Grantham Institute

Briefing paper No 36
May 2021

The impact of climate change on mental health

and emotional wellbeing: current evidence and
implications for policy and practice
DR EMMA LAWRANCE, RHIANNON THOMPSON, GIANLUCA FONTANA, DR NEIL JENNINGS

Headlines Contents
• C
 limate change is negatively affecting the mental health and emotional wellbeing of people
around the world. Executive summary..................2
• The literature shows that: Introduction.............................3
– There is a clear relationship between increased temperatures and number of suicides;
– There is clear evidence for severe distress following extreme weather events; What is known?........................8
– People who meet criteria for mental illness are more vulnerable to the effects of climate
What can be done about it?.... 17
change on physical as well as mental health;
– The climate crisis threatens to disrupt the provision of care for people with a mental Conclusions........................... 19
illness diagnosis;
Recommendations................ 20
– Climate change exacerbates mental distress, particularly among young people, even for
individuals who are not directly affected (e.g. ‘eco-anxiety’). References............................ 26
• These impacts:
Acknowledgements...............35
– Will get worse without meaningful interventions, driving and exacerbating health and
social inequalities which themselves worsen mental health; About the authors................. 36
– Are currently ‘hidden costs’, unaccounted for in policy and planning;
– Are likely to be vastly underestimated as despite the serious effects, this has been
a neglected area of research.
• There are win-win opportunities (co-benefits) for improving mental health and emotional
wellbeing associated with taking actions to reduce greenhouse gas emissions and adapt to
a warming climate.

Key recommendations:
• Establish an international network including key stakeholders (e.g. government, healthcare
systems, community groups, academics, emergency responders) to catalyse knowledge-
sharing, target research efficiently, and identify and scale up successful interventions.
• Conduct robust, interdisciplinary and collaborative research to fully understand the true
impact of climate change on mental health and emotional wellbeing. Grantham Briefings
• Ensure that the cost of climate change on mental health, and the multiple benefits of climate analyse climate change
and environmental research
action are fully considered in the decision-making process. linked to work at Imperial,
• Prioritise successful climate mitigation and adaptation actions that have co-benefits for setting it in the context of
mental health and reducing social inequalities. Such actions could include: improving air national and international
policy and the future research
quality, providing equitable access to nature and improving the energy efficiency of housing.
agenda. This paper and other
• Implement appropriate strategies to manage and reduce the severity of any negative mental publications are available from
health impacts when they do occur. www.imperial.ac.uk/grantham/
publications
Grantham Institute   Institute of Global Health Innovation

Executive summary emotional impacts of climate change, and are at higher risk of
negative mental health and wellbeing outcomes15–17. The effects
Climate change and mental health are two of the most of climate change on mental health are therefore a driver and
significant and pressing challenges facing societies across the compounder of health and social inequality.
world. Yet, growing awareness of these global issues has not
been met with sufficient action to mitigate their impacts. Mental Even for those not yet directly affected by its impacts,
illness – or the disabling effects of distress – already affects awareness of the climate crisis can exacerbate mental and
around a billion people globally1,2, while the effects of climate emotional distress. Young people seem particularly affected by
change are increasingly apparent3. Both of these issues are such distress, perhaps as their futures will be highly affected
projected to increase and stand to affect many more people by a changing climate, but they feel limited control over the
without sufficient action4,5. Climate change has been recognised actions taken by those in positions of power18–21. The range of
by governments, academics, advocacy groups and medical ways individuals respond psychologically and emotionally to
professions as a health emergency6–9, though, to date, the the climate crisis not only has implications for mental health but
focus has been largely on physical health. In contrast, mental also for the actions people take individually and collectively22–24.
illness, “the most neglected of all human health conditions”10,
and emotional wellbeing have been overlooked in their interplay The evidence for the multiple impacts of climate change on
with climate change. Policymakers stand to benefit from mental health and emotional wellbeing warrants this issue to
identifying the opportunity of potential common solutions, be given much greater prominence within public policy and
stemming from some common causes, to these two global public discourse. These impacts are currently ‘hidden costs’,
challenges. Policymakers, health systems and communities unaccounted for in policy and planning. Specifically, greater
have not yet recognised and responded to the threat that action is required to: prevent the impacts of climate change on
climate change poses to our mental health and health systems, mental health by addressing the root causes of climate change;
and there is much to be gained by proactively building resilience proactively address predicted mental health impacts while
in individuals, communities and health systems. building resilience; mitigate and respond to the impacts on
mental health and emotional wellbeing already occurring; and
The available evidence suggests that climate change has innovate in response to these challenges through evidence-
a significant and multi-faceted impact on mental health based interventions for policy and practice. This paper proposes
and emotional wellbeing. Data shows that there is a clear a detailed set of recommendations to stimulate greater
relationship between experiencing the effects of climate knowledge, awareness and action.
change – such as rising temperatures or more frequent and
severe extreme weather events – and worsening mental There is good news, as there is still an opportunity to turn this
health, even resulting in more suicides11–13. Experiencing the from a vicious to a virtuous cycle. Actions that address climate
effects of climate change first-hand, for example by a flooding change will have an even greater return than currently expected,
event, directly raises the risk of experiencing post-traumatic as they will prevent or reduce adverse effects on mental health
stress disorder (PTSD), depression or low mood, and extreme that have not yet been considered in policies and budgets.
distress. Individuals meeting criteria for mental illness are also For example, burning fossil fuels causes climate change and
more vulnerable to impacts of the changing climate, such as poor air quality, and hence cutting back on fossil fuels reduces
high temperatures, which worsen their physical as well as a) climate change, b) the impact of warming temperatures on
mental health. Damage to infrastructure and supply chains mental health, and c) the mental health impacts associated with
arising from climate change impacts also risk disrupting the poor air quality. Such action provides opportunity to build more
provision of mental healthcare. Hence the overall picture is equitable societies (itself vital for improving mental health and
one of increasing demand with simultaneous reductions in the wellbeing), with individuals in poorer areas more likely to be
ability of the health system to cope and respond. The true costs affected by, for example, poor air quality associated with fossil
of climate change on mental health and emotional wellbeing fuel burning. Further, when individuals take action to address
remain largely unquantified in policy and practice. This is and respond to climate change, this may also be protective
particularly concerning considering that the number of cases for their mental health25–27. Policy responses can therefore
of psychological trauma arising from a disaster can exceed make multiple gains, win-win opportunities or ‘co-benefits’,
physical injury cases by 40–114. by leveraging common solutions to the dual challenges of
climate change and mental health.
Groups already affected by social inequalities such as those
with existing mental illness or living in poorer countries are
more likely to be affected by climate change, are less likely to
have access to support and resources to mitigate against the

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Grantham Institute   Institute of Global Health Innovation Institute of Global Health Innovation   Grantham Institute

Introduction

Key message
• Climate change has been shown to create a range of threats to health, but the interactions between, and common causes for,
climate change and mental health issues have been largely neglected. There has been insufficient research, attention and
conversations on this important issue which together have led to a lack of necessary and urgent action.

There is increasing awareness that climate change is a change and proposed a framework to map the health impacts
human health and healthcare emergency. The World Health of climate change (Figure 1). It also highlighted the negative
Organization (WHO) has pursued a work plan on climate change impacts of the climate crisis on healthcare delivery and on
and health since 201528 and in the United States, the Centers for the global efforts to ensure that every person has access to
Disease Control and Prevention (CDC) established a programme quality healthcare (universal health coverage). This briefing
on the topic in 201029. The National Health Service (NHS) in paper builds on the findings of that report and is intended as a
England was the first national health system to commit to first step to recognise and address the gaps in knowledge and
achieving net zero emissions of carbon dioxide30. In its 2020 awareness about the relationships between climate change and
World Innovation Summit for Health (WISH) report “Health In mental health and emotional wellbeing. The following sections
The Climate Crisis: A Guide For Health Leaders”31, the Institute provide context on both issues individually before discussing
of Global Health Innovation (IGHI) at Imperial College London the interlinkages between them.
called on the health community to contribute to tackling climate

Figure 1: The health threats resulting from current and anticipated climate change impacts. Climate change results in threats
to health including food and water insecurity, storms and floods, and social and economic instability. These in turn produce
detrimental physical health outcomes (e.g. malnutrition and heat stress) and mental health outcomes (e.g. depression). From World
Innovation Summit for Health report: “Health In The Climate Crisis: A Guide For Health Leaders” (2020)31 and the Centers for Disease
Control and Prevention (CDC) “Climate effects on health” (2020)32.

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Climate change Individuals who experience changes in thoughts, emotions,

Invisible gases in the Earth’s atmosphere including carbon perceptions or behaviours that cause significant distress and/
dioxide and methane act as a blanket, trapping warmth from the or interfere with their daily lives may be diagnosed with a
sun and making our planet a habitable temperature. However, mental illness or mental disorder (often used interchangeably).
human activities – such as burning fossil fuels for energy, The most common are anxiety or depression, but other
transport and manufacturing, and changing natural landscapes conditions include post-traumatic stress disorder (PTSD),
for agricultural crops and farming animals – are increasing the substance abuse, eating disorders or psychosis. Developmental
amount of these ‘greenhouse gases’ and global temperatures disorders such as autism, and degenerative disorders such as
have risen by over 1°C since 1850 as a result33. dementia also fall under the umbrella of mental disorders37.
Individuals with mental illness are at higher risk of physical
The influence of human activities on the climate is clear illness and vice versa (referred to as a comorbidity)38.
and recent increases in global temperatures have already
had widespread impacts on physical, biological and human There are many different definitions and important debates
systems34. These include an increase in the frequency and surrounding terms used for mental health and mental illness.
intensity of various extreme weather events (acute events e.g. The following mental health outcomes are defined by widely
heavy rainfall, high winds, storm surges) and extreme climate used framings:
events (chronic events e.g. drought) and the effects associated
with these events such as flooding and wildfires34. The present • Worsened population mental health and emotional
and future risks from climate change vary across the world wellbeing: An increase in the number of people with poorer
(see Figure 2) and include reduced water availability in North mental health or emotional wellbeing such as persistent
Africa, an increased risk of flooding in Europe, wildfires in distress, in either the short or long term.
North America and the bleaching of coral reefs in Australia34. • Increased risk of meeting the criteria for a mental illness
Such climate impacts are expected to become increasingly or mental disorder: More people with a diagnosable mental
severe and/or frequent with rising temperatures34, so reducing illness or mental disorder as per current standards for
greenhouse gas emissions (climate mitigation) is essential diagnosis.
to minimise global temperature rise while societies try to • Poorer outcomes for those who have already been
build resilient infrastructure, and anticipatory policies and diagnosed with or who meet the criteria for mental illnesses:
behaviours suitable for a warming planet (climate adaptation). An increase in symptoms or more severe symptoms, and/
or poorer physical health, and/or an increased risk of death
The causes of climate change are rooted in human behaviour for individuals who meet the criteria for diagnosis of a
and hence human psychology, with action to tackle climate mental illness.
change requiring a reshaping of societal and individual choices • Increase in suicidal thoughts (suicidality), suicide attempts
and lifestyles that minimise the emission of greenhouse or completed suicides: An increase in the number of
gases. It is important to understand the range of psychological completed or attempted suicides.
responses – thoughts and feelings – that individuals and
communities have in relation to climate change in order to The increasing unmet mental health needs and cases of
appropriately engage communities in climate adaptation mental illness in people across the world constitutes an urgent
and mitigation efforts while supporting mental health and global health challenge. Depression is a leading cause of
emotional wellbeing. disability worldwide39, and the global economic cost of mental
disorders (from direct healthcare costs and indirect costs in
Mental health productivity) was estimated in 2010 at $2.5 trillion40, while the
Mental health is an all-encompassing term – just like physical Lancet Commission on Global Mental Health and Sustainable
health, everyone has mental health that can generally be Development predicts a cost to the global economy of $16
better or worse at any one time, as ups and downs in thoughts, trillion between 2010 – 203041. There is a large unmet need or
feelings and ability to cope with life. Hence, good mental ‘treatment gap’ globally42,43, with mental health often lagging
health is not just the absence of illness or disorder, but positive behind physical health; an issue the NHS across the United
wellbeing that leads to flourishing and resilience to adversity36. Kingdom (UK) seeks to address through its aim for “parity
Other terms such as emotional wellbeing are also increasingly of esteem”44,45 between physical and mental health. This is a
used in an attempt to avoid pathologizing the range of human system already under strain, where increased burden or further
emotions and experiences. In this briefing, mental health is reduced capacity would have large societal and financial
used as shorthand for ‘mental health and emotional wellbeing’. impacts. Crucially, 75% of mental illness has been estimated to
The term ‘psychological responses’ is used to indicate the range start before the age 2446, a relevant statistic to consider when
of thoughts and feelings, including different emotions, concerns young people are the generation growing up with full awareness
or distress, people may have to climate change. of the climate crisis and with the largest burden to shoulder to
adapt and respond to its effects throughout their lives.

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Figure 2: Key near term (2030-2040) risks to physical, biological, human and managed systems resulting from climate change across different regions of the world. Risks include reduced water
availability in South America, reduced food security in Africa and changes in species distribution and regional species loss in mountainous areas across the world. Adapted from Figure SPM.8 of
the IPCC Fifth Assessment Report Summary for Policymakers (2014)35.

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The number of articles published between 2011 – 2021 in The number of articles published between 2011 – 2021 in

mentions of ‘mental health’ in IPCC assessment reports

(period up to 2014)

Figure 3: Illustrative comparison of coverage considering the connection between climate change and mental health, compared with
coverage of climate change and mental health as separate topics, across settings reflecting levels of knowledge and awarenessi.

i Specifically, the PubMed database from 2010 to 2020 was searched as a proxy for academic evidence or knowledge generation. It is noted that PubMed has a focus on
biomedical literature and hence will not cover climate change fully as a standalone issue but it does provide useful context for how frequently climate change and mental
health are considered together. Search terms: “Mental health” + MeSH terms, “Climate change” + MeSH terms, “Mental health” AND “Climate change”’ + MeSH terms,
search date 02/02/21. A search of the New York Times from 2010 to 2020 was used as a proxy for media coverage of the topics related to greater public awareness. Search
terms: “Mental health” (articles containing), “Climate change” (articles containing), “Mental health” “Climate Change” (articles containing), search date 02/02/21.

In considering the social and economic cost of mental health injustice”57. As emphasised by our own analysis (see Figure 3),
and mental illness, it is worth noting the recent Dasgupta Report the lack of research and awareness is startling. As proxy
on the Economics of Biodiversity (2021) which suggests that indicators of relative knowledge and awareness, the academic
“we must change how we think, act and measure success”47. journal database PubMed and the New York Times were
A vision and action plan for a mentally healthy world must searched for mentions of climate change and mental health,
“recognise that wellbeing depends on enabling every person first separately and then together. While these are raw
to lead a life of dignity and opportunity, while safeguarding the measures, the dearth of results on the interactions between
integrity of Earth’s life-supporting systems”48. Good mental these issues accurately reflects the reality of this field and may
health (i.e. flourishing) and protection against mental illness help to explain why there has been insufficient action on this
is known to depend on and be supported by equitable and issue. For example, mental health has never been a subject
connected communities and a healthy environment26,49–61. of discussion in any official side events at the Conference of
Parties (COP) of the United Nations Framework Convention on
Climate change and mental health – Climate Change (UNFCCC) to date. This is particularly concerning
an overlooked issue considering that cases of psychological traumas from any form
of disaster exceed those of physical injury by 40–114.
While progress has been made on recognising the physical
health impacts of climate change (as illustrated in Figure 1),
the effects on mental health have been called an “invisible

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Figure 4: The physical and mental health threats resulting from current and anticipated climate change impacts. Adapted from World Innovation Summit for Health report: “Health in the climate
crisis: A guide for health leaders” (2020) to further illustrate examples of the mental health outcomes (psychological traumas) expected from the threats arising from climate change. The threats
to health such as food and water insecurity, storms and floods and social and economic instability can directly and indirectly impact mental health. Direct impacts include trauma, grief and loss,
increased suicide rates and cases of anxiety, depression and post-traumatic stress disorder (PTSD). Impacts experienced even when not directly exposed to a climate-related disaster include
emotional and mental distress, grief, loss and anxiety that have been termed ‘eco-anxiety’, ‘climate grief’ and ‘solastalgia’ (see definitions in Table 1). Note that poorer physical health is also a cause
of poorer mental health.

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What is known?

Key messages
• There is limited and incomplete evidence on the links between climate change and mental health and emotional wellbeing
• However, the evidence that does exist clearly suggests that all the major threats to physical health linked to climate change
also have negative effects on mental health. Experiencing the effects of climate change first-hand is psychologically traumatic,
and this shows up as a direct and severe impact on mental health outcome figures, including for rates of suicide, PTSD,
depression, and extreme distress.
• In particular, the literature shows that:
– There is a clear relationship between higher temperatures and number of suicides
– There is clear evidence for severe distress (increased mental illness onset) following extreme weather events (e.g. PTSD
following flood events)
– People who meet criteria for mental illness are more vulnerable to the effects of climate change on physical as well as mental
health
– The climate crisis threatens to disrupt the provision of care for people with a mental illness diagnosis
– Climate change exacerbates mental distress, particularly among the young, even for individuals who have not been affected
directly yet (e.g. eco-anxiety)
– The effects of climate change on mental health are a driver of health and social inequality
– There is a hidden and unquantified economic cost associated with the impacts of climate change on mental health
– There are win-win opportunities (co-benefits) for improving mental health associated with taking action on climate change.

How does climate change affect mental health? psychological stress for some individuals, with longer term
All the major threats to physical health from climate change also distress in some cases. These experiences are most commonly
have detrimental effects on mental health. This is not surprising described as post-traumatic stress disorder (PTSD), depression
as mental health and physical health are tightly linked, with and anxiety92–103. There is also evidence that these events
high rates of comorbidities (multiple conditions that occur at can cause increased substance abuse and a higher risk of
the same time in the same person)38,62–65 and at the population suicide104–107. For some individuals, the effects on mental health
level, good physical health and good mental health are strongly have been shown to persist or increase even years after the
correlated66. The following section describes how climate change events17,108–111. Reoccurring disasters, such as if one’s house
threatens the mental health of citizens around the world, either or business is repeatedly flooded, have been shown to have
directly or indirectly. Figure 4 shows a further iteration of the a particularly damaging psychological impact112. Figure 5
framework on the health impacts of climate change from the illustrates examples of the mental health impacts caused
WISH report (Figure 1), which expands the illustration of the by extreme weather events, which will become increasingly
relationships between climate change impacts and mental frequent or severe without meaningful and urgent action to
health. reduce emissions of greenhouse gases.

High temperatures worsen a range of health outcomes. The social and economic disruption caused by climate change,
They have been shown to increase rates of suicide67–69, including for example migration, has a negative impact on
mental distress70–75, and hospitalisations for mental health mental health. Forced displacement or evacuation after
conditions76–80, and to have negative consequences for physical climate-related disasters has been linked to depression122,123,
and mental health including increased mortality of people anxiety122, and PTSD123. Longer-term forced migration
who meet the criteria for mental illness81–87. Heatwaves and resulting from climate-related threats can also lead to higher
extreme high temperatures have been associated with a range rates of diagnosed mental disorders and worsening mental
of negative societal outcomes and increased risks, which wellbeing113,124.
may in turn influence mental health. These include reduced
economic outputs88, increased conflict and societal violence89, Food and water insecurity also have implications for mental
and disturbed sleep90,91. Temperature change can also lead to health. Drought and crop failures lead to economic losses,
changes in the body, for example affecting blood flow and the hunger, and thirst, which clearly can lead to distress and
central nervous system91, which can in turn lead to cognitive and desperation, i.e. poor mental health and wellbeing95,125,
emotional changes that can negatively impact mental health and with increased suicide rates for farmers affected by drought95,126.
emotional wellbeing. A lack of clean water can also affect mental health and
emotional wellbeing, with a disproportionate effect on women,
Experiencing the direct impacts of extreme weather events, including due to the need for water to manage menstrual
including intense storms and floods, is associated with extreme hygiene127,128.

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Figure 5: Examples of the impact of extreme weather events on mental health across the world (United Kingdom11,110,112, United States17,105,113, Puerto Rico114–117, Colombia118, Sudan118, Thailand96,119,
Vanuatu118, and Australia120,121). Extreme weather events including floods, hurricanes and droughts have produced increases in depression, anxiety, PTSD, psychological distress and worsened
population mental health and wellbeing. Climate change will increase the frequency and/or severity of such events.

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Figure 6: Examples of the continuum of impacts that climate change has on mental health outcomes. Climate change impacts (top row of circles) including rising temperatures and sea level,
and extreme weather events such as floods or droughts, lead to mental health impacts (bottom row of circles) including new cases of mental illness, mental and emotional distress, and increased
susceptibility to physical illness or death for those who meet the criteria for mental illness. This occurs directly and indirectly via a variety of pathways represented here as a continuum, from direct
experiences (left hand side of shaded box) for example of extreme high temperatures or home loss in a wildfire, to indirect experiences of climate impacts (right hand side of shaded box) for example
by reading about such events in the media.

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The impact of communicable diseases on mental health has Increased new cases of mental health problems
never been more clearly apparent. The COVID-19 pandemic Climate change increases the risk that people will experience
highlights the increased mental health needs that epidemics prolonged distress that meets criteria for mental illness,
and pandemics produce, due to a combination of health, including PTSD, depression, anxiety and substance abuse.
economic and social pressures2,129. Climate change will increase Climate change increases the likelihood of extreme weather
the risk of infectious diseases spreading over a greater and climate events which can damage local environments and
geographical area, which is expected to ultimately exacerbate the communities that depend on them (as outlined in Figure 2).
distress, i.e. mental health impacts130. Such events are associated with stressors and traumas (e.g.
displacement, food insecurity, grief and loss) that may increase
Air and noise pollution are often attributable to actions that mental health burden and reduce wellbeing.
also cause climate change, such as transport and industry.
There is emerging evidence that links higher levels of air and Experiences of psychological trauma, including new cases of
noise pollution with poorer mental health, including increased individuals reaching the criteria for mental illness, have been
levels of depression, anxiety, psychosis, bipolar disorder, understandably observed following extreme weather events
schizophrenia, suicide, and worsened mental wellbeing131,132. including floods, hurricanes and bushfires94,104,136 but also in
response to slower acting climate events such as droughts95,97
Direct and indirect impacts of climate change on and rising sea level137. Worsened mental health including new
mental health cases or worsened symptoms of PTSD, depression, anxiety
Climate change can impact mental health in multiple ways which and substance abuse have been observed in citizens of all
can be grouped as direct or indirect effects. Direct effects arise ages as well as healthcare professionals working in disaster
from first-hand experiences of climate change, whereas indirect relief102,103,105,138–140.
effects stem from awareness or bearing witness to changes
caused by the climate crisis. It is important to note that healthy There could be as many as 200 million climate refugees by 2050
psychological processing of crisis, trauma, uncertainty, change as a result of climate change and the associated flooding, rising
and loss can be part of the response to both direct and indirect sea level, droughts and growing shortage of food and arable
experiences, and with appropriate support may not create or land141. People will increasingly be temporarily evacuated or
exacerbate mental illness or poor mental health. Direct and locally displaced by climate-related disasters, such as those
indirect impacts are not isolated from one another, instead they who had to temporarily flee or permanently lost their homes
span a continuum as illustrated in Figure 6, which aims to aid in in the Australian bushfires. All these forms of displacement or
thinking holistically about the ways that climate change impacts migration triggered by the effects of climate change come with
mental health. To illustrate further, Figure 7 takes the example mental health burdens114,118,122–124.
of an extreme weather event such as a flood, and shows
the multiple routes by which this one event can directly and Worse outcomes for people with mental illness
indirectly impact upon mental health and emotional wellbeing People who experience mental illness are more vulnerable to the
in both the immediate and longer term. effects of climate change on physical as well as mental health.
People with pre-existing mental illness, particularly psychosis,
Evidence for impacts on specific mental dementia and substance abuse, have a two to three times higher
health outcomes risk of death during heatwaves than people without76,81–83,142.
Suicide
Higher temperatures have been associated globally with
Increased suicide rates with increasing temperatures have
increased risks of hospital admissions – including in the
been reported globally, from low- to high- income settings.
emergency department – for experiences diagnosed as bipolar
Analyses suggest that there is approximately a 1% increase
disorder, schizophrenia, alcohol and substance misuse,
in the number of suicides for each 1°C temperature increase,
dementia, and self-harm77,143–146. This could be explained, in
once the temperature passes a threshold that is unique to each
part, by side-effects of medications for mental illness, because
location133,134. The exact relationship depends on contextual
they impair the body’s ability to regulate temperature, leading
factors such as humidity or demographic variables70,135.
to higher risk of severe physical symptoms84,87,91 particularly
Research has estimated that if climate change continues at
among the elderly84,147. There may be insufficient awareness
its current rate, rising temperatures will lead to 22,000 extra
of this risk among those on such medication or indeed among
suicides (95% confidence interval 9,000 – 40,000) across the
healthcare and first aid practitioners85,86. High temperatures can
United States and Mexico alone by 205067.
lead to poorer sleep, altered blood flow and other physiological
processes that underlie cognition, which in turn can worsen the
There is also evidence that air pollution131 and extreme weather
symptoms of mental illness and reduce mental wellbeing148,149.
events such as a wildfire or hurricane17,104,106 can both contribute
towards higher rates of suicide.

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Population health and wellbeing Notably, evidence suggests that individual and collective action
The climate crisis affects the mental wellbeing of hundreds of on climate change may support good mental health and reduce
millions of people around the world. Beyond the more severe climate-related psychological distress and anxiety25–27,170,171.
outcomes described above, there is evidence that increased Strategies that help people to engage their values and goals
temperatures are also associated with: increased psychological in ‘meaning-focussed’ activities and appraisals, can induce
distress70, negative emotions150, mental distress70, fatigue150, positive emotions that aid them to constructively cope
sleep difficulties and feeling unable to cope151, ‘depressive’ with distress and anxiety. Such ‘meaning-focussed coping’
language used in social media posts74, crisis support-seeking strategies may help children and young people to constructively
behavior152, reported mental health difficulties72,153, and cope with and act on climate change2,17.
reductions in positive emotions71 and wellbeing 71,151. Humidity
seems to worsen the negative effects of heat, while moderately How people behave as individuals or collectively in response to
warm weather or more hours of sunshine may benefit peoples’ the threat of climate change depends on the way they think and
wellbeing in some cases74,75. feel about it – their psychological response173–175. Climate denial
and fatalism are psychological responses that may help
Climate change causes significant concern even among those individuals cope emotionally with the threat but reduce taking
who don’t experience the direct impact of climate change first action to mitigate it176–178. Decision-makers should consider
hand (see Figure 6). In the UK in 2019, it was found to be the these factors carefully in order to provide the necessary
most important issue for young people and among the top five conditions for individuals and communities to take and support
for the whole population, ranking more important than terrorism climate action while enhancing community resilience to
and housing154. In the US in 2020, 66% of people were at least climate threats.
‘somewhat worried’ about global warming and 26% were ‘very
worried’155. 72% of 18-34 year old Americans sometimes have Evidence for impacts to mental health systems
distressing emotional reactions to negative news stories about and health inequality
the environment (anxiety, racing thoughts, sleep problems, a Inequality
feeling of uneasiness)21. Climate-related anxieties and strong
Both climate change and mental health are linked with
emotional responses have also been identified in the UK,
social inequality. For climate change, “available evidence
Australia, and United States in large proportions (44-82%) of
indicates... a vicious cycle, whereby initial inequality causes
university students156,157 and children20,158,159, though data is still
the disadvantaged groups to suffer disproportionately from
lacking and the trends painted from limited existing research
the adverse effects of climate change, resulting in greater
suggests this is an issue that is underestimated in society.
subsequent inequality”15. Poor mental health is both a cause
and a consequence of social inequalities190, whereby people
Younger adults show especially high levels of anxiety about
with poor mental health are more likely to have insecure
climate change and environmental degradation, which some
employment191,192, insecure housing and experience stigma,
research has found to be associated with more generalised
discrimination and social isolation193, while people experiencing
anxiety and depression160. Experiences of anxiety, grief and
social inequalities stemming from financial difficulties, racism,
distress related to awareness of the climate and ecological
homophobia and/or other injustices are at higher risk of mental
crises have been increasingly reported by mental health
illness51–53.
practitioners, parents, teachers and the mainstream media161,162.
This has given rise to a new lexicon to describe ‘eco-emotions’163
Taken together, climate change and mental health, if not
(see definitions, Table 1). These may most helpfully be regarded
adequately addressed, will exacerbate social inequality across
not as new forms of ‘mental disorder’ but as shorthand terms
the world. Climate change and mental health disproportionately
for understandable responses to concerns about climate
impact vulnerable people, fragile health systems and poor
change. Despite a recent increase in interest164–167, there remains
countries. These people, systems and countries most at risk are
a relative dearth of robust supporting data on the prevalence,
typically also those least historically responsible for the causes
nature and severity of the mental health impact of awareness
of climate change. Box 1 provides examples of some of the
about the climate crisis. Importantly, strong emotional
groups of people who are more likely to experience the worst
responses and even distress can be considered a “rational
mental health effects of extreme weather events. It provides
response to the facts” and is not a pathology168,169. Support to
a clear picture – the mental health of the most vulnerable in
enable people to process the strong emotions and loss evoked
society is particularly at risk.
by climate change may help to protect their mental health
and wellbeing.

12 Briefing paper No 36 May 2021 The impact of climate change on mental health and emotional wellbeing: current evidence and implications for policy and practice
Grantham Institute   Institute of Global Health Innovation

Figure 7: Illustrative pathways by which extreme weather events impact mental health, with arrows indicating direction from cause to effect. Climate change occurs by greenhouse gas emissions
increasing global temperatures. This effect ultimately impacts a range of mental health outcomes via many different pathways, and so the mental health impacts of climate change must ultimately be
assessed by thinking about entire systems. Example pathways shown here arise from an extreme weather event (e.g. a flood or wildfire), which has immediate direct impacts (e.g. physical injury and
loss and damage to homes), longer term direct impacts (e.g. forced migration and disrupted food supply) and indirect impacts (e.g. witnessing changes to landscapes and ecosystems). Each of these
impacts or consequences flowing from the climate change-related extreme weather event can impact mental health outcomes. Although mental health outcomes are typically measured in terms of
diagnostic categories, in relation to climate change they can all be seen as a form of psychological trauma.

13 Briefing paper No 36 May 2021 The impact of climate change on mental health and emotional wellbeing: current evidence and implications for policy and practice
Grantham Institute   Institute of Global Health Innovation

Table 1: ‘Eco-emotions’
Emotions Definition Evidence
Eco-anxiety/ Defined by the American Psychological Eco-anxiety has been observed in children158,179,
Eco-distress Association in 2017 as: “the chronic fear of adolescents172, students156, and adults160, and may
environmental doom” . May include a range
81
affect young people especially21,160.
of anxiety, worry, stress, hopelessness, sleep
disturbance, irritability, despair, bodily symptoms
of anxiety (e.g. awareness of heartbeat, butterflies
in stomach, sweaty palms, perceived shortness of
breath) and other similar responses.
Climate grief/ “The grief felt in relation to experienced or Ecological grief has been found to affect
Ecological grief/ anticipated ecological losses, including the loss of those with strong ties to a particular place and
Eco-grief species, ecosystems and meaningful landscapes those witnessing environmental destruction,
due to acute or chronic environmental change”180. including for example indigenous and farming
communities180,181 and climate scientists182.
Solastalgia The distress experienced when someone’s home Solastalgia has been reported in youth in
environment is changing in ways perceived to Indonesia184, Inuit communities in northern
be profoundly negative, either by events related Canada180,181, farmers in the Australian
to climate change but also scenarios such as wheatbelt126,185, residents and tourists of
establishment of a mine or a volcanic eruption. communities around the Great Barrier Reef186,
Changes that attack someone’s sense of home, elders in the Torres Strait187 between Australia and
even without dislocation, can create a deep New Guinea, and Ghanians188,189.
homesickness183.

Economic impact the number of people in need of support (e.g. by increasing

Mental illness generates a global economic burden of at the burden of disease and pushing more people into poverty),
least $2.5 trillion in direct and indirect costs, including by negatively impacting the ability of healthcare systems to
lost productivity and economic growth40. Therefore, the provide support (e.g. as extreme weather events damage
deterioration in mental health caused by climate change facilities and disrupt supply chains) and by threatening the
will carry a significant cost, which is currently not being proportion of healthcare services freely available (e.g. by
considered. For example, the 2020 Australian bushfires negatively impacting economic growth and reducing health
necessitated a A$76 million investment in immediate and budgets)31. Already fragile health systems, such as those
long-term psychological support for those affected136. To our in countries yet to fully attain universal health coverage,
knowledge, there is no research into how big the cost of climate are most vulnerable.
change’s mental health impacts could be. Quantifying it is
crucial to ensure that both climate and mental health policy Mental health services are already particularly overstretched
decisions don’t ignore the full costs of climate change, and and unable to provide the care that people need. It is estimated
that the full benefits of climate action are appreciated by that up to 50% of people with mental health disorders in
decision-makers. Investments to address climate change that high-resource settings and up to 90% of those in low-resource
also improve mental health will have an additional economic settings receive no treatment at all43,207. Rates of ‘effective
benefit – the WHO estimates that for every dollar invested in coverage’ – good-quality, accessible services that actually work
mental health, there is a return of four dollars in better health – are even lower. Hence, decision-makers must be proactive in
and ability to work206. building resilience in mental health systems, including those in
low-resource settings who are already most at risk from climate
Disruption to the provision of mental health services change impacts, to continue to provide care during extreme
weather events or other climate-related disasters, and respond
The climate crisis, through changing temperatures and more
to predicted increases in mental health burden. Developing and
frequent and severe weather events, will not only increase
implementing robust climate adaptation plans that draw on
mental health needs but also disrupt systems of mental
available evidence can mitigate the risk of both short and long-
healthcare, exacerbating the gap between mental health needs
term mental health impacts – such as incorporating community
and provision of quality care. Climate change threatens progress
mental health support in the first response to extreme
towards provision of high-quality healthcare for all by increasing
weather events208–210.

14 Briefing paper No 36 May 2021 The impact of climate change on mental health and emotional wellbeing: current evidence and implications for policy and practice
Grantham Institute   Institute of Global Health Innovation

Co-benefits of climate action for mental inequalities in access to green spaces, highlighted during the
health outcomes COVID-19 pandemic55. Public opinion polls have shown the UK
public want more green spaces and biodiversity in their local
Taking action against climate change could benefit mental
area, recognising its benefits for health and wellbeing221,222.
health not only by mitigating the mental health effects outlined
Nature-based solutions to climate mitigation and adaptation,
above, but also through the variety of co-benefits or ‘win-wins’
such as tree-planting, can be win-win-wins for boosting
that are associated with actions that reduce greenhouse gas
economies, protecting urban communities against the impacts
emissions and/or adapt to a warming climate (see Figure 8).
of climate change, and creating communities with more resilient
mental health217,223.
Co-benefits are “the positive effects that a policy or measure
aimed at one objective might have on other objectives”3.
On an individual level, taking action to tackle climate change
Policies to reduce greenhouse gas emissions may bring a
may reduce eco-anxiety and benefit mental wellbeing26,27,224.
number of direct and indirect co-benefits for reducing mental
As well as reducing greenhouse gas emissions or building
illness and improving population mental health and wellbeing.
resilience to climate change impacts, individual and collective
Identifying and integrating these policies into carbon reduction
actions can also provide a greater sense of agency and
plans can help decision-makers to make limited budgets go
control, increase feelings of meaning and empowerment,
further by achieving multiple policy goals simultaneously.
and provide social support through connection with like-minded
For example, creating ‘green’ and ‘blue’ spaces (i.e.
communities25,170,225.
incorporating plants and water) in urban areas can help to limit
the global increase in greenhouse gases211,212, while access to
While Indigenous communities are some of the most vulnerable
such spaces can reduce psychological distress and depression
to the impacts of climate change, they also offer knowledge and
symptoms, and increase happiness and wellbeing54,213–218.
expertise invaluable to mitigate and adapt to its effects223, for
Adding ponds and waterways and planting trees, for example,
example ‘caring for country’ projects in First Nation Australian
can help to mitigate increasing heat in cities (urban heat
communities, which have dual benefits for climate change
islands), which is important for limiting the negative effects
mitigation and social and emotional well-being213.
of rising temperatures on mental health219,220. Such evidence
should be borne in mind when considering the impact of current

Box 1: People who are particularly vulnerable to the mental health effects of extreme weather events
(not exhaustive)
• People with prior experiences of deprivation107,194 or mental health issues106,195
• Women (particularly pregnant or postnatal)196
• Children196
• Minoritised ethnic groups (for example First Nations Australians and Black Americans)97,197
• People with less social support92,99,198,199
• People experiencing:
– inadequate medical care200–202
– inadequate welfare support (e.g. unsafe or unclean accommodation, inadequate food, water, and electricity)203,204
– financial loss or instability.13,199,205

15 Briefing paper No 36 May 2021 The impact of climate change on mental health and emotional wellbeing: current evidence and implications for policy and practice
Grantham Institute   Institute of Global Health Innovation

Figure 8: Examples of the co-benefits of climate action for mental health. These include benefits of improving the energy efficiency of houses on reducing carbon emissions, making homes more
affordable to heat, reducing fuel poverty and improving physical and mental health.

16 Briefing paper No 36 May 2021 The impact of climate change on mental health and emotional wellbeing: current evidence and implications for policy and practice
Grantham Institute   Institute of Global Health Innovation

What can be done about it?

Key messages
• Action on climate change will have the additional benefit of providing positive impacts for mental health. This effect should be
properly considered in policy decisions.
• There are a number of actions that communities, policy-makers, researchers, third sector organisations and health care
systems can take to mitigate and manage specifically the mental health impacts of climate change.
• Collective knowledge on climate change and mental health must improve. Knowledge can be used to help raise awareness,
which in turn can help raise the likelihood of appropriate widespread action.
• Establishment of a new international cross-sector network to bring together relevant researchers, practitioners and decision-
makers could catalyse knowledge-sharing, target research efficiently, and identify and scale up successful interventions.
• This section provides specific recommendations for relevant stakeholder groups, including:
– Health systems leaders and healthcare practitioners
– Policymakers
– Researchers, research funders and innovators
– Third sector and community organisations.

The societal and economic impact of climate change on mental Robust, proactive systems must also be in place to support
health and emotional wellbeing has been largely overlooked people when their mental health and emotional wellbeing
in policy and planning. Considering this health and economic is affected.
impact in the decision-making process will further strengthen
the case for climate action while improving mental health and Action by government and community leaders to support
emotional wellbeing for millions of people. individual and community resilience to a changing climate,
before disasters occur, may create circumstances more likely to
Given that a certain amount of climate change has already result in post-traumatic growth209,226,229 (“positive psychological
happened and further effects are unavoidable even with rapid change that is experienced as a result of the struggle with
mitigation of greenhouse gas emissions, specific action to highly challenging life circumstances”230). Psychologists have
address the mental health impacts of climate change will still be noted that “we do need disaster management, but there’s no
required. Decision-makers need to support climate adaptation way we’re going to respond to every big weather event and
for communities, so that when they experience climate change- treat everyone who is impacted — we can’t even do that now.
related disasters such as flooding, the extent of loss and We know how to help people learn resilience and increase their
trauma, and hence the impact on mental health, is minimised. capacity to cope with uncertainty and trauma. Given what’s
coming at us, a major focus has to be on prevention tools”196.
Proactive measures to build resilience of individuals,
communities and support systems to climate change-related Co-designed, evidence-based solutions must be developed
events, and offering early and appropriate support, can and/or scaled-up to build individual and societal resilience to
also minimise the impacts of such events on mental health. our changing climate, using emerging data on psychological
Appropriate responses to emergencies such as extreme responses and mental health needs of different groups.
weather events can reduce the risk of negative mental health The support provided should incorporate current psychological
outcomes – in both the short and long term. Evaluations of knowledge and evaluated best practices228,231,232, including
previous responses to extreme weather and climate events the potential benefits of community support, connection
or environmental disasters have emphasised the importance with nature or involvement in environmental projects (e.g.
of creating multi-sector collaborations and plans that link volunteering and social prescribing)233, and will require tailoring
governments, private sector, and local organisations before to different cultural and demographic contexts, e.g. Indigenous
events happen, so that emergency responses are organised, communities234. Future research should, for example, aim
efficient and comprehensive226–228, and capitalise on the to reveal relevant differences in mental health impacts for
leadership of community figures such as teachers and religious young people from different socioeconomic backgrounds with
leaders209,210. Comprehensive support to mitigate the stressful differing experiences of climate change – whether witnessing
secondary impacts of a disaster (secondary stressors, e.g. first-hand climate related disruptions such as the Australian
insurance or financial difficulties) will reduce the mental bushfires and sea level rise in Pacific islands, or watching
health effects of disasters and forced migration111, and lead these events unfold on UK news. The language used to express
to significant social and economic benefits. Such support can distress over the direct or indirect impacts of climate change will
include timely provision of quality accommodation, financial also likely differ significantly across contexts and settings235.
support, and high quality and accessible medical care111.

17 Briefing paper No 36 May 2021 The impact of climate change on mental health and emotional wellbeing: current evidence and implications for policy and practice
Grantham Institute   Institute of Global Health Innovation

Figure 9: Examples of responses by stakeholders to reduce the impacts of indirect impacts of the climate crisis, particularly emotional and mental distress associated with climate crisis awareness
(sometimes known as eco-anxiety or climate grief). These include social prescribing and increasing training for mental health professionals. Such responses would be strengthened by political
support to ensure funding for the implementation of relevant strategies and ongoing research. Adapted from Cunsolo et al. (2020)169.

18 Briefing paper No 36 May 2021 The impact of climate change on mental health and emotional wellbeing: current evidence and implications for policy and practice
Grantham Institute   Institute of Global Health Innovation

Development of interventions and support will be significantly The final section of this paper provides recommendations
bolstered by drawing on expertise across sectors and fields, for the major stakeholder groups. It is important that these
including knowledge of how to best support grief and loss, priorities are pursued collaboratively. Our recommendation is to
adaptation to uncertainty and change, secondary trauma, and establish an international network including key stakeholders
resilience236. While the climate crisis has unique features, there (e.g. government, healthcare systems, community leaders,
will be learnings from other crises (e.g. the COVID-19 pandemic) vulnerable groups, academics, emergency responders) to
that may contribute to planning appropriate mental health catalyse knowledge-sharing, target research efficiently, and
provision for the climate crisis. Strategic investment in the identify and scale up successful interventions. Figure 9 provides
development of appropriate individual and community support, an example of stakeholder responses that can reduce the
tailored to the range of psychological needs, could potentially impacts of climate change upon mental health and emotional
reduce mental health burden arising from multiple crises wellbeing, in this case in the context of the indirect impacts of
including climate change and future pandemics. Identification, climate change, as previously described in Cunsolo et al.169.
evaluation and scale-up of current interventions, many of which
have developed informally, could provide a rich starting point.
Such investment will reduce longer term mental health burden, Conclusions
and should be mirrored by changes in the mental healthcare
system to mitigate against and respond to the mental health Climate change poses an under-appreciated threat to mental
impacts outlined in this paper. As noted by Bourque and health and emotional wellbeing. The evidence presented here
Cunsolo, “mental healthcare professionals would (also) highlights the multiple pathways by which climate change
benefit from further training and guidance in assessing and can affect mental health, and the interrelationships between
providing assistance to people suffering from climate-related these two pressing global challenges. Extreme weather and
psychological distress and mental health problems”237. climate events lead to severe psychological trauma, which can
show up as increased suicide rates, new cases and worsened
The response to the current and anticipated mental health symptoms of mental illness, and worsened mental health and
needs outlined in this paper must happen against a background emotional wellbeing in the population. Further, climate change
of currently inadequate provision of mental health prevention exacerbates inequalities such that individuals with diagnosable
and care services almost everywhere in the world238. This is mental illnesses are more vulnerable, including to the threat of
particularly the case in poorer communities that also tend to high temperatures on physical health and mortality. Awareness
be more vulnerable to the effects of climate change41,239,240. of current and future climate change threats, and/or witnessing
“Social factors, such as poverty, urbanisation, internal related damage to local environments, ecosystems and
migration, and lifestyle changes, are moderators of the high societies can be distressing for many people. The impact of
burden of mental illness in many low and middle income such emotional and mental distress is under-researched, but
countries”241; climate change is likely to exacerbate these terminology such as eco-anxiety, climate grief and solastalgia
factors. Work to address these underlying inequalities and has been used in attempts to capture these experiences.
accelerate provision of appropriate and accessible community
care for mental health and psychological distress206 is even The impacts of climate change on mental health have been
more urgent in the context of a changing climate. There is no largely ignored when accounting for the costs and benefits of
silver bullet, and innovation is therefore necessary to solve climate action and planning climate mitigation and adaptation
this challenge238 (e.g. via the provision of digital mental health responses. The good news is that climate action is likely to
training for community workers242), and learning must be yield even greater benefits than previously considered, when
inclusive, to draw upon expertise and successful approaches accounting for the opportunities to prevent poor mental health
in all countries and settings243. Mental health and care leaders outcomes and to improve mental health through win-win
need to fully leverage proven or innovative approaches and scenarios such as reduced air pollution and the wellbeing
technologies that could scale up to meet the huge needs for benefits to the individuals involved in community responses
support, that will only be exacerbated by climate change. to climate change. Further targeted research is needed to
understand the interrelationships between climate change and
Collective knowledge needs to improve, starting with defining mental health, but action must start now, with cross-sectoral
the key questions that need to be answered, reached through collaborations to support individual and community resilience,
expert consensus. A particular research priority will be to proactively mitigate against and support negative mental health
develop indicators of the impact of climate change on mental impacts, and provide opportunities to process psychological
health that can be tracked over time to measure progress. responses to our changing world in moving societies from
It is important that such research is communicated with climate awareness to climate action.
policymakers, innovators and the public in an accessible way,
to inform decisions and motivate action. Such engagement
across sectors should be two-way, such that research priorities
and directions are informed by expertise from all relevant
stakeholder groups.

19 Briefing paper No 36 May 2021 The impact of climate change on mental health and emotional wellbeing: current evidence and implications for policy and practice
Grantham Institute   Institute of Global Health Innovation

Recommendations
The following recommendations have been compiled for each group of relevant stakeholders: health system leaders and
healthcare practitioners; policymakers; researchers, research funders and innovators; and third sector and community
organisations. Some duplication of recommendations between each stakeholder group is included deliberately – this design allows
for each stakeholder to have a clear map of all relevant priorities for their sector. Figure 10 provides illustrative examples of how
implementation of these recommendations can help to break some of the pathways by which climate change can worsen mental
health, alleviating some of the mental health burden by preventing or responding to increased needs.

Health system leaders and healthcare practitioners

1. A
 dvocate for climate mitigation and adaptation, and take action within health systems to reduce greenhouse gas emissions
and therefore prevent the impacts of climate change on physical and mental health. Examples of actions to “be the change”
and “lead the change” are provided in Figure 11 adapted from the WISH report on Climate Change and Health. It is also
suggested that mental health system leaders and practitioners use evidence of the impact that climate change has upon
mental health and emotional wellbeing as part of the rationale for why climate action is needed.

2. R
 aise awareness of the mental health impacts of climate change among the general public through government and health
system messaging (e.g. public health campaign on heat vulnerability) to increase individuals’ ability to recognise and
manage these impacts on themselves and their community.

3. T
 rain healthcare workers to identify, manage and speak out about the impacts of climate change on mental health,
for example to:
a. Screen for mental health burden generated by climate distress;
b. Respond to temperature-induced symptoms of mental ill-health or physical heat stress in those with pre-existing mental
illnesses;
c. Develop proactive responses to natural disasters that mitigate mental health impacts.

4. Collaborate with researchers to strengthen the evidence base on climate change and mental health.

5. 
Facilitate or join cross-organisational and cross-sector collaborations to develop, evaluate, share and scale-up successful
interventions and best practices that support those experiencing mental health impacts due to the direct and indirect effects
of the climate crisis. For example:
a. So that mental health practitioners can share best practice on supporting those experiencing mental distress in
response to climate crisis awareness;
b. To guide effective and proactive interventions across social and emergency services and mental health systems to
mitigate the mental health impacts of extreme weather events such as wildfires or floods;
c. So that proactive support for climate migrants is effective and culturally sensitive (i.e. collaboration between healthcare
and aid provision).
6. Include the voices of those particularly vulnerable to, and with lived experience of, climate change impacts, (e.g. those
affected by flooding) in the development and delivery of services in response to climate change and related mental
health needs.
7. 
Incorporate the evidence for the mental health impacts of climate change in risk assessment and forecasting needs,
including identifying currently ‘hidden costs’. For example:
a. Incorporate an understanding of the mental health impact of heat into structural response planning and clinical practice;
b. Include climate migration scenarios in forecasting the future requirements of local mental healthcare systems.
8. 
Build resilience into the mental healthcare system so it is prepared for disruptions due to climate-related disasters and can
continue providing care during times of disaster (e.g. through the provision of digital mental health services).

20 Briefing paper No 36 May 2021 The impact of climate change on mental health and emotional wellbeing: current evidence and implications for policy and practice
Grantham Institute   Institute of Global Health Innovation

Policymakers
1. 
Prioritise climate mitigation policies that:
a. Simultaneously provide mental health benefits and greater resilience to climate change (co-benefits);
b. Alleviate existing inequalities and their associated mental health impacts.
2. 
Direct proactive adaptation interventions to reduce mental health burden to communities that are most vulnerable to
climate-related threats. For example:
a. Provision of support to reduce the vulnerability of communities susceptible to flooding (e.g. early warning systems,
flood prevention equipment (e.g. sandbags) and personal flood plans);
b. Support those with mental illness to ensure they have adequate access to cool environments during periods of excess
heat (e.g. via provision of urban green spaces).
3. I nclude the voices of those particularly vulnerable to and with lived experience of climate change impacts, alongside mental
health professionals and other clinicians, in the development of all policies related to climate change and mental health.
4. Allocate funds to relevant research and required actions by health system leaders to build resilience and manage the
impact of climate change on mental health as well as helping to identify and quantify these hidden costs.
5. Ensure that the co-benefits of climate action for mental health are adequately incorporated into cost-benefit calculations
for climate-focused policies and vice-versa for health-focused policies.
6. Work closely with a range of researchers in the relevant fields to learn from the current evidence and how it intersects,
integrates, and can be applied in practice.
7. Consider the evidence for how individuals may respond psychologically and emotionally to narratives around climate
change and climate action when developing and promoting policy, to facilitate desired individual and collective action and
protect mental health (e.g. ensure that climate change and climate action is communicated in a way that minimises the risk
of prompting an emotional response of hopelessness and maximises the chance of encouraging action).

21 Briefing paper No 36 May 2021 The impact of climate change on mental health and emotional wellbeing: current evidence and implications for policy and practice
Grantham Institute   Institute of Global Health Innovation

Researchers, research funders and innovators

1. Raise awareness of the evidence of the impact of climate change on mental health, including by engaging with policymakers
and health system leaders (for example at international climate or health/mental health summits and communicating
with the press and the public). Such evidence can support the case for climate mitigation and adaptation that protects
mental health.
2. Develop and communicate a research agenda for climate change and mental health, identifying priority research questions
through a consensus-building process with members of the public, experts and policymakers.
3. Fund and conduct robust, interdisciplinary and collaborative research, for example to understand:
a. The economic burden caused by climate change’s impact on mental health and emotional wellbeing, to make clear the
currently hidden costs and enable the true cost/benefit of climate action to be considered in decision-making;
b. How and to what extent the climate crisis impacts populations’ mental health, who is affected, and to identify
corresponding stressors, protective factors, support needs, and at risk groups;
c. How climate change threatens to exacerbate inequalities through its effects on mental health and wellbeing;
d. Associations and underlying mechanisms relating temperature and mental health outcomes;
e. Psychological responses (healthy and unhealthy) to the climate crisis in different groups, and their relationship to
mental health, climate action, information messaging, and resilience.
4. I nclude the voices of those particularly vulnerable to and with lived experience of climate change impacts alongside
psychologists and other clinicians in all research and innovation activities.
5. 
Learn from individuals and communities who are already responding to climate-related impacts on mental health,
to understand needs, coping mechanisms and how to build resilience.

6. 
Develop, identify, evaluate and support the scaleup of effective programs and interventions to reduce the harmful effects
of climate change on mental health, and support individuals and communities whose mental health is at risk from or has
been affected by the climate crisis.
7.  evelop training programmes for relevant stakeholders to increase awareness, share effective interventions and best
D
practices, and build capacity to prevent and respond to the mental health impacts of climate change.

8. C
 ommunicate research findings with policymakers, innovators and the public in an accessible way, to help inform decisions
and motivate action.

22 Briefing paper No 36 May 2021 The impact of climate change on mental health and emotional wellbeing: current evidence and implications for policy and practice
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Third sector and community organisations

1. 
Stimulate, support and amplify the efforts of health systems, policymakers and researchers to mitigate and adapt to
climate change to reduce its impacts on mental health (see recommendations for those stakeholders) with a particular focus
on actions that reduce inequalities and increase climate change resilience.
2. F und and raise awareness of the mental health impacts of the climate crisis among both policymakers and the public,
including at international climate and physical or mental health summits.
3.  nsure that health-related organisations, volunteers providing first aid, mental health crisis responders and those caring
E
for vulnerable groups are aware of the mental health impacts of climate change and trained to respond. For example:
a. First aiders to understand and be equipped to respond to the impact of high temperatures on mental health risks;
b. Mental health support organisations to be aware of climate change as a source of mental health distress, particularly in
young people, and learn about best practices for supporting these concerns.
4.  limate change and disaster relief organisations should incorporate mental health as a key pillar of emergency responses,
C
particularly in assessing risk, planning and responding to climate-related disasters.
5. Identify and respond to the gaps in efforts by other stakeholders:
a. On activities that third sector and community organisations are best placed to lead, for example grassroots
programmes such as rewilding of urban spaces that have multiple benefits, including for community mental health;
b. In areas that other stakeholders might be less able to implement the recommendations directed at them without
support, for example where health systems are under-developed or governments lack resources.
6. 
Establish cross-organisational and cross-sector collaborations to develop, communicate and replicate successful
approaches. The networks should include community responders, charity and NGO workers, medical professionals,
academics, policymakers, clinicians, and members of the public.

23 Briefing paper No 36 May 2021 The impact of climate change on mental health and emotional wellbeing: current evidence and implications for policy and practice
Grantham Institute   Institute of Global Health Innovation

Figure 10: Selected illustrative examples of how the implementation of specific recommendations in this report can help to break
the pathway by which climate change negatively impacts upon mental health. The position of each icon illustrates the part of the
pathway that can be partially broken by implementing the proposed recommendation. Some recommendations appear in more than
one place, for example those focused on climate mitigation and adaptation.

24 Briefing paper No 36 May 2021 The impact of climate change on mental health and emotional wellbeing: current evidence and implications for policy and practice
Grantham Institute   Institute of Global Health Innovation

Figure 11: Index card of climate change action for health leaders, as recommended by the WISH report “Health in the Climate Crisis”31.

25 Briefing paper No 36 May 2021 The impact of climate change on mental health and emotional wellbeing: current evidence and implications for policy and practice
Grantham Institute   Institute of Global Health Innovation

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34 Briefing paper No 36 May 2021 The impact of climate change on mental health and emotional wellbeing: current evidence and implications for policy and practice
Grantham Institute   Institute of Global Health Innovation

Acknowledgements
The authors would like to thank Dr Katie Hayes (Health Canada), Dr Jacob Krzanowski and Dr Lisa Page (Royal College of
Psychiatrists), Annie Mitchell (Clinical and Community Psychologist, University of Plymouth), Dr Gareth Morgan (Clinical
Psychologist, University of Leicester), Dr Lucy Johnstone (Consultant Clinical Psychologist), Lauren Dowling and Pip Batey (Helix
Centre), Dr Justine Alford (Institute of Global Health Innovation (IGHI)) and Simon Levey (Grantham Institute – Climate Change and
the Environment) for their detailed and helpful comments in the development of this paper.

This report builds on previous work by the Institute of Global Health Innovation as part of the World Innovation Summit for Health,
which is an initiative of the Qatar Foundation.

• The report was informed by the Climate Cares Advisory Board, which includes:

• Bohdana Dock, Data Evaluation & Insights Manager at The Mix

• Alex Evans, Executive Director, Larger Us

• Dr Renzo Guinto, Chief Planetary Doctor, PH Lab

• Dr Elly Hanson, Clinical Psychologist and Researcher

• Dr Oliver Harrison, CEO, Alpha Health

• Dr Katie Hayes, Climate change and mental health researcher, Canada

• Clover Hogan, Founder & Executive Director, Force of Nature

• Dr Julia Kagunda, Chief Psychologist, Inuka Wellness

• Dr Sarah Niblock, CEO, UK Council for Psychotherapy

• Zoe Papadopoulou, Designer (specialising in grief)

• Dr Robbie Parks, Post-doc Research Fellow at the Earth Institute

• Ivor Williams, Lead for End-of-Life Care, Institute of Global Health Innovation

• Britt Wray, Author, Broadcaster and Researcher (with a focus on climate change and emotional wellbeing)

Climate Cares is an initiative by the Institute of Global Health Innovation and the Grantham Institute – Climate Change and
Environment at Imperial College London. The team includes:

• Prof David Nabarro – Co-Director, Institute of Global Health Innovation (IGHI)

• Dr Emma Lawrance – Mental Health Innovations Fellow, IGHI

• Dr Neil Jennings – Partnership Development Manager, Grantham Institute

• Pip Batey – Design Strategist, Helix Centre, IGHI

• Rhiannon Thompson – PhD Student, NIHR School for Public Health

• Dr Ans Vercammen – Research Fellow, Centre for Environmental Policy

• Lauren Dowling – Design and Policy Intern, Climate Cares

• James Diffey – Research and Intervention Design Intern, Climate Cares

• Vasiliki Kioupi – Research Postgraduate, Centre for Environmental Policy

• Gianluca Fontana – Senior Policy Fellow and Director of Operations, Centre for Health Policy, IGHI

• Lenny Naar – Head of Design Strategy Team, Helix Centre, IGHI

• Emma Slater – Public Engagement Producer, Imperial College London

• Dr Hutan Ashrafian – Honorary Scientific Advisor, IGHI

• Lily Roberts – Teaching Assistant, NHS Digital Academy, IGHI

• Dr Justine Alford – Communications Manager, IGHI

35 Briefing paper No 36 May 2021 The impact of climate change on mental health and emotional wellbeing: current evidence and implications for policy and practice
Grantham Institute   Institute of Global Health Innovation

About the authors About the Grantham Institute, the

Dr Emma Lawrance is the Mental Health Innovations Fellow Institute of Global Health Innovation
at the Institute of Global Health Innovation. Her work with and Imperial College London
the Climate Cares programme focuses on understanding
In 2007, the Grantham Foundation for the Protection of
and responding to interrelationships between the climate
the Environment made the visionary decision to support
crisis and mental health and wellbeing. Other aspects of
an Institute at Imperial College London to provide a vital
her work include a focus on understanding the experiences
global centre of excellence for research and education on
of those using mental health services, particularly
climate change. Ten years on, the Grantham Institute is
young people. She has a background in neuroscience,
established as an authority on climate and environmental
science communication, chemistry, physics and mental
science. The Grantham Institute is Imperial’s hub for climate
health support.
change and the environment, and one of seven Global
Rhiannon Thompson is a postgraduate researcher and PhD Institutes established to promote inter-disciplinary working
candidate in the School of Public Health at Imperial College and to meet some of the greatest challenges faced by
London. Her current research focuses upon the relationship society. We drive forward discovery, convert innovations
between the physical environment and mental health. into applications, train future leaders and communicate
Her background is in psychology and philosophy and she academic knowledge to businesses, industry and
is interested in the risk factors in development that lead to policymakers to help shape their decisions.
poor mental health.
The Institute of Global Health Innovation is dedicated to
Gianluca Fontana is Senior Policy Fellow and Director of solving some of the biggest healthcare challenges of today
Operations at the Centre for Health Policy of the Institute of and sustainably reducing inequalities in global health for
Global Health Innovation, Imperial College London. In his generations to come. As one of Imperial College London’s
role, he oversees innovation programmes in areas such as Global Institutes, the Institute of Global Health Innovation’s
mental health, patient safety, end-of-life care and digital mission is to transform health for everyone through
health. His main focus is on accelerating the translation of evidence-based innovation. Our approach is to identify,
research into practice and the diffusion of evidence-based develop and implement healthcare innovations, leading to
innovation in health systems. sustainable improvements in global health and care.
Dr Neil Jennings is Partnership Development Manager Imperial College London is a global university with a
at the Grantham Institute – Climate Change and the world-class reputation in science, engineering, business
Environment, at Imperial College London, and is responsible and medicine, and excellence in teaching and research.
for supporting the development of strategic partnerships Consistently rated amongst the world’s best universities,
with policy, business and non-governmental organisations. Imperial is committed to developing the next generation of
Trained as a geographer, Neil has a particular interest in researchers, innovators and leaders through collaboration
the co-benefits of climate action and in interdisciplinary across disciplines.
approaches to understanding and tackling complex
www.imperial.ac.uk
problems such as climate change.

doi: https://doi.org/10.25561/88568 Contact us

For more information about this subject, to discuss how the
issues covered affect you and your work, or to contact the
authors, please email us at:

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36 Briefing paper No 36 May 2021 The impact of climate change on mental health and emotional wellbeing: current evidence and implications for policy and practice