Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

The clinical implications of climate change for mental health

Abstract

Climate change affects mental health through multiple pathways, including direct and indirect impacts, physical health and awareness of the climate crisis. Climate change increases the magnitude and frequency of extreme events with little or no time for recovery. This Review aims to provide an overview of the current evidence to inform the mental health field’s response to climate change. While further innovation is needed, promising approaches for health professionals are identified at the levels of interventions for individuals, community and system-wide responses, and advocacy and education. Health worker training is important, so we offer guidance on mental health assessment and clinical risks from climate change. We also outline strategies to enhance individual and community psychological resilience and promising approaches to working with people experiencing emerging climate-related disorders. Beyond clinical care, mental health professionals can lead on climate action and sustainability in health care and can research and educate on the health effects of climate change.

This is a preview of subscription content, access via your institution

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

All prices are NET prices.

Fig. 1: Roles and priorities of health professionals.
Fig. 2: SAFE mental health assessment.

References

  1. Mental Health and Climate Change: Policy Brief https://www.who.int/publications/i/item/9789240045125 (World Health Organization, 2022).

  2. GBD Mental Disorders Collaborators. Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Psychiatry 9, 137–150 (2022).

    Article  Google Scholar 

  3. Goldmann, E. & Galea, S. Mental health consequences of disasters. Annu. Rev. Public Health 35, 169–183 (2014).

    Article  PubMed  Google Scholar 

  4. Dodgen, D. et al. Ch. 8: Mental Health and Well-Being (US Global Change Research Program, 2016).

  5. James, L. E., Welton-Mitchell, C., Noel, J. R. & James, A. S. Integrating mental health and disaster preparedness in intervention: a randomized controlled trial with earthquake and flood-affected communities in Haiti. Psychol. Med. 50, 342–352 (2020).

    Article  PubMed  Google Scholar 

  6. American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) 5th edn (American Psychiatric Publishing, 2013).

  7. Charlson, F. et al. Climate change and mental health: a scoping review. Int. J. Environ. Res. Public Health https://doi.org/10.3390/ijerph18094486 (2021).

  8. Benedek, D., Morganstein, J., Holloway, H. & Ursano, R. in Kaplan and Sadock’s Comprehensive Textbook of Psychiatry (eds Sadock, J., Sadock, V. & Ruiz, P.) 2564–2576 (Lippincott Williams & Wilkins, 2017).

  9. Lawrance, E. et al. The Impact of Climate Change on Mental Health and Emotional Wellbeing: Current Evidence and Implications for Policy and Practice (Imperial College London, 2021).

  10. Clemens, V., von Hirschhausen, E. & Fegert, J. M. Report of the Intergovernmental Panel on Climate Change: implications for the mental health policy of children and adolescents in Europe—a scoping review. Eur. Child Adolesc. Psychiatry 31, 701–713 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  11. Alter, C. L. & Epstein, S. A. in Kaplan and Sadock’s Comprehensive Textbook of Psychiatry (eds Sadock, J., Sadock, V. & Ruiz, P.) 2177-2186 (Lippincott Williams & Wilkins, 2017).

  12. Ye, G., Baldwin, D. S. & Hou, R. Anxiety in asthma: a systematic review and meta-analysis. Psychol. Med. 51, 11–20 (2021).

    Article  PubMed  Google Scholar 

  13. Ferro, M. A. et al. Condition-specific associations of symptoms of depression and anxiety in adolescents and young adults with asthma and food allergy. J. Asthma 53, 282–288 (2016).

    Article  PubMed  Google Scholar 

  14. D’Amato, G. et al. Meteorological conditions, climate change, new emerging factors, and asthma and related allergic disorders: a statement of the World Allergy Organization. World Allergy Organ. J. https://doi.org/10.1186/s40413-015-0073-0 (2015).

  15. Clayton, S. & Karazsia, B. T. Development and validation of a measure of climate change anxiety. J. Environ. Psychol. https://doi.org/10.1016/j.jenvp.2020.101434 (2020).

  16. Taylor, S. Anxiety disorders, climate change, and the challenges ahead: introduction to the special issue. J. Anxiety Disord. 76, 102313 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  17. Cunsolo, A. & Ellis, N. R. Ecological grief as a mental health response to climate change-related loss. Nat. Clim. Change 8, 275–281 (2018).

    Article  Google Scholar 

  18. Clayton, S. & Karazsia, B. T. Development and validation of a measure of climate change anxiety. J. Environ. Psychol. 69, 101434 (2020).

    Article  Google Scholar 

  19. Clayton, S. Climate anxiety: psychological responses to climate change. J. Anxiety Disord. 74, 102263 (2020).

    Article  PubMed  Google Scholar 

  20. Hickman, C. et al. Climate anxiety in children and young people and their beliefs about government responses to climate change: a global survey. Lancet Planet. Health 5, e863–e873 (2021).

    Article  PubMed  Google Scholar 

  21. Stanley, S. K., Hogg, T. L., Leviston, Z. & Walker, I. From anger to action: differential impacts of eco-anxiety, eco-depression, and eco-anger on climate action and wellbeing. J. Clim. Change Health 1, 100003 (2021).

    Article  Google Scholar 

  22. Reyes, M. E. S., Carmen, B. P. B., Luminarias, M. E. P., Mangulabnan, S. A. N. B. & Ogunbode, C. A. An investigation into the relationship between climate change anxiety and mental health among Gen Z Filipinos. Curr. Psychol. https://doi.org/10.1007/s12144-021-02099-3 (2021).

  23. Romanello, M. et al. The 2021 report of the Lancet Countdown on health and climate change: code red for a healthy future. Lancet https://doi.org/10.1016/s0140-6736(21)01787-6 (2021).

  24. 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).

    Article  PubMed  PubMed Central  Google Scholar 

  25. Vergunst, F. & Berry, H. L. Climate change and children’s mental health: a developmental perspective. Clin. Psychol. Sci. https://doi.org/10.1177/21677026211040787 (2021).

  26. Sanson, A. V., Van Hoorn, J. & Burke, S. E. L. Responding to the impacts of the climate crisis on children and youth. Child Dev. Perspect. 13, 201–207 (2019).

    Article  Google Scholar 

  27. Stone, K., Blinn, N. & Spencer, R. Mental health impacts of climate change on women: a scoping review. Curr. Environ. Health Rep. 9, 228–243 (2022).

    Article  PubMed  Google Scholar 

  28. Middleton, J., Cunsolo, A., Jones-Bitton, A., Wright, C. J. & Harper, S. L. Indigenous mental health in a changing climate: a systematic scoping review of the global literature. Environ. Res. Lett. https://doi.org/10.1088/1748-9326/ab68a9 (2020).

  29. Nori-Sarma, A. et al. Association between ambient heat and risk of emergency department visits for mental health among US adults, 2010 to 2019. JAMA Psychiatry https://doi.org/10.1001/jamapsychiatry.2021.4369 (2022).

  30. Liu, J. et al. Is there an association between hot weather and poor mental health outcomes? A systematic review and meta-analysis. Environ. Int. 153, 106533 (2021).

    Article  PubMed  Google Scholar 

  31. Roos, N. et al. Maternal and newborn health risks of climate change: a call for awareness and global action. Acta Obstet. Gynecol. Scand. 100, 566–570 (2021).

    Article  PubMed  Google Scholar 

  32. Newbury, J. B. et al. Association between air pollution exposure and mental health service use among individuals with first presentations of psychotic and mood disorders: retrospective cohort study. Br. J. Psychiatry 219, 678–685 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  33. Lund, C. et al. Social determinants of mental disorders and the Sustainable Development Goals: a systematic review of reviews. Lancet Psychiatry 5, 357–369 (2018).

    Article  PubMed  Google Scholar 

  34. Cianconi, P., Betrò, S. & Janiri, L. The impact of climate change on mental health: a systematic descriptive review. Front. Psychiatry https://doi.org/10.3389/fpsyt.2020.00074 (2020).

  35. Ghio, L., Gotelli, S., Marcenaro, M., Amore, M. & Natta, W. Duration of untreated illness and outcomes in unipolar depression: a systematic review and meta-analysis. J. Affect. Disord. 152, 45–51 (2014).

    Article  PubMed  Google Scholar 

  36. Patrick, R. et al. Prevalence and determinants of mental health related to climate change in Australia. Aust. N. Z. J. Psychiatry https://doi.org/10.1177/00048674221107872 (2022).

  37. Burke, M., Hsiang, S. M. & Miguel, E. Climate and conflict. Annu. Rev. Econ. 7, 577–617 (2015).

    Article  Google Scholar 

  38. Brewin, C. R. Complex post-traumatic stress disorder: a new diagnosis in ICD-11. BJPsych Adv. 26, 145–152 (2020).

    Article  Google Scholar 

  39. Siegel, E. J. & Traube, C. Pediatric delirium: epidemiology and outcomes. Curr. Opin. Pediatr. 32, 743–749 (2020).

    Article  PubMed  Google Scholar 

  40. Martin-Latry, K. et al. Psychotropic drugs use and risk of heat-related hospitalisation. Eur. Psychiatry 22, 335–338 (2007).

    Article  PubMed  Google Scholar 

  41. Jönsson, A. K., Lövborg, H., Lohr, W., Ekman, B. & Rocklöv, J. Increased risk of drug-induced hyponatremia during high temperatures. Int. J. Environ. Res. Public Health 14, 827 (2017).

    Article  PubMed Central  Google Scholar 

  42. Page, L. A., Hajat, S., Kovats, R. S. & Howard, L. M. Temperature-related deaths in people with psychosis, dementia and substance misuse. Br. J. Psychiatry 200, 485–490 (2012).

    Article  PubMed  Google Scholar 

  43. Crandon, T. J., Scott, J. G., Charlson, F. J. & Thomas, H. J. A social–ecological perspective of climate anxiety in children and adolescents. Nat. Clim. Change 12, 123–131 (2022).

    Article  Google Scholar 

  44. Hwong, A. R. et al. Climate change and mental health research methods, gaps, and priorities: a scoping review. Lancet Planet. Health 6, e281–e291 (2022).

    Article  PubMed  Google Scholar 

  45. Bryant, R. A. et al. Psychological outcomes following the Victorian Black Saturday bushfires. Aust. N. Z. J. Psychiatry 48, 634–643 (2014).

    Article  PubMed  Google Scholar 

  46. Emergencies Happen: Protect What Matters Most https://www.redcross.org.au/globalassets/cms-assets/documents/emergency-services/2017-03-06-rediplan-comprehensive-guide.pdf (Australian Red Cross, 2017).

  47. Disaster Mental Health Hub: Prepare https://www.phoenixaustralia.org/disaster-hub/prepare/ (Phoenix Australia, 2022).

  48. Cooper, R. The impacts of extreme heat on mental health. Psychiatric Times https://www.psychiatrictimes.com/view/impacts-extreme-heat-mental-health (30 July 2019).

  49. Obradovich, N. & Minor, K. Identifying and preparing for the mental health burden of climate change. JAMA Psychiatry 79, 285–286 (2022).

    Article  PubMed  Google Scholar 

  50. Baudon, P. & Jachens, L. A scoping review of interventions for the treatment of eco-anxiety. Int. J. Environ. Res. Public Health https://doi.org/10.3390/ijerph18189636 (2021).

  51. Bourque, F. & Willox, A. C. Climate change: the next challenge for public mental health? Int. Rev. Psychiatry (Abingdon, Engl.) 26, 415–422 (2014).

    Article  Google Scholar 

  52. Frumkin, H., Hess, J., Luber, G., Malilay, J. & McGeehin, M. Climate change: the public health response. Am. J. Public Health 98, 435–445 (2008).

    Article  PubMed  PubMed Central  Google Scholar 

  53. Doherty, T. J. in Psychology and Climate Change (eds Clayton, S. & Manning, C.) 245–266 (Elsevier, 2018).

  54. Chapman, D. A., Trott, C. D., Silka, L., Lickel, B. & Clayton, S. in Psychology and Climate Change (eds Clayton, S. & Manning, C.) 267–288 (Elsevier, 2018).

  55. Hrabok, M., Delorme, A. & Agyapong, V. I. Threats to mental health and well-being associated with climate change. J. Anxiety Disord. 76, 102295 (2020).

    Article  PubMed  Google Scholar 

  56. Sisto, A. et al. Towards a transversal definition of psychological resilience: a literature review. Medicina 55, 745 (2019).

    Article  PubMed Central  Google Scholar 

  57. de Terte, I., Stephens, C. & Huddleston, L. The development of a three part model of psychological resilience. Stress Health 30, 416–424 (2014).

    Article  PubMed  Google Scholar 

  58. Mah, A. Y., Chapman, D. A., Markowitz, E. M. & Lickel, B. Coping with climate change: three insights for research, intervention, and communication to promote adaptive coping to climate change. J. Anxiety Disord. 75, 102282 (2020).

    Article  PubMed  Google Scholar 

  59. Keim, M. E. Building human resilience: the role of public health preparedness and response as an adaptation to climate change. Am. J. Prev. Med. 35, 508–516 (2008).

    Article  PubMed  Google Scholar 

  60. Lopes, A. P., Macedo, T. F., Coutinho, E. S. F., Figueira, I. & Ventura, P. R. Systematic review of the efficacy of cognitive-behavior therapy related treatments for victims of natural disasters: a worldwide problem. PLoS ONE 9, e109013 (2014).

    Article  PubMed  PubMed Central  Google Scholar 

  61. Hopwood, T. L. & Schutte, N. S. A meta-analytic investigation of the impact of mindfulness-based interventions on post traumatic stress. Clin. Psychol. Rev. 57, 12–20 (2017).

    Article  PubMed  Google Scholar 

  62. Ma, T., Moore, J. & Cleary, A. Climate change impacts on the mental health and wellbeing of young people: a scoping review of risk and protective factors. Soc. Sci. Med. (1982) 301, 114888 (2022).

    Article  Google Scholar 

  63. Hwong, A. R. et al. Climate change and mental health: implications for the psychiatric workforce. Psychiatr. Serv. 73, 592–595 (2022).

    Article  PubMed  Google Scholar 

  64. Keynejad, R. C., Dua, T., Barbui, C. & Thornicroft, G. WHO Mental Health Gap Action Programme (mhGAP) Intervention Guide: a systematic review of evidence from low and middle-income countries. Evid. Based Ment. Health 21, 30–34 (2018).

    Article  PubMed  Google Scholar 

  65. Pollack, D. Climate change and its impacts on mental health. Psychiatr. Times 35, 7–8 (2018).

    Google Scholar 

  66. Berry, H. L., Bowen, K. & Kjellstrom, T. Climate change and mental health: a causal pathways framework. Int. J. Public Health 55, 123–132 (2010).

    Article  PubMed  Google Scholar 

  67. Jacobs, G. A., Gray, B. L., Erickson, S. E., Gonzalez, E. D. & Quevillon, R. P. Disaster mental health and community-based psychological first aid: concepts and education/training. J. Clin. Psychol. 72, 1307–1317 (2016).

    Article  PubMed  Google Scholar 

  68. Morrissey, S. A. & Reser, J. P. Natural disasters, climate change and mental health considerations for rural Australia. Aust. J. Rural Health 15, 120–125 (2007).

    Article  PubMed  Google Scholar 

  69. Sartore, G.-M. et al. Improving mental health capacity in rural communities: mental health first aid delivery in drought-affected rural New South Wales. Aust. J. Rural Health 16, 313–318 (2008).

    Article  PubMed  Google Scholar 

  70. Math, S. B., Nirmala, M. C., Moirangthem, S. & Kumar, N. C. Disaster management: mental health perspective. Indian J. Psychol. Med. 37, 261–271 (2015).

    Article  PubMed  PubMed Central  Google Scholar 

  71. McMichael, C., Barnett, J. & McMichael, A. J. An ill wind? Climate change, migration, and health. Environ. Health Perspect. 120, 646–654 (2012).

    Article  PubMed  PubMed Central  Google Scholar 

  72. Rosen, A., Gill, N. S. & Salvador-Carulla, L. The future of community psychiatry and community mental health services. Curr. Opin. Psychiatry 33, 375–390 (2020).

    Article  PubMed  Google Scholar 

  73. Disaster Mental Health Handbook http://www2.cuny.edu/wp-content/uploads/sites/4/page-assets/about/administration/offices/ovsa/disaster-relief/hurricanes-harvey-irma/Disaster-Mental-Health-Handbook.pdf (American Red Cross, 2012).

  74. Clayton, S., Manning, C., Krygsman, K. & Speiser, M. Mental Health and Our Changing Climate: Impacts, Implications, and Guidance (American Psychological Association and ecoAmerica, 2017).

  75. Silva, J. F. B. & Coburn, J. Therapists’ experience of climate change: a dialectic between personal and professional. Couns. Psychother. Res. https://doi.org/10.1002/capr.12515 (2022).

  76. Global Green and Healthy Hospitals https://www.greenhospitals.net/about-challenge/ (Health Care Without Harm, 2022).

  77. Siah, C. R., Kua, E. H. & Goh, Y. S. The impact of restorative green environment on mental health of big cities and the role of mental health professionals. Curr. Opin. Psychiatry 35, 186–191 (2022).

    Article  PubMed  Google Scholar 

  78. Godden, N. J. et al. Climate change, activism, and supporting the mental health of children and young people: perspectives from Western Australia. J. Paediatr. Child Health 57, 1759–1764 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  79. Powers, M. C. F. & Engstrom, S. Radical self-care for social workers in the global climate crisis. Soc. Work 65, 29–37 (2019).

    Article  PubMed  Google Scholar 

  80. Basu, R., Gavin, L., Pearson, D., Ebisu, K. & Malig, B. Examining the association between apparent temperature and mental health-related emergency room visits in California. Am. J. Epidemiol. 187, 726–735 (2018).

    Article  PubMed  Google Scholar 

  81. Niu, Y. et al. Short-term effect of apparent temperature on daily emergency visits for mental and behavioral disorders in Beijing, China: a time-series study. Sci. Total Environ. 733, 139040 (2020).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  82. Heo, S., Lee, W. & Bell, M. L. Suicide and associations with air pollution and ambient temperature: a systematic review and meta-analysis. Int. J. Environ. Res. Public Health 18, 7699 (2021).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  83. Chae, E.-H., Kim, T. W., Rhee, S.-J. & Henderson, T. D. The impact of flooding on the mental health of affected people in South Korea. Community Ment. Health J. 41, 633–645 (2005).

    Article  PubMed  Google Scholar 

  84. Austin, E. K. et al. Drought-related stress among farmers: findings from the Australian Rural Mental Health Study. Med. J. Aust. 209, 159–165 (2018).

    Article  PubMed  Google Scholar 

  85. Mulchandani, R. et al. The English National Cohort Study of Flooding & Health: psychological morbidity at three years of follow up. BMC Public Health 20, 321 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  86. Nomura, Y. et al. Prenatal exposure to a natural disaster and early development of psychiatric disorders during the preschool years: stress in pregnancy study. J. Child Psychol. Psychiatry, https://doi.org/10.1111/jcpp.13698 (2022).

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Fiona J. Charlson.

Ethics declarations

Competing interests

The authors declare no competing interests.

Peer review

Peer review information

Nature Human Behaviour thanks Yoonhee Kim, Lawrence Palinkas and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Crandon, T.J., Dey, C., Scott, J.G. et al. The clinical implications of climate change for mental health. Nat Hum Behav 6, 1474–1481 (2022). https://doi.org/10.1038/s41562-022-01477-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41562-022-01477-6

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing