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A systematic review of the effects of chronic, slow-onset climate change on mental health

Nature Mental Health volume 2, pages 228–243 (2024)Cite this article

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Abstract

The mental health effects of weather-related disasters are well characterized, yet less is known about the effect of chronic, slow-onset climate change. We systematically reviewed qualitative, quantitative and mixed-methods studies (57 were included) that investigated the effects of slow-onset climate change on a range of mental health indicators. Droughts, changing temperatures over time and local perceptions of ecosystem changes were the most studied slow-onset conditions. Several quantitative studies noted adverse mental health outcomes associated with these exposures, including depression and anxiety symptoms, suicide and non-specific psychological distress. Qualitative studies further elucidated negative emotions related to chronic climate change, including worry, grief and frustration. However, some studies noted mixed or null findings. Results suggest a need for further research to identify causal pathways and mechanisms through which chronic changes in the climate may affect changes in mental health. Instead of focusing on trauma-based frameworks (as are commonly used in studies of acute disasters), this work should holistically consider individual, community and societal factors that shape the mental health consequences of slow-onset climate change.

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Fig. 1: PRISMA diagram.
Fig. 2: Word cloud visualization summarizing the description and frequency of mental health conditions associated with slow-moving climate change in the qualitative literature.

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This is a systematic review article based on findings in published literature and did not involve analysis of newly generated data.

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Acknowledgements

This work was supported by an Exploratory Seminar Award from the Radcliffe Center for Advanced Study at Harvard University to C.A.D., K.C.K. and L.D.K., a National Institute of Mental Health grant (K23MH117278) to C.A.D. and a Voss Postdoctoral Fellowship (Brown University) to K.B.

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Author notes

  1. These authors contributed equally: Kate Burrows, Christy A. Denckla.

Authors and Affiliations

  1. Department of Public Health Sciences, Biological Sciences Division, University of Chicago, Chicago, IL, USA

    Kate Burrows

  2. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Christy A. Denckla, Jill Hahn, Sakurako S. Okuzono, Laura D. Kubzansky & Karestan C. Koenen

  3. Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

    Christy A. Denckla & Karestan C. Koenen

  4. Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK

    Jessica E. Schiff

  5. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Hervet Randriamady

  6. Countway Library, Harvard Medical School, Boston, MA, USA

    Carol Mita

  7. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Karestan C. Koenen

  8. Department of Social and Behavioral Science, School of Public Health, Yale University, New Haven, CT, USA

    Sarah R. Lowe

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Contributions

C.A.D., L.D.K., K.C.K. and S.R.L. were responsible for conceptualization of the study. C.A.D., C.M., S.S.O., L.D.K. and K.C.K. were responsible for the methodology. K.B., C.A.D., J.H., J.E.S., S.S.O. and S.R.L. carried out the investigation. K.B., C.A.D. and C.M. were responsible for data curation. K.B., C.A.D., J.H., J.E.S., S.S.O., C.M. and S.R.L. wrote the original draft of the manuscript, and K.B., C.A.D., H.R., L.D.K., K.C.K. and S.R.L. reviewed and edited the work. L.D.K. and K.C.K. supervised the project, and K.B. and C.A.D. administered the project.

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Correspondence to Christy A. Denckla.

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Nature Mental Health thanks Helen L. Berry, Fiona Charlson and Elizabeth Marks for their contribution to the peer review of this work.

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Extended data

Extended Data Fig. 1 Global distribution of included studies.

Cartographic visualization of included studies based on location (where the climatic change occurred) and type of study design (qualitative, mixed methods, or quantitative).

Extended Data Fig. 2 Waffle chart displaying one included study per cell.

Panel A displays included studies organized by study method, Panel B depicts included studies organized by climate exposure and study design, Panel C displays the direction of association between climate exposure and mental health outcomes among quantitative studies only, and Panel C depicts included studies organized by mental health outcome among qualitative studies only. Note: Marks in each cell correspond to protection against bias rating: X (probably a high risk of bias), XX (probably a low risk of bias), XXX (definitely a low risk of bias). In Panel C, a positive association indicates that slow-onset climate change is associated with an increased risk of adverse mental health outcomes. Conversely, a negative association suggests that slow-onset climate change is linked to a reduced risk of adverse mental health outcomes. A null association signifies that there was no evidence of a statistically significant association. The term “mixed” describes associations encompassing a combination of positive, negative, or null relationships, depending on the exposure categories, or when the effect is heterogeneous across different subgroups.

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Supplementary Information

Supplementary Sections 1 (Results) and 2 (Methods).

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Burrows, K., Denckla, C.A., Hahn, J. et al. A systematic review of the effects of chronic, slow-onset climate change on mental health. Nat. Mental Health 2, 228–243 (2024). https://doi.org/10.1038/s44220-023-00170-5

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