: current evidence and implications for policy and practice'.

To launch the report, Imperial are bringing together experts for two free online panel discussions on 27 May and 2 June, to raise awareness and drive action on the mental health impacts of the climate crisis.

See side-bar for details and how to register to attend. 

See the press release of this article