Mental health impacts of the climate crisis: the urgent need for action.

Signs of climate breakdown are evident across the globe. From wildfires in the US and Europe to heatwaves in India and Pakistan and heavy rainfall in the UK, recordbreaking extreme weather events are occurring in every continent and increasing in frequency and intensity. What is unexpected, however, is the speed with which global warming even at the current level of 1 C is resulting in climate chaos. Contrary to earlier scientific forecasts that temperatures would rise to over 40C by 2050 in the UK, this record has already been reached by the summer of 2022, prompting leading climate scientists to warn that the future is already here. We are informed that climate breakdown is inevitable and global leaders acknowledge that they are scared, as avoiding the most catastrophic outcomes is the best we can now do. That climate change is the biggest threat to global public health was recognised more than a decade ago but carbon emissions have simply continued to increase. Estimations of the direct health effects of aspects of climate change such as heat stress, floods, air pollution, food insecurity and the spread of vector-borne disease demonstrate that the global burden of morbidity and mortality is also increasing steeply on every continent. But, despite the recognition that the mental health toll is likely to be as severe, few efforts have been made to quantify this burden, study its extended impact on society, forecast its effects on socio-economic trends of the future or to explore ways by which the negative impacts could be addressed and hope could be harnessed to ensure the best societal outcomes for the future. This collection of research studies, commentaries and analyses aims to help remedy this gap, as it shines a light on this relatively neglected area of the health impacts of climate change. It brings together authors drawn from a uniquely broad range of backgrounds including mental and public health, climate and social sciences, the arts and young people’s networks, united in their ambition to emphasise the mental health impacts of climate change and encourage everyone to contribute to action. A growing body of evidence is demonstrating that the direct impacts of the climate chaos on mental health range from an increase in suicides and worsened outcomes for those with diagnosable mental health disorders to declining population mental health and wellbeing. Authors commenting from geographies as diverse as Bangladesh, South Africa, the Philippines and the Caribbean confirm that acute extreme weather events as well as chronic extreme climate events such as prolonged drought are associated with an increasing burden of post-traumatic stress disorder (PTSD), depression, anxiety, extreme psychological stress and distress, substance use and suicidality in people of all ages groups. Healthcare professionals working in disaster relief are not invulnerable to these risks. Longer term, climate impacts such as rising sea levels, forced migration and conflict are resulting in the loss of community identity and disruptions to emotional bonds to place and ancestral heritage, with profound effects on the wellbeing of the affected communities. However, these impacts are not confined to those countries hardest hit by the climate crisis, as being aware of current and future climate-related risks is adversely affecting the psychological and emotional wellbeing of all populations. What of young people around the world, on the frontline and the worst off, in terms of facing the consequences of inaction in previous generations? A study of the climate-related feelings, experiences and hopes of 23 young people aged 16-29 from 15 countries around the world reported on the following pages makes for uncomfortable reading. Authored by the young people themselves, this unique study highlights the intensity of their emotional stresses, as they find themselves often coping alone with feelings of unimportance, and anger and distress at the indifference and lack of urgency with which adults and organisations treat climate change. Their feelings of powerlessness, hopelessness and uncertainty, especially among those living in the most climate-vulnerable communities deserve attention as the consequences of their neglect may be a fatalism and inability to engage with positive action or imagine a hopeful future. Despite this bleak background, solutions are emerging, offering a glimmer of hope for the future. There is growing awareness that it is a false dichotomy to separate human health and ecosystem health and that access to and the nurture of the natural environment have the dual benefit of delivering mental health improvement and restoring nature. A study of nature based activities offered as a therapeutic intervention in a child and adolescent mental health service has demonstrated this, as outcomes included wide-ranging health benefits as well as an enhanced appreciation of the environment. The